TY - JOUR
T1 - Pain in osteoarthritis
T2 - Driven by intrinsic rather than extrinsic joint afferents and why this should impact treatment
AU - Devor, Marshall
N1 - Publisher Copyright:
© 2024 The Author
PY - 2024/3
Y1 - 2024/3
N2 - 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.
AB - 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.
KW - Bone
KW - Cartilage
KW - Extrinsic innervation
KW - Genicular nerve
KW - Intrinsic innervation
KW - Joint pain
KW - Osteoarthritis
KW - Subchondral bone
UR - http://www.scopus.com/inward/record.url?scp=85192148716&partnerID=8YFLogxK
U2 - 10.1016/j.inpm.2023.100381
DO - 10.1016/j.inpm.2023.100381
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C2 - 39239488
AN - SCOPUS:85192148716
SN - 2772-5944
VL - 3
JO - Interventional Pain Medicine
JF - Interventional Pain Medicine
IS - 1
M1 - 100381
ER -