Journal of Behavioral Medicine

, Volume 15, Issue 2, pp 189–214

Pain and disability in osteoarthritis: A review of biobehavioral mechanisms


  • Joost Dekker
    • Netherlands Institute of Primary Health Care
  • Bob Boot
    • Faculty of Human Movement SciencesFree University
  • Luc H. V. van der Woude
    • Faculty of Human Movement SciencesFree University
  • J. W. J. Bijlsma
    • Department of RheumatologyUniversity of Utrecht

DOI: 10.1007/BF00848325

Cite this article as:
Dekker, J., Boot, B., van der Woude, L.H.V. et al. J Behav Med (1992) 15: 189. doi:10.1007/BF00848325


Pain and disability are cardinal symptoms in osteoarthritis. The literature is reviewed in order to identify causes of these symptoms at the articular, kinesiological, and psychological level. It is concluded that pain and disability are associated with degeneration of cartilage and bone (articular level), with muscle weakness and limitations in joint motion (kinesiological level), and with anxiety, coping style, attentional focus on symptoms, and possibly depression (psychological level). Biobehavioral mechanisms of pain and disability which explain the observed associations are described and the empirical evidence for these mechanisms is evaluated. Methodological and conceptual deficiencies in the research reviewed are pointed out and suggestions for further research are given.

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© Plenum Publishing Corporation 1992