Pain in osteoarthritis: Driven by intrinsic rather than extrinsic joint afferents and why this should impact treatment

Marshall Devor

Research output: Contribution to journalEditorial

2 Scopus citations

Abstract

Pain in osteoarthritis (OA) results from erosion of joint cartilage, resulting in bone contacting bone without an intervening cushion. The periosteum, including its nociceptive innervation, ends at the border of the cartilage. No other innervated tissue is present between the denuded articular bone ends that could serve as a neuronal pathway to carry a bone-on-bone pain signal to the brain. The pain signaling pathway must therefore originate in afferent axons with electrogenic nociceptive sensory endings that reside within the bone itself, specifically in the opposing surfaces of epiphyseal subchondral bone. Selective ablation of this intrinsic nerve pathway, using any of a variety of approaches, is expected to permanently eliminate OA pain.

Original languageEnglish
Article number100381
JournalInterventional Pain Medicine
Volume3
Issue number1
DOIs
StatePublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2024 The Author

Keywords

  • Bone
  • Cartilage
  • Extrinsic innervation
  • Genicular nerve
  • Intrinsic innervation
  • Joint pain
  • Osteoarthritis
  • Subchondral bone

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