Is Chronic Knee Pain Linked to Depression?

Is Chronic Knee Pain Linked to Depression?

By Staff.

About 13 percent of women and 10 percent of men over 60 have knee pain as a result of osteoarthritis (OA). Knee pain from OA can make it harder to take care of yourself, lesson the amount of exercise you get, and can impact your overall quality of life.  As a result, this can lead to depression, according to a new study.

Researchers from Japan published a new study, “The Association of Knee Pain and Impaired Function with the Development of Depressive Symptoms ” in the Journal of the American Geriatrics Society where they examined the effects of knee pain on depression.  Until now, few studies have focused on how knee pain and impaired knee function relate to depression.

To study the relationship between knee pain and depression, the researchers examined information from 573 people (260 men and 313 women) aged 65 or older who participated in the Kurabuchi Study, which is an ongoing look at the health of older adults living in central Japan.

When the study began (between 2005 and 2006) none of the participants had symptoms of depression. Two years later, nearly all participants completed follow-up interviews. The participants answered questions about their knee pain and were evaluated for symptoms of depression.

Nearly 12 percent of the participants had, indeed, developed symptoms of depression.

People who experienced knee pain at night while in bed, while putting on socks, or while getting in or out of a car were more likely to report having symptoms of depression, noted the researchers.

The researchers concluded that asking older adults with knee pain whether they have pain at night in bed, when putting on socks, or while getting in or out of a car could be useful for helping to screen people at risk for developing depression.

Knee osteoarthritis (OA) is a chronic disease with no cure, and is common in middle‐aged and elderly people. It causes degeneration and destruction of articular cartilage and surrounding joint structures, which often limits daily living activities. The global prevalence of symptomatic knee OA is reported to be approximately 13% in women and 10% in men aged 60 and older.

While OA is incurable, there are treatments available to help manage symptoms.  According to the Arthritis Foundation, long term management of the disease includes:

  • Managing pain, stiffness and swelling
  • Improving joint mobility and flexibility
  • Maintaining a healthy weight
  • Getting enough exercise.

And given the results of this study, perhaps maintaining good mental health should be added to the list.

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Authored by: Staff

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I have had knee pain for years and one day while eating pumpkin seeds and Brazil nuts my pain drastically improved. I attributed it to the magnesium and selenium in both nuts but now after reading this article it dawned on me: both mg and selenium fight depression. So is it a question of chicken and the egg here? Does depression lead to knee pain or is it the other way around?? And is magnesium and selenium fighting the inflammation to the knee or is it improving the symptoms of depression thus improving my knee pain??? This is what researchers need to zero in on. But yes I can say with integrity that knee pain and depression are very related. But which came first is the question?


Why is it that some people can’t read an article but feel free to comment. They can’t even read that it says in the FIRST SENTENCE of the article that 10% have the depression. Maybe, that is because the vast majority of people, with arthritic knees, do not have pain. Their pain is controllable with NSAIDS. Someone mentioned that knee replacement patients did not have depression. But, they also, no longer have knee pain that keeps them from doing daily activities of living, that so many people take for granted. Why don’t they consider the fact that one a patient has knee replacement, they should not have any knee pain! (My mother had pain after her replacement. But, it did allow her to get around in the house. That was , until the disease got so severe that she could not walk on a walker.) They did not say EVERYONE became depressed!

Pain and brain has got an important role. Being a professional physiotherapist many times I have wondered why despite of best exercise protocol the patients morale is down especially with multiple joint arthritis. Depression affect overall posture of the body, the study gives an important insight to physiotherapist that along with exercise counselling the client is also important

Lisa Shuman

I responeded earlier..i am also depressed because I can NOT WALK without my pain meds..i was just saying everyone is not depressed as this article states..


Thanks Bob, for elaborating on our pain management issues and speaking out how medically/scientifically continuous, incurable, lifetime pain so badly effects the psyche. I appreciate your “inside” expressions for the patients now suffering beyond human endurance is subjective to each, different patient. Again, Thank You for your medical analysis.

Neldine Ludwigson

My husband and I can both attest that any severe ongoing, unrelieved pain is going to tank the Happy Happy Joy Joy right out from under you. Not even being able to even climb a ladder to change ceiling lightbulbs, or barely take the lightening/numbness in your legs long enough to prep and cook a meal. Heck, even driving for a half hour is murderous. Now, pain relief is a vanishing memory. Rambling I know, but if you could lose every enjoyable part of your life and not feel blue, I’m envious of you.


TELL me how to advise my 37 year old school teacher son who followed ALL advice from a surgeon that stated, and I was present when he was 27 years old, that ONE minor surgery and time to heal would VASTLY improve his knee pain. The SOB surgeon took two surgeries to TOTALLY destroy my sons knee. This was done in a very small town hospital by the second “most cutting” surgery in the city. I did not know this at the time of his advice. His “one” minor surgery turned into four years of MORE surgery, at Duke Hospital where they could NOT repair the damage done by the local, small town surgeons two screwed up knee surgeries. He was actually DROPPED, abandoned from Duke Hospital where the head orthopedic surgeon took a look at my sons surgeries after the small town surgeon DESTROYED his knee and said and I quote, “this knee is a DISASTER” !. After abandoned by the “head” orthoperdic surgeon” at Duke Orthopedic, we went to Charlotte, NC and found a surgeon that told my son, you need a knee replacemet. He also stated, your knee is in such bad shape, I can do a knee replacement surgery and after the ONE surgery, NOTHING else can be done. This is all after the local “small town” general surgeon, orthopedic surgeon TOLD my son “I can fix your knee with ONE minor surgery”! Four years later, two major knee infections, my son had his knee replaced. He STILL teaches school, everyday in agony and because of CDC “policy” for opioid prescribing doctors. FOUR effing years for ONE minor knee surgery and the NC State Medical Board stated that the first surgeon had “done no wrong”. Now he can’t even get efficient knee pain relief and continue to be self reliant but, he does……somehow. Doctors SCREW up but, they pay NO penalty. The patients must suffer and the doctors….get paid?????? Where is justice? Even if the patient is forced to “acccept” the doctor eff up, pain managment in an effective therapy is NOT available and the “regular” people are to just accept incompetence? Can you say NAZI? Can you say doctor protection? Can you say “gray areas”? BS. I personally am tired of doctor privilege in NC. Sorry, again my opinion (which means NOTHING!)

Lisa Shuman

I would love to know how these people come up with their statistics…that is the craziest thing I ever heard..ive known lots of people who have had knee replacements and they were in NO way..shape..or form depressed…HOWEVER why don’t you worry about the chronic pain patients that are in severe pain..i think they have finally figured out that opiods are NOT a problem for the people that actually need them and take them as perscribed..the Drs know who is following the rules and who dont..they just act stupid..myself..can NOT walk at all without cutting them back on me has only made me more depressed..i had 2 failed spine surgeries with severe acute pain radiating down my left leg along with crazy severe spasms..without them I can do absolutely do nothing..and let me tell you..its no way to live..put yourself in my shoes for 1 day..i look around looking what needs to be done..but sadly know it’s no way possible for me to do it..if I didn’t have my 2 pugs.i can guarantee you I would not be here 54 years think about that for your own life..its no joke..PLEASE leave the pain patients ALONE

Depression researcher Paul W Andrews of McMaster University has written extensively on Evolutionary Psychology, expressing the view that the disease we call depression, is an attempt by the body to conserve resources and focus all available cognitive resources on solving a problem. ( “Is Serotonin an upper or a downer? The evolution of the serotonergic system and its role in depression and the antidepressant response”; Neuroscience & Biobehavioral Reviews 2015; 51: 164-188. ). What makes sense in explaining why some pain patients become clinically depressed, is that if there are things we need to do, but cannot do because of the pain, we begin seeking alternative ways to do them that don’t involve causing us to suffer more pain. So if one has a joint pain that impairs walking, but taking medicine for the pain enables one to ignore the pain and get necessary walking done, the pain won’t make one depressed. But if the same person has their medicine taken away, and now cannot do the walking that’s absolutely necessary, that person will begin searching for a solution that cannot be found, which is what triggers clinical depression.

That’s why some people whose knees ache after walking a mile, will cut down their walking to a manageable amount and take pain medicine. And it’s why people whose knees give them a stabbing, intolerable pain just to stand up out of bed and crawl in the shower, will lay in the bed and sweat and develop body odor that constantly reminds them of how once they used to have knees that could carry their weight and allow them to stand up in the shower and get clean. The pain-depression link is very much an individual matter, of exactly how badly the pain adversely affects the person’s ability to function. We can’t generalize about this and say that a Level 1 pain and a Level 9 pain are equally-likely to cause depression, because they’re not.

Carol Hammond

Absolutely NOT! I have a chronic pain in my knee after my 2014 TKR. I am not a depressed person!


Seriously? I hope they didn’t spend much on this study.
Just ask ANYONE with ongoing severe chronic pain (anywhere) if they feel depressed and you will find the answer is a resounding YES!

Well if one is human, it is going to be some what depressing when you can’t walk across your floor, into the grocery store or other places anymore doing the things you once did. Especially when it’s due to “chronic” pain. I should know for my knees were smashed in a car accident and my ankle was broken. Though what’s more depressing is knowing there’s life-saving pain medicine readily available but you can’t have it anymore because the government has told your doctor that he or she is no longer allowed to prescribe it to you. All because “they’re” in a “crisis” and want to make life miserable for the people who have taken it safely and effectively for years and years. People who depend on it for their livelihood and know the difference in which pain medicine can help. As for being depressed, I can only speak for myself and my knees. They do not cause me depression. The government and their barbaric law; another story. Also knowing there are millions of people who are needlessly suffering due to the “government’s opioid crisis”; now that is depressing, among a few other words. I’m still praying with faith for all of us and I refuse to give up!

Janice Snyder

Chronic pain anywhere can be depressing.