Pain in osteoarthritis. Implications for optimal management

Area of Science:

• Rheumatology
• Pain Medicine
• Neuroscience

Background:

• Osteoarthritis (OA) is a prevalent condition affecting 20% of adults, with increasing incidence linked to aging and obesity.
• OA-related pain is a significant burden, causing disability and high healthcare costs.
• Traditionally, OA pain was viewed as solely nociceptive, directly correlating with joint degradation.

Purpose of the Study:

• To highlight that Osteoarthritis (OA)-related pain is a complex disease, not merely a symptom of joint damage.
• To emphasize the multifactorial pathophysiology of OA pain, including neuropathic and inflammatory components.
• To underscore the importance of considering factors beyond structural damage in OA pain management.

Main Methods:

• Review of existing literature on Osteoarthritis (OA) pain pathophysiology.
• Analysis of clinical findings regarding the variability and independence of OA pain from structural modifications.
• Inclusion of recent neuroimaging studies on central mechanisms of OA pain.

Main Results:

• Osteoarthritis (OA)-related pain involves complex pathophysiology, including peripheral and central neuropathic abnormalities and local inflammation.
• Pain experience in OA is not linear and can be independent of structural joint damage.
• Psychological, genetic, and potentially meteorological factors modulate OA pain intensity and quality.

Conclusions:

• Osteoarthritis (OA)-related pain is a distinct disease entity with a complex pathophysiology.
• Effective management requires understanding the interplay of neuropathic, inflammatory, and central mechanisms.
• Future research should focus on the diverse factors influencing OA pain experience and explore novel therapeutic targets.