Which mechanisms are responsible for the perception of pain in osteoarthritis (OA)?

Updated: Jun 10, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Pain, the main presenting symptom of osteoarthritis, is presumed to arise from a combination of mechanisms, including the following:

  • Osteophytic periosteal elevation

  • Vascular congestion of subchondral bone, leading to increased intraosseous pressure

  • Synovitis with activation of synovial membrane nociceptors

  • Fatigue in muscles that cross the joint

  • Overall joint contracture

  • Joint effusion and stretching of the joint capsule

  • Torn menisci

  • Inflammation of periarticular bursae

  • Periarticular muscle spasm

  • Psychological factors

  • Crepitus (a rough or crunchy sensation)

  • Central pain sensitization


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