Are psychological factors associated with patient-reported pain and function in individuals with hip joint-related pain? A systematic review.

Abstract

Objective: To examine associations between (1) baseline psychological factors and pain and function, (2) baseline psychological factors and postintervention (nonoperative or surgery) pain and function, and (3) how psychological factors change following intervention in patients with hip joint-related pain.

Literature survey: In July 2021 and June 2023, PubMed, Scopus, Web of Science Core Collection, CINAHL with Full Text, and SPORTDiscus were searched. Search strategies are available in our institutional repository. Quantitative research studies (observational, interventional, case-series/case-control) on hip joint--related pain were included if one psychological and one pain or functional patient-reported outcome measure were reported. Qualitative methods, non-hip joint-related pain pathologies, nonoriginal/non-peer-reviewed, review papers, dissertation/thesis, conference proceedings, book chapters, and protocols were excluded.

Methodology: Two authors screened titles/abstracts and read all articles to confirm eligibility. Results were reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed using National Institutes of Health Study Quality Assessment Tools. Data (demographics, diagnosis, psychological factors, pain/function, intervention) were extracted. A quantitative analysis was not performed due to lack of study homogeneity and outcome data. Descriptive data and Grading of Recommendations Assessment, Development, and Evaluation ratings were reported.

Synthesis: A total of 6040 abstracts/titles and 93 full texts were screened. Sixty articles published between 2007 and 2023 were included. Most were observational, with acceptable quality and moderate-to-low-level bias. Nineteen studies examined baseline associations between psychological factors and pain and function. Of those, 17 studies (89.5%) identified at least one association. Twenty-six studies examined the association between baseline psychological factors and postintervention pain and function. Twenty of these studies (76.9%) identified an association. It is unclear whether or how psychological factors change following intervention.

Conclusions: There is consistent, low- to moderate-grade evidence supporting an association between psychological factors and pain and function in patients with hip joint-related pain at baseline and following intervention. There is inconsistent, very low-grade evidence on whether psychological factors improve following intervention.