title: Pain and disability in osteoarthritis: a review of biobehavioral mechanisms.
abstract: Pain and disability are cardinal symptoms in osteoarthritis. The literature is reviewed in order to identify causes of these symptoms at the articular, kinesiological, and psychological level. It is concluded that pain and disability are associated with degeneration of cartilage and bone (articular level), with muscle weakness and limitations in joint motion (kinesiological level), and with anxiety, coping style, attentional focus on symptoms, and possibly depression (psychological level). Biobehavioral mechanisms of pain and disability which explain the observed associations are described and the empirical evidence for these mechanisms is evaluated. Methodological and conceptual deficiencies in the research reviewed are pointed out and suggestions for further research are given.
authors.affiliation: Netherlands Institute of Primary Health Care, Utrecht, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Dekker
authors.forename: B
authors.initials: B
authors.lastname: Boot
authors.forename: L H
authors.initials: LH
authors.lastname: van der Woude
authors.forename: J W
authors.initials: JW
authors.lastname: Bijlsma
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D007596:Joints / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009068:Movement; D009119:Muscle Contraction; D010003:Osteoarthritis / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D010146:Pain / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology