Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Lisa Carlesso, McMaster University, Canada
- Second opponent: Professor Martin van der Esch, Amsterdam University of Applied Sciences, The Netherlands
- Third member and chair of the evaluation committee: Associate Professor Maren Falch Lindberg, University of Oslo
Chair of the Defence
Professor Stephan Rörhl, University of Oslo
Principal Supervisor
Senior researcher Ida K. Haugen, Diakonhjemmet Hospital
Summary
Pain is the hallmark of osteoarthritis (OA) with large impact on the patient´s health-related quality of life. The knowledge about pain in hand OA is limited. This doctoral thesis aimed to increase knowledge about pain and pain sensitization in people with hand OA by exploring possible hand OA phenotypes, as well as the relationship between biopsychosocial factors and the hand OA pain experience.
The thesis is based on data from the Nor-Hand study, hospital-based observational hand OA cohort study which includes men and women between 40 and 70 years with hand OA. The first paper in this thesis utilizes data from the baseline examination (2016–2017), and the follow-up examination (2019–2021).
Results showed that symptoms of depression, anxiety, pain catastrophizing, and low self-efficacy were associated with greater pain in hand OA, however not with measures of pain sensitization. The relationships were stronger in people with younger age, overweight/obesity, higher comorbidity burden, and poor sleep. We also found that higher burden of comorbidities was associated with more severe pain in hand OA, but not with changes in pain over time. Back pain and depression were associated with higher pain scores at both baseline and 3.5 years later, whilst associations for hypertension and heart disease were less consistent.
Five possible phenotypes of hand OA, each characterized by different levels of biological, psychological, and social factors were identified. The participants in the phenotype characterized by higher levels of biopsychosocial burden reported the most pain, despite having the least severe hand OA. In contrast, the phenotypes with the most severe hand OA and low levels of biopsychosocial burden reported less pain.
The relationships between factors explored within this thesis, such as psychological factors and comorbidity burden are complex and likely bidirectional. However, the findings underline factors such as psychological symptoms, coping skills and comorbidity burden are important factors to consider when managing hand OA pain. Further, biopsychosocial factors, individually or in interplay, may exacerbate the pain experience in people with hand OA.
Additional information
Contact the research support staff.