Could Your Knee Pain Alter Your Brain Function?

Date: Nov 11, 2021

If your child or teen has ever complained of knee pain, then you know the worry it can bring when you’re left to wonder if they’ve suffered some sort of injury that could impact their ability to stay active.

A common type of knee condition, however, is not caused by a specific injury or problems with the knee’s structure. And, new research suggests that this knee pain—called patellofemoral pain (PFP)—may actually be linked to changes within the brain.

In a study published in the Journal of Orthopaedic Research, scientists used brain imaging tests to evaluate the connection between brain regions associated with pain processing, psychological functioning, and motor control. The team found altered connections in the brains of study participants with PFP compared to those without. Further, alterations in brain connectivity were related to patients’ perceptions of function, pain, and fear of movement.

Greg Myer HeadshotStudy co-author Gregory D. Myer, PhD, FACSM, CSCS*D, professor of orthopaedics at Emory University School of Medicine, says the findings have the potential to guide new treatment strategies for eliminating PFP pain focused not only on the knee itself but also to fix the altered connections in the brain.

About Patellofemoral Pain (PFP)

PFP affects more than 20% of the population. It is more common in women than in men and has been linked to knee problems later in life, including osteoarthritis.

Common treatments for PFP include rest, pain-relieving medications, and physical therapy. These treatments, however, are not considered effective for long-term pain resolution for patients with PFP.

Promising Findings on the Future of PFP Treatment

Because of its long-term impact on daily living and overall quality of life, the study’s authors say PFP has been “deemed an urgent research priority.”

Myer, who also serves as division director of the Emory Sports Performance and Research Center, conducts research on athletic injury and human performance.

For their study, Myer and team evaluated 15 young women between the ages of 11 and 24 with PFP. A group of 30 young women without PFP was also evaluated.

Each study participant completed questionnaires focused on their perceived pain symptoms, physical functioning, and fear of movement and physical activity (kinesiophobia). The team then compared responses to these questions and associated functional magnetic resonance imaging data from the patients with PFP in the study. Brain functional connectivity was also compared between patients with PFP and pain-free controls.

The brain scans of the young women with PFP showed altered functional connectivity between regions of the brain important for pain, psychological functioning, and sensorimotor control compared to the pain-free controls. Altered functional connectivity was also related to the degree of perceived pain, movement dysfunction, and movement-related fear/disability in patients with PFP.

“We were able to show through neuroimaging that the changes in the brains of patients with PFP were strongly tied to that person’s perceived symptoms, their physical functioning, and their fear of injury,” Myer said. “This connection between brain connectivity and self-reported outcomes suggests there could be better approaches to treat PFP using tools like cognitive-behavioral therapy and/or biofeedback to break the connection between movement and pain by alleviating fear associated with activity. Future research is needed to determine if which treatments could best restore altered functional connectivity in patients with PFP.”

Innovation at Emory’s Sports Performance and Research Center

The Sports Performance and Research Center located inside the Emory Orthopaedics & Spine Center at Flowery Branch is a new leading-edge research center, serving both the professional athletes of the Atlanta Falcons as well as community members of all ages. Researchers are focused on injury prevention in young athletes. The team conducts ongoing research and technology development for concussion prevention, sports injury prevention, and performance enhancement.

About Emory Orthopaedics & Spine Center

Emory Orthopaedics & Spine Center offers a full range of services to diagnose, treat and repair bones, joints, and connective tissue, such as muscles and tendons. Our team puts your health and well-being first. Part of our commitment to patients is making sure you receive the care you need when you need it.

We have 11 office locations throughout metro Atlanta and beyond. We are the official healthcare team provider for the Atlanta Braves, Atlanta Dream, Atlanta Falcons, Atlanta Hawks, and over 40 collegiate, high school, and community sports programs.

Learn more about the Emory Sports Performance & Research Center.

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