Pain coping strategy, pain and activity restriction among middle-aged and elderly women with knee pain

Aim: The present study examined the association of pain coping strategy with pain and activity restriction among middle-aged and elderly women with the knee pain. Methods: The participants were 134 female community residents (62.1 ± 8.2 years) with knee pain. The pain and activity restriction were assessed with the Japanese Knee Osteoarthritis Measure (JKOM). The pain coping strategy was evaluated using the Japanese short version of the Coping Strategy Questionnaire (CSQ). A theoretical model was developed to explain the relationships among age, pain, activity restriction, and pain coping strategy. This model was then tested using structural equation modeling (SEM). Results: The overall fit index was adequate for the final model (GFI = .980, AGFI = .946, CFI = .995, RMSEA = .022). SEM indicated that increasing age had a significant association with increasing pain, and indirect influence on progressive activity restriction. Also, aggravating pain was significantly associated with adopting more "praying or hoping", "catastrophizing", and "increasing pain behavior" as pain coping strategy, and indirectly affected progress in activity restriction. Conclusions: The results indicate that reducing the use of maladaptive coping strategy would be important to promote the ability of pain self-management among middle-aged and elderly women with knee pain. The present study suggests that it would be necessary to incorporate the cognitive-behavioral approaches in order to modify the use of maladaptive coping strategy in existing therapeutic exercise intervention for knee pain.