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Peripheral Mechanisms Contributing to Osteoarthritis Pain

  • Chronic Pain (R Staud, Section Editor)
  • Published:
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Abstract

Purpose of Review

Osteoarthritis (OA) is the most common form of arthritis and a major source of pain and disability worldwide. OA-associated pain is usually refractory to classically used analgesics, and disease-modifying therapies are still lacking. Therefore, a better understanding of mechanisms and mediators contributing to the generation and maintenance of OA pain is critical for the development of efficient and safe pain-relieving therapies.

Recent Findings

Both peripheral and central mechanisms contribute to OA pain. Clinical evidence suggests that a strong peripheral nociceptive drive from the affected joint maintains pain and central sensitization associated with OA. Mediators present in the OA joint, including nerve growth factor, chemokines, cytokines, and inflammatory cells can contribute to sensitization. Furthermore, structural alterations in joint innervation and nerve damage occur in the course of OA.

Summary

Several interrelated pathological processes, including joint damage, structural reorganization of joint afferents, low-grade inflammation, neuroplasticity, and nerve damage all contribute to the pain observed in OA. It can be anticipated that elucidating exactly how these mechanisms are operational in the course of progressive OA may lead to the identification of novel targets for intervention.

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Funding

Delfien Syx is a postdoctoral fellow of the Research Foundation—Flanders (FWO). Rachel Miller is supported by the US National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIH/NIAMS) (K01AR070328). Anne-Marie Malfait (R01AR064251 and R01AR060364) is supported by NIAMS.

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Dr. Malfait reports personal fees from Regeneron, personal fees from Eli Lilly, personal fees from Pfizer, personal fees from Galapagos, outside the submitted work.

Delfien Syx, Phuong B. Tran and Rachel E. Miller declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Syx, D., Tran, P.B., Miller, R.E. et al. Peripheral Mechanisms Contributing to Osteoarthritis Pain. Curr Rheumatol Rep 20, 9 (2018). https://doi.org/10.1007/s11926-018-0716-6

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