Factors Associated With Pain and Physical Function in Osteoarthritis: A Systematic Review

Pain Manag Nurs. 2026 Jun 13:S1524-9042(26)00175-X. doi: 10.1016/j.pmn.2026.05.007. Online ahead of print.

ABSTRACT

PURPOSE: This systematic review aimed to identify and synthesize the psychological, physical, and behavioral factors associated with pain and physical function in individuals with nonsurgically managed OA.

DESIGN: A systematic review following JBI methodology and PRISMA guidelines.

METHODS: Studies from the last 10 years were searched across four major databases (PubMed, Scopus, CINAHL, and ScienceDirect). Twelve observational studies met the inclusion criteria for synthesis.

RESULTS: For pain, adverse psychological states, including kinesiophobia, pain catastrophizing, and depression, were strongly associated with higher pain intensity. A higher Body Mass Index (BMI), insufficient physical activity, and poor sleep were also linked to greater pain. For physical function, psychological distress (catastrophizing, depression) and key physical impairments were dominant predictors of functional decline. Older age, higher BMI, and lower socioeconomic status were also associated with worse function.

CONCLUSIONS: The experience of OA is multifactorial, shaped by an interplay of psychological, physical, and behavioral factors.

CLINICAL IMPLICATIONS: These findings highlight the importance of comprehensive assessment, including psychological screening, lifestyle evaluation, and culturally sensitive care planning, to optimize pain management and functional outcomes in individuals with OA.

PMID:42288413 | DOI:10.1016/j.pmn.2026.05.007