Mental health associated with changes in foot pain

Mental health is associated with changes in foot pain, according to researchers from Southern Cross University.

Dr Paul Butterworth, a podiatrist from the School of Health and Human Sciences, recently led a longitudinal study over three years examining the relationship between mental health and foot pain in a community based population. The research was recently published in Arthritis Care and Research.

“It’s understood that mental health is related to the persistence of musculoskeletal pain, be it lower back, hips or knees,” Dr Butterworth said.

“However, no longitudinal research had been conducted on foot pain and the relationship with mental health. Subsequently, we conducted the longitudinal study to examine the relationship between mental health and foot pain in the community.

“What we found was that mental health is associated with changes in foot pain. Clinicians dealing with this population should consider the contribution of mental health in their management and treatment of foot pain.

“There are a number of possible reasons that could link mental health and foot pain. It could be that chronic pain is a symptom or a manifestation of mental health disorders such as depression.

“Alternatively, muscle atrophy may be associated with activity avoidance and therefore chronic joint pain. The avoidance of pain related activity theory, suggests that people with osteoarthritis avoid activity that induces short term pain. A consequence of this muscle atrophy and subsequent joint instability, is that it may lead to increased tissue stress and chronic pain.”

The research, initiated in 2008 and concluded in 2011, was with 62 participants who had foot pain at the inception of the study and for whom measures of mental health were available. Change in foot pain was determined by the difference between the Manchester Foot Pain and Disability Index score at baseline and follow-up.

Of the respondents, there were 27 whose foot pain deteriorated. When those with improved and deteriorating foot pain were compared, those with improved foot pain had a significantly higher baseline Mental Component Summary, which predicts improved mental health.

“There were some limitations with the study, but the key strengths was that we used a validated measure of foot pain and for measuring mental health and it was of a longitudinal design,” Dr Butterworth said.

“Clinicians, be they podiatrists, surgeons or doctors, should consider the patient’s mental health in their management of other chronic musculoskeletal conditions.”

(Source: Southern Cross University, Arthritis Care and Research)