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A reduction in perceived psychological distress over three years is associated with improvements in pain and symptoms in patients with longstanding hip and groin pain - a longitudinal prospective cohort study

Pålsson, Anders LU ; Ivarsson, Andreas and Ageberg, Eva LU orcid (2026) In BMC Musculoskeletal Disorders 27. p.1-6
Abstract

BACKGROUND: Previous cross-sectional studies report an association between psychological distress and severity of pain and symptoms in patients with longstanding non-arthritic hip and groin pain (LHGP). However, there is a lack of longitudinal studies exploring changes in psychological distress over time, and whether these changes relate to changes in pain and symptoms in LGHP patients. This study aimed to assess any changes in patient-reported psychological distress in patients with LHGP from the time of referral to orthopedic care to a follow-up three years later. An additional aim was to explore the relationship between changes in psychological distress and changes in patient-reported pain and symptoms from baseline to the three-year... (More)

BACKGROUND: Previous cross-sectional studies report an association between psychological distress and severity of pain and symptoms in patients with longstanding non-arthritic hip and groin pain (LHGP). However, there is a lack of longitudinal studies exploring changes in psychological distress over time, and whether these changes relate to changes in pain and symptoms in LGHP patients. This study aimed to assess any changes in patient-reported psychological distress in patients with LHGP from the time of referral to orthopedic care to a follow-up three years later. An additional aim was to explore the relationship between changes in psychological distress and changes in patient-reported pain and symptoms from baseline to the three-year follow-up.

METHODS: Eighty-one patients who had previously participated in a cross-sectional study were invited for follow-up three years after their referral for orthopedic care due to LHGP. The Kessler Psychological Distress Scale (K-10) was used to assess psychological distress, and the subscales for pain and symptoms in the Copenhagen Hip and Groin Outcome Score (HAGOS) was used to assess pain and symptoms. The Wilcoxon signed-rank test was used for comparisons of K-10 scores from baseline to follow-up, and Spearman's rank order correlation was used to examine the association between changes in K-10 scores and changes in HAGOS scores.

RESULTS: Forty-five (56%) patients participated in the follow-up. No significant group-level change in the K-10 total score was found from baseline to the three-year follow-up (median change 0.0, IQR - 4.25; 4.25, p = 0.792). Significant improvements in the HAGOS subscales for pain (mean change 14.3, 95%CI 7.8;20.8) and symptoms (16.4, 95%CI 8.9;24.0) were reported (p < 0.001). A moderate association was observed between changes in the K-10 total score and changes in the HAGOS subscale for pain (r
s=-0.436, p = 0.004) and symptoms (r
s=-0.431, p = 0.005) from baseline to the three-year follow-up.

CONCLUSIONS: Despite no significant group-level change in psychological distress, reductions in psychological distress were moderately associated with improvements in pain and symptom scores. The relationship between psychological distress and hip and groin pain and symptoms highlights the importance of considering both physical and psychological factors in patient management.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, Female, Male, Groin, Psychological Distress, Middle Aged, Longitudinal Studies, Prospective Studies, Cross-Sectional Studies, Pain Measurement/psychology, Aged, Follow-Up Studies, Stress, Psychological/psychology, Adult, Time Factors, Hip Joint
in
BMC Musculoskeletal Disorders
volume
27
article number
613
pages
1 - 6
publisher
BioMed Central (BMC)
external identifiers
  • scopus:105045127528
  • pmid:42469751
ISSN
1471-2474
DOI
10.1186/s12891-026-10231-2
project
Longstanding hip and groin pain: Patient characteristics, diagnosis and physical impairments
language
English
LU publication?
yes
additional info
© 2026. The Author(s).
id
e07da49a-b927-487f-b096-23acf9dd1173
date added to LUP
2026-08-19 09:43:52
date last changed
2026-08-20 04:01:28
@article{e07da49a-b927-487f-b096-23acf9dd1173,
  abstract     = {{<p>BACKGROUND: Previous cross-sectional studies report an association between psychological distress and severity of pain and symptoms in patients with longstanding non-arthritic hip and groin pain (LHGP). However, there is a lack of longitudinal studies exploring changes in psychological distress over time, and whether these changes relate to changes in pain and symptoms in LGHP patients. This study aimed to assess any changes in patient-reported psychological distress in patients with LHGP from the time of referral to orthopedic care to a follow-up three years later. An additional aim was to explore the relationship between changes in psychological distress and changes in patient-reported pain and symptoms from baseline to the three-year follow-up.</p><p>METHODS: Eighty-one patients who had previously participated in a cross-sectional study were invited for follow-up three years after their referral for orthopedic care due to LHGP. The Kessler Psychological Distress Scale (K-10) was used to assess psychological distress, and the subscales for pain and symptoms in the Copenhagen Hip and Groin Outcome Score (HAGOS) was used to assess pain and symptoms. The Wilcoxon signed-rank test was used for comparisons of K-10 scores from baseline to follow-up, and Spearman's rank order correlation was used to examine the association between changes in K-10 scores and changes in HAGOS scores.</p><p>RESULTS: Forty-five (56%) patients participated in the follow-up. No significant group-level change in the K-10 total score was found from baseline to the three-year follow-up (median change 0.0, IQR - 4.25; 4.25, p = 0.792). Significant improvements in the HAGOS subscales for pain (mean change 14.3, 95%CI 7.8;20.8) and symptoms (16.4, 95%CI 8.9;24.0) were reported (p &lt; 0.001). A moderate association was observed between changes in the K-10 total score and changes in the HAGOS subscale for pain (r<br>
 s=-0.436, p = 0.004) and symptoms (r<br>
 s=-0.431, p = 0.005) from baseline to the three-year follow-up.<br>
 </p><p>CONCLUSIONS: Despite no significant group-level change in psychological distress, reductions in psychological distress were moderately associated with improvements in pain and symptom scores. The relationship between psychological distress and hip and groin pain and symptoms highlights the importance of considering both physical and psychological factors in patient management.</p>}},
  author       = {{Pålsson, Anders and Ivarsson, Andreas and Ageberg, Eva}},
  issn         = {{1471-2474}},
  keywords     = {{Humans; Female; Male; Groin; Psychological Distress; Middle Aged; Longitudinal Studies; Prospective Studies; Cross-Sectional Studies; Pain Measurement/psychology; Aged; Follow-Up Studies; Stress, Psychological/psychology; Adult; Time Factors; Hip Joint}},
  language     = {{eng}},
  month        = {{07}},
  pages        = {{1--6}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Musculoskeletal Disorders}},
  title        = {{A reduction in perceived psychological distress over three years is associated with improvements in pain and symptoms in patients with longstanding hip and groin pain - a longitudinal prospective cohort study}},
  url          = {{http://dx.doi.org/10.1186/s12891-026-10231-2}},
  doi          = {{10.1186/s12891-026-10231-2}},
  volume       = {{27}},
  year         = {{2026}},
}