Pain Empathy and Its Association with the Clinical Pain in Knee Osteoarthritis Patients

Ruipeng Zhao; Yupei Ji; Jiahui Li; Xinhua Li; Ting Wu; Hongru Wu; Cuizhen Liu

doi:10.2147/JPR.S379305

Pain Empathy and Its Association with the Clinical Pain in Knee Osteoarthritis Patients

J Pain Res. 2022 Dec 19:15:4017-4027. doi: 10.2147/JPR.S379305. eCollection 2022.

Authors

Ruipeng Zhao¹, Yupei Ji², Jiahui Li¹, Xinhua Li¹, Ting Wu¹, Hongru Wu³, Cuizhen Liu²

Affiliations

¹ Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Taiyuan, People's Republic of China.
² School of Psychology, Shaanxi Normal University, Xi'an, People's Republic of China.
³ Shanxi Institute of Sports Science, Taiyuan, People's Republic of China.

Abstract

Objective: Knee osteoarthritis (KOA) is a painful chronic disorder. Evidence has shown that a history of chronic pain plays an important role in shaping empathy. Empathy, a valuable indicator of social functioning that refers to an individual's ability to share the experiences of others, however, has been overlooked in KOA patients. This study aimed to investigate empathy and its association with clinical pain in KOA patients.

Methods: KOA patients (n=47) and healthy controls (HCs, n=44) completed two empathy-for-pain tasks: a pain judgment task in which participants judged whether a person in an image felt pain or not, and a pain rating task in which they estimated pain intensity for themselves and others. The Interpersonal Reactivity Index was used to measure participants' trait empathy, and clinical severity and psychological factors were assessed using relevant instruments.

Results: Compared to HCs, KOA patients showed higher accuracy when judging pain and non-pain images and reported overall higher pain intensity when rating for themselves and others. KOA patients also showed greater personal distress than HCs in terms of their self-reported empathy. Moreover, pain catastrophizing particularly mediated the relationship between pain severity and pain ratings for others, and depression, anxiety, and pain catastrophizing all mediated the association between pain severity and empathy-induced personal distress.

Conclusion: These findings suggest that patients with KOA have increased empathy, demonstrated by elevated sensitivity to pain-related scenes and intense emotional responses.

Keywords: emotion; empathy; knee osteoarthritis; pain; pain catastrophizing.

Grants and funding

This work was supported by grants from the National Natural Science Foundation of China (Grant No. U21A20353), the Shanxi Province Colleges and Universities Science and Technology Innovation Project (Grant No. 2021L179), the Basic Research Program of Shanxi Province (Grant No. 202103021223443), and the Start-up Funding of Shaanxi Normal University (Grant No. 1110011242).