Physiotherapist Elisabeth Mulrooney (PhD) at Diakonhjemmet hospital has researched the connection between pain and biological, psychological and social factors in patients with hand osteoarthritis.
The doctoral work explores how the degree of osteoarthritis, sensitization, disease burden, anxiety, depression and coping skills can affect the pain experience in people with this condition.
The thesis is entitled, " Pain in hand osteoarthritis in a biopsychosocial framework ." Pain is a dominant symptom of osteoarthritis and has a major impact on the patients' quality of life.
Hand osteoarthritis is a condition about which there is limited knowledge, and the treatment options are few. Those who have it are encouraged to self-train. In addition, they can take pain and anti-inflammatory drugs. Several also receive customized orthoses. There are aids that can relieve pain, improve function or help correct a wrong position.
Biopsychosocial factors and pain experience
Mulrooney's findings show that patients with high levels of anxiety, depressive symptoms and catastrophic thoughts experience more pain than those with lower levels of these factors.
She also found that people with a high degree of other disease burden experienced more pain than those without a corresponding disease burden.
Five possible subgroups of patients were identified, based on biological, psychological and social factors. Patients with a high level of stress, poor sleep and several concurrent illnesses experienced significantly more pain than those with more serious joint damage, but otherwise a low burden of disease. 
Elisabeth Mulrooney has obtained her PhD on 11 December 2024.
- We cannot conclude whether these factors are causes or consequences of pain, but our findings indicate that biopsychosocial factors, individually or in combination, can worsen the pain experience in people with hand osteoarthritis, explains Mulrooney.
She believes that the results clearly show the need for individually adapted treatment.
- We have to find the risk factors that can be influenced and help the patients with them, says Mulrooney.
This research can have consequences for how pain treatment is adapted individually in patients with hand osteoarthritis, and it provides important perspectives for future studies.
The Nor-Hand study
The research project is part of the Nor-Hand study. The observational cohort study of men and women with hand osteoarthritis has been followed at Diakonhjemmet hospital since 2016. The study has collected extensive information on pain experience, including psychological factors, pain sensitivity and additional diseases.
Doctoral examination
Title of the trial lecture: “The role of metabolic syndrome in hand OA. Underlying mechanisms and potential treatment”
Supervisors:
Principal supervisor Ida K. Haugen. Co-supervisors Hanne Dagfinrud, Hilde Berner Hammer, Karin Magnusson, Tore K. Kvien
Assessment committee:
First opponent: Associate Professor Lisa Carlesso, McMaster University, Canada
Second opponent: Professor Martin van der Esch, Amsterdam University of Applied Sciences, The Netherlands
Chair of the committee: Associate Professor Maren Falch Lindberg, University of Oslo
Discussion leader:
Stephan Röhrl, University of Oslo
The thesis is funded by Helse Sør-East and is based on the University of Oslo in collaboration with Diakonhjemmet Hospital, which has also been responsible for the data collection through the Nor-Hand study.
Elisabeth Mulrooney together with the assessment committee, defense supervisor and main supervisor.
