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Elevated body mass index and obesity are associated with pain-associated psychological distress in patients with hip pain
Introduction Little research has investigated the relationship between musculoskeletal pain and body mass index (BMI) in the context of pain-associated psychological distress. This study aims to determine if independent associations exist between BMI, obesity, demographic variables, and psychologica...
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| Published in: | Archives of orthopaedic and trauma surgery 2024-12, Vol.145 (1), p.22, Article 22 |
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| container_title | Archives of orthopaedic and trauma surgery |
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| creator | Ashley, Lucas W. Sutton, Kent F. Cabell, Grant H. Lentz, Trevor A. Lewis, Brian D. Olson, Steven A. Mather, Richard C. |
| description | Introduction
Little research has investigated the relationship between musculoskeletal pain and body mass index (BMI) in the context of pain-associated psychological distress. This study aims to determine if independent associations exist between BMI, obesity, demographic variables, and psychological distress in patients presenting with hip pain.
Materials and methods
Using a retrospective cross-sectional study design, 428 patients completed the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) and were categorized into pain-associated psychological distress phenotypes using latent class analysis. Participants were stratified into five BMI categories outlined by the Centers for Disease Control and Prevention (CDC) using descriptive statistics. Multinomial logistic regression was employed to determine a relationship between psychological distress phenotype and BMI (first as a continuous variable, then as a categorical variable), age, gender, race, and veteran status as candidate variables.
Results
Four psychological distress phenotypes were generated: high distress (n = 172, 40.2%), low distress (n = 114, 26.6%), negative pain coping (n = 98, 22.9%), and low self-efficacy and acceptance (n = 44, 10.3%). BMI analyses identified 4 participants (0.9%) as being underweight (BMI |
| doi_str_mv | 10.1007/s00402-024-05665-z |
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Little research has investigated the relationship between musculoskeletal pain and body mass index (BMI) in the context of pain-associated psychological distress. This study aims to determine if independent associations exist between BMI, obesity, demographic variables, and psychological distress in patients presenting with hip pain.
Materials and methods
Using a retrospective cross-sectional study design, 428 patients completed the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) and were categorized into pain-associated psychological distress phenotypes using latent class analysis. Participants were stratified into five BMI categories outlined by the Centers for Disease Control and Prevention (CDC) using descriptive statistics. Multinomial logistic regression was employed to determine a relationship between psychological distress phenotype and BMI (first as a continuous variable, then as a categorical variable), age, gender, race, and veteran status as candidate variables.
Results
Four psychological distress phenotypes were generated: high distress (n = 172, 40.2%), low distress (n = 114, 26.6%), negative pain coping (n = 98, 22.9%), and low self-efficacy and acceptance (n = 44, 10.3%). BMI analyses identified 4 participants (0.9%) as being underweight (BMI < 18.5), 146 participants (34.1%) with recommended weights (18.5 < BMI < 24.9), 133 (31.1%) as overweight (25 < BMI < 29.9), 113 (26.4%) with obesity (30 < BMI < 39.9), and 32 (7.5%) with severe obesity (BMI > 40). Additionally, 54.0% of participants with obesity and 59.4% of participants with severe obesity had high psychological distress. As a continuous and categorical variable, elevated BMI was independently associated with membership in the high distress phenotype (p < 0.001). The overweight (p = 0.043), obesity (p < 0.001), and severe obesity (p = 0.034) subgroups and Black/African American participants (p = 0.020) were also all significantly associated with high distress.
Conclusions
Elevated BMI and obesity are associated with high psychological distress in patients with hip pain. These results may inform operative, nonoperative, and behavioral health treatment pathways for patients with comorbid obesity and hip pain, as well as provide direction for prospective studies to address obesity and psychological distress among patients with musculoskeletal pain.]]></description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-024-05665-z</identifier><identifier>PMID: 39666030</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Arthralgia - etiology ; Arthralgia - psychology ; Body Mass Index ; Cross-Sectional Studies ; Female ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity ; Obesity - complications ; Obesity - epidemiology ; Obesity - psychology ; Orthopedics ; Overweight ; Pain ; Psychological Distress ; Retrospective Studies</subject><ispartof>Archives of orthopaedic and trauma surgery, 2024-12, Vol.145 (1), p.22, Article 22</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Copyright Springer Nature B.V. Dec 2025</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-d0ed639421df2b8bf1d1dac6f588f6e1cadaf1564ad3423ad1cbcdd472993ffb3</cites><orcidid>0009-0004-0343-8398</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39666030$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ashley, Lucas W.</creatorcontrib><creatorcontrib>Sutton, Kent F.</creatorcontrib><creatorcontrib>Cabell, Grant H.</creatorcontrib><creatorcontrib>Lentz, Trevor A.</creatorcontrib><creatorcontrib>Lewis, Brian D.</creatorcontrib><creatorcontrib>Olson, Steven A.</creatorcontrib><creatorcontrib>Mather, Richard C.</creatorcontrib><title>Elevated body mass index and obesity are associated with pain-associated psychological distress in patients with hip pain</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description><![CDATA[Introduction
Little research has investigated the relationship between musculoskeletal pain and body mass index (BMI) in the context of pain-associated psychological distress. This study aims to determine if independent associations exist between BMI, obesity, demographic variables, and psychological distress in patients presenting with hip pain.
Materials and methods
Using a retrospective cross-sectional study design, 428 patients completed the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) and were categorized into pain-associated psychological distress phenotypes using latent class analysis. Participants were stratified into five BMI categories outlined by the Centers for Disease Control and Prevention (CDC) using descriptive statistics. Multinomial logistic regression was employed to determine a relationship between psychological distress phenotype and BMI (first as a continuous variable, then as a categorical variable), age, gender, race, and veteran status as candidate variables.
Results
Four psychological distress phenotypes were generated: high distress (n = 172, 40.2%), low distress (n = 114, 26.6%), negative pain coping (n = 98, 22.9%), and low self-efficacy and acceptance (n = 44, 10.3%). BMI analyses identified 4 participants (0.9%) as being underweight (BMI < 18.5), 146 participants (34.1%) with recommended weights (18.5 < BMI < 24.9), 133 (31.1%) as overweight (25 < BMI < 29.9), 113 (26.4%) with obesity (30 < BMI < 39.9), and 32 (7.5%) with severe obesity (BMI > 40). Additionally, 54.0% of participants with obesity and 59.4% of participants with severe obesity had high psychological distress. As a continuous and categorical variable, elevated BMI was independently associated with membership in the high distress phenotype (p < 0.001). The overweight (p = 0.043), obesity (p < 0.001), and severe obesity (p = 0.034) subgroups and Black/African American participants (p = 0.020) were also all significantly associated with high distress.
Conclusions
Elevated BMI and obesity are associated with high psychological distress in patients with hip pain. These results may inform operative, nonoperative, and behavioral health treatment pathways for patients with comorbid obesity and hip pain, as well as provide direction for prospective studies to address obesity and psychological distress among patients with musculoskeletal pain.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Arthralgia - etiology</subject><subject>Arthralgia - psychology</subject><subject>Body Mass Index</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Obesity - epidemiology</subject><subject>Obesity - psychology</subject><subject>Orthopedics</subject><subject>Overweight</subject><subject>Pain</subject><subject>Psychological Distress</subject><subject>Retrospective Studies</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kctOxCAYRonROOPoC7gwJG7cVLmVtksz8ZZM4kbXhHJxMJ1SoaPWpxen3uLCFYT_fB-EA8AhRqcYoeIsIsQQyRBhGco5z7O3LTDFjLKMVphv_9pPwF6MjwhhUlZoF0xoxTlHFE3BcNGYZ9kbDWuvB7iSMULXavMKZauhr010_QBlMDBNvHIb9MX1S9hJ12a_Drs4qKVv_INTsoHaxT6YTVkie2faPo65pes22X2wY2UTzcHnOgP3lxd38-tscXt1Mz9fZIrkvM80MprTihGsLanL2mKNtVTc5mVpucFKamlxzpnUlBEqNVa10poVpKqotTWdgZOxtwv-aW1iL1YuKtM0sjV-HQXFLP0dzRM-A8d_0Ee_Dm163QdFWV6URZEoMlIq-BiDsaILbiXDIDASH2LEKEYkMWIjRryl0NFn9bpeGf0d-TKRADoCMY3aBxN-7v6n9h2ClZw_</recordid><startdate>20241212</startdate><enddate>20241212</enddate><creator>Ashley, Lucas W.</creator><creator>Sutton, Kent F.</creator><creator>Cabell, Grant H.</creator><creator>Lentz, Trevor A.</creator><creator>Lewis, Brian D.</creator><creator>Olson, Steven A.</creator><creator>Mather, Richard C.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0004-0343-8398</orcidid></search><sort><creationdate>20241212</creationdate><title>Elevated body mass index and obesity are associated with pain-associated psychological distress in patients with hip pain</title><author>Ashley, Lucas W. ; Sutton, Kent F. ; Cabell, Grant H. ; Lentz, Trevor A. ; Lewis, Brian D. ; Olson, Steven A. ; Mather, Richard C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-d0ed639421df2b8bf1d1dac6f588f6e1cadaf1564ad3423ad1cbcdd472993ffb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Arthralgia - etiology</topic><topic>Arthralgia - psychology</topic><topic>Body Mass Index</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Obesity - epidemiology</topic><topic>Obesity - psychology</topic><topic>Orthopedics</topic><topic>Overweight</topic><topic>Pain</topic><topic>Psychological Distress</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ashley, Lucas W.</creatorcontrib><creatorcontrib>Sutton, Kent F.</creatorcontrib><creatorcontrib>Cabell, Grant H.</creatorcontrib><creatorcontrib>Lentz, Trevor A.</creatorcontrib><creatorcontrib>Lewis, Brian D.</creatorcontrib><creatorcontrib>Olson, Steven A.</creatorcontrib><creatorcontrib>Mather, Richard C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ashley, Lucas W.</au><au>Sutton, Kent F.</au><au>Cabell, Grant H.</au><au>Lentz, Trevor A.</au><au>Lewis, Brian D.</au><au>Olson, Steven A.</au><au>Mather, Richard C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elevated body mass index and obesity are associated with pain-associated psychological distress in patients with hip pain</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2024-12-12</date><risdate>2024</risdate><volume>145</volume><issue>1</issue><spage>22</spage><pages>22-</pages><artnum>22</artnum><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract><![CDATA[Introduction
Little research has investigated the relationship between musculoskeletal pain and body mass index (BMI) in the context of pain-associated psychological distress. This study aims to determine if independent associations exist between BMI, obesity, demographic variables, and psychological distress in patients presenting with hip pain.
Materials and methods
Using a retrospective cross-sectional study design, 428 patients completed the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) and were categorized into pain-associated psychological distress phenotypes using latent class analysis. Participants were stratified into five BMI categories outlined by the Centers for Disease Control and Prevention (CDC) using descriptive statistics. Multinomial logistic regression was employed to determine a relationship between psychological distress phenotype and BMI (first as a continuous variable, then as a categorical variable), age, gender, race, and veteran status as candidate variables.
Results
Four psychological distress phenotypes were generated: high distress (n = 172, 40.2%), low distress (n = 114, 26.6%), negative pain coping (n = 98, 22.9%), and low self-efficacy and acceptance (n = 44, 10.3%). BMI analyses identified 4 participants (0.9%) as being underweight (BMI < 18.5), 146 participants (34.1%) with recommended weights (18.5 < BMI < 24.9), 133 (31.1%) as overweight (25 < BMI < 29.9), 113 (26.4%) with obesity (30 < BMI < 39.9), and 32 (7.5%) with severe obesity (BMI > 40). Additionally, 54.0% of participants with obesity and 59.4% of participants with severe obesity had high psychological distress. As a continuous and categorical variable, elevated BMI was independently associated with membership in the high distress phenotype (p < 0.001). The overweight (p = 0.043), obesity (p < 0.001), and severe obesity (p = 0.034) subgroups and Black/African American participants (p = 0.020) were also all significantly associated with high distress.
Conclusions
Elevated BMI and obesity are associated with high psychological distress in patients with hip pain. These results may inform operative, nonoperative, and behavioral health treatment pathways for patients with comorbid obesity and hip pain, as well as provide direction for prospective studies to address obesity and psychological distress among patients with musculoskeletal pain.]]></abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39666030</pmid><doi>10.1007/s00402-024-05665-z</doi><orcidid>https://orcid.org/0009-0004-0343-8398</orcidid></addata></record> |
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| subjects | Adult Aged Arthralgia - etiology Arthralgia - psychology Body Mass Index Cross-Sectional Studies Female Humans Male Medicine Medicine & Public Health Middle Aged Obesity Obesity - complications Obesity - epidemiology Obesity - psychology Orthopedics Overweight Pain Psychological Distress Retrospective Studies |
| title | Elevated body mass index and obesity are associated with pain-associated psychological distress in patients with hip pain |
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