Osteoarthritis pain

Abstract

Osteoarthritis (OA) represents one of the most frequently occurring painful conditions. Pain is the major OA symptom, involving both peripheral and central neurological mechanisms. OA pain is initiated from free axonal endings located in the synovium, periosteum bone, and tendons, but not in the cartilage. The nociceptive message involves not only neuromediators and regulating factors such as neuronal growth factor (NGF) but also central modifications of pain pathways. OA pain is a mixed phenomenon where nociceptive and neuropathic mechanisms are involved in both the local and central levels. OA pain perception is influenced by multiple environmental, psychological, or constitutional factors, and OA pain intensity is not correlated with joint degradation. OA pain may present with different clinical features: constant and intermittent pain, with or without a neuropathic component, and with or without central sensitization. Finally, OA pain should be considered as a complex and not unique pain condition, where precise clinical assessment may drive specific therapeutic approaches.

Labral calcification in end‐stage osteoarthritis of the hip correlates with pain and clinical function

“…While it is well recognized that OA affects the whole joint as an organ, involving multiple tissues next to hyaline cartilage, namely fibrocartilage, subchondral bone, the synovium, the joint capsule and periarticular ligaments, and muscles, the etiology of primary OA remains largely unknown. Interestingly, and mainly for unknown reasons, there is a poor correlation between pain intensity and the radiological degree of joint degeneration . It is known that the joint capsule, ligaments, periosteum, and subchondral bone are innervated by primary nociceptors, while hyaline cartilage is not .…”

Dor articular: inflamatória ou neuropática? / Joint pain: inflammatory or neuropathic pain?

“…Estudos recentes acrescentam o envolvimento de mecanismos neuro isiológicos central e perifeŕico para a persistencia do sintoma álgico na OA, sensibilizando o neurônio aferente primário, corno posterior da medula espinal. Ao nıv el perifeŕico descreve-se a transdução da dor pelas terminações nervosas livres do tecido ósseo, tendões e capsula sinovial, destaca-se a ausencia destas 17 na cartilagem.…”

“…No SNC, os estıḿ ulos não nociceptivos são interpretados como dor por um processo de aprendizagem contıń ua, por meio do excesso de informação nociceptiva, 17 que ascende a este sistema. Recentemente, são reconhecidas as alterações neuroplásticas na dor crônica, bem como sua componente neuropática.…”

Daily Pain Measurements and Retrospective Pain Measurements in Hip Osteoarthritis Patients With Intermittent Pain

“…Pain is one of the most important symptoms in patients with osteoarthritis (OA) of the hip (1). Therefore, pain is one of the main outcomes in OA clinical trials (2).…”