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A Correlation Between Hand/Wrist and/or Knee Joint Pain and Depression: A Retrospective Chart Review

1 August 2005


Context: Joint pain is one of the most common complaints in a primary care office, as well as in an' orthopaedic office. Depression is one of the most common diagnoses nationwide and is possibly under diagnosed.

Objective: This study attempts to find a correlation between joint pain and depression. It is hypothesized that there will be a positive correlation between knee and/or hand pain and depression; the hypothesis proposes that there will be a more significant correlation between hand pain and depression than that of knee pain.

Design: A retrospective chart review was conducted in a rural orthopaedic office, where 864 charts were reviewed. The charts of patients with one of six complaints within the last 3 years were reviewed. Based upon a common in-office survey, it was determined whether or not the patient was receiving current treatment for depression, or had been treated in the past. The patients were coded by age, sex, whether the complaint was hand/wrist or knee, separated by specific diagnosis; 354.0 - Carpal Tunnel Syndrome (CTS) , 715.001715.14 - Osteoarthritis (OA) of wrist/hand, 719.43 - Wrist pain, 719.46 - Knee pain, 717.9 - Chronic meniscus tear, 717.7 - Chondromalacia. Then the patients were coded for depression by two separate forms that were filled out in the office containing whether or not the patient has been diagnosed with depression, whether they had a history of depression, and/or they were taking medicine for depression.

Setting: This study was compieted at a rural Orthopaedic office in Utah using an Excel database.

Subjects: Patients charts were reviewed within the last three years, no patient contact was made.

Results: The results were calculated using cross-. tabulation, followed by a Chi-Square analysis and both the Cramer's V and Lambda coefficient tests. Each of these tests showed significant results to the 0.01 or 0.001 level. Through this chart review it was shown that there was a significant association between hand and/or knee joint pain and depression. The association was significant to the 0.01 . level.

Discussion: Though the results show a significant association, it could be due to chance. The relationship shown between pain and depression is significant, but it may not be a strong enough association to be clinically relevant. Further studies need to be conducted in relation to treatment of one or the other, the causal relationship, and the correlation of pain and depression.

Conclusions: The goal of this study was to determine whether or not pain and depression had a significant relationship. The results reflected a positive significant association between the two, as well as a significant relationship between depression and other variables. Although the results may not be clinically relevant, patients with joint pain need to be aware that they are at risk for developing depression. Also, providers need to be aware of this interaction and ensure proper treatment of their patients to avoid prolonged treatment and suffering.


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