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Osteogenic Pain: A "Novel" Concept Based on Rodent and Human Studies
Ricard Plancarte1, Sudhir A Diwan2, Alaa A Abd-Elsayed3
1Nacional de Cancerologia (National Cancer Institute), Mexico City, DF Mexico.
Background:
The chronic bone pain associated with various skeletal conditions poses significant challenges to clinical management. Current treatments, which often rely on systemic opioids, come with adverse effects, emphasizing the need for safer alternatives. Understanding the neurobiology of bone pain and exploring novel therapeutic avenues for the condition are critical for improving patient outcomes.
Objectives:
This review aims to examine recent preclinical studies elucidating the mechanisms underlying bone pain and to propose an innovative concept, known herein as osteogenic pain, to aid in relieving it.
Study Design:
A comprehensive review of preclinical studies investigating bone pain mechanisms and treatment approaches was conducted. Literature focusing on the interaction between neurons and bone microenvironment cells was examined, as was literature concerning the development of nonopioid analgesics targeting peripheral processes.
Results:
This review highlights the intricate interactions among neurons, immune cells, osteoclasts, and osteoblasts within the bone microenvironment that contribute to the pathophysiology of bone pain. The study identifies the increased excitability of primary afferent neurons as a crucial factor in bone pain development, and a new concept of osteogenic pain is proposed.
Limitations:
The translation of preclinical findings to clinical settings requires further validation, highlighting the need for more clinically relevant animal models and experimental methods.
Conclusion:
The proposal of "osteogenic pain" as a new concept underscores the need for improved clinical methods of treating bone pain and validated tools for the assessment and diagnosis thereof. The future of bone pain management lies in exploration, including targeting peripheral processes and leveraging innovative therapies, interventional techniques, and inclusive integration of artificial intelligence into them. Through new tools for assessment and monitoring, these efforts may provide patients who have bone disorders with better pain relief and improved quality of life.
Insights
Chronic bone pain management needs safer alternatives. This review explores osteogenic pain mechanisms and proposes new therapeutic targets for better patient relief.
Area of Science:
- Neuroscience
- Orthopedics
- Pain Management
Background:
- Chronic bone pain presents significant clinical challenges.
- Opioid-based treatments have adverse effects, necessitating safer alternatives.
- Understanding bone pain neurobiology is crucial for improved patient outcomes.
Purpose of the Study:
- Review preclinical studies on bone pain mechanisms.
- Propose a novel concept of "osteogenic pain" for therapeutic development.
Main Methods:
- Comprehensive review of preclinical bone pain research.
- Analysis of neuron-bone cell interactions.
- Examination of non-opioid analgesic development.
Main Results:
- Bone pain involves complex interactions between neurons and bone microenvironment cells.
- Increased primary afferent neuron excitability is key to bone pain.
- A new concept, "osteogenic pain," is proposed.
Conclusions:
- Clinical translation requires validation with relevant models.
- "Osteogenic pain" concept necessitates improved clinical assessment tools.
- Future bone pain management may involve AI, novel therapies, and peripheral targeting.
