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The sources of pain in osteoarthritis: a pathophysiological review
Salaffi, F ; Ciapetti, A ; Carotti, M
Reumatismo, 2014-06, Vol.66 (1), p.57-71
[Peer Reviewed Journal]
Italy: PAGEPress Publications
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Title:
The sources of pain in osteoarthritis: a pathophysiological review
Author:
Salaffi, F
;
Ciapetti, A
;
Carotti, M
Subjects:
Afferent Pathways - physiopathology
;
Arthritis
;
Bone and Bones - pathology
;
Cartilage, Articular - pathology
;
Central Nervous System Sensitization
;
Cost of Illness
;
Diagnostic Imaging
;
Humans
;
Musculoskeletal Pain - diagnostic imaging
;
Musculoskeletal Pain - etiology
;
Musculoskeletal Pain - physiopathology
;
Musculoskeletal Pain - psychology
;
Nervous system
;
Neuralgia - etiology
;
Neuralgia - physiopathology
;
Neuropeptides - physiology
;
Nociceptors - physiology
;
Osteoarthritis
;
Osteoarthritis - diagnostic imaging
;
Osteoarthritis - economics
;
Osteoarthritis - epidemiology
;
Osteoarthritis - physiopathology
;
Overweight - complications
;
Pain
;
Pain Perception - physiology
;
Pain, Osteroarthritis, Risk factors
;
Posterior Horn Cells - physiology
;
Prevalence
;
Radiography
;
Synovial Fluid - metabolism
Is Part Of:
Reumatismo, 2014-06, Vol.66 (1), p.57-71
Notes:
ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
content type line 23
ObjectType-Review-1
Description:
The pain of osteoarthritis (OA) has multifaceted etiologies within and outside the joint. It is believed to be driven by both nociceptive and neuropathic mechanisms, as well as abnormal excitability in the pain pathways of the peripheral and central nervous system. Inflammation in the joint triggers a cascade of events that leads to peripheral sensitization, increased sensitivity of nociceptive primary afferent neurons, and hyperexcitability of the nociceptive neurons in the central nervous system. Pain receptors have been found in the synovium, ligaments, capsule, subchondral bone and surrounding tissues, with the exception of articular cartilage. The bone-related causes of pain in OA include subchondral microfractures, bone stretching with elevation of the periosteum due to osteophyte growth, bone remodeling and repair, bone marrow lesions, and bone angina caused by decreased blood flow and increased intra-osseous pressure. Central factors alter pain processing by setting the gain in such a way that, when a peripheral input is present, it is processed against a background of central factors that can enhance or diminish the experience of pain. As a complex phenomenon with a strong subjective component, pain can also be influenced by the nature of the underlying disease, personal predisposition (biological and psychological), and environmental and psychosocial factors. This review examines the current literature regarding the sources and mechanisms of pain in OA.
Publisher:
Italy: PAGEPress Publications
Language:
English;Italian
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