A Spouse Can Help Ease the Pain of Osteoarthritis

With the help of a spouse, improvement can be made in the self-management of osteoarthritis (OA) pain. According to research funded in part by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) at Duke University Medical Center, an intervention using spouse-assisted coping skills training and exercise training can improve physical fitness, pain coping, and self-efficacy in patients with OA of the knees.

The study, undertaken by Duke University Medical Center's Francis Keefe, Ph.D., and his colleagues at several other institutions, tested 72 married OA patients with persistent knee pain. The patients and their spouses were randomly assigned to receive spouse-assisted pain coping skills training and exercise training either in combination or alone. Still others were randomly assigned to receive only standard care. The data suggest that a combination of both spouse-assisted pain coping skills training and exercise training leads to more improvements than could be achieved with either intervention alone.

Over the past 15 years, spouse-assisted coping skills training and exercise training were developed as two approaches toward the self-management of OA pain. This resulted from the recognition that medical treatments have limitations. In this study, spouse-assisted training, either alone or in combination with exercise training, was found to produce improvements in coping and self-esteem. Exercise training, either alone or in combination with spouse-assisted coping skills training, caused improvements in physical fitness and muscle strength. The findings emphasize the importance of self-efficacy (a sense of feeling more in control of one's health) in adjusting to living with arthritis .

Osteoarthritis is the most common type of arthritis, especially among older people. It is one of the most frequent causes of physical disability among adults, affecting more than 20 million people nationwide. People with osteoarthritis usually have joint pain and limited movement. Unlike some other forms of arthritis, osteoarthritis affects only joints and not internal organs.

In addition to the Duke University Medical Center, other institutions contributing to this research were the University of North Carolina at Chapel Hill, the University of Connecticut (Storrs) and Wofford College, Spartanburg, S.C.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services' National Institutes of Health, is to support research into the causes, treatment and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases. For more information about NIAMS, call the Information Clearinghouse at (301) 495-4484 or (877) 22-NIAMS (free call) or visit the NIAMS Web site at www.niams.nih.gov.

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Keefe FJ, et al. Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study. Pain 2004;110: 539-549.

SOURCE: National Institute of Arthritis and Musculoskeletal and Skin Diseases, www.niams.nih.gov