We recently demonstrated the utility of quantifying spontaneous pain in mice via the blinded coding of facial expressions. As the majority of preclinical pain research is in fact performed in the laboratory rat, we attempted to modify the scale for use in this species. We present herein the Rat Grimace Scale, and show its reliability, accuracy, and ability to quantify the time course of spontaneous pain in the intraplantar complete Freund's adjuvant, intraarticular kaolin-carrageenan, and laparotomy (post-operative pain) assays. The scale's ability to demonstrate the dose-dependent analgesic efficacy of morphine is also shown. In addition, we have developed software, Rodent Face Finder®, which successfully automates the most labor-intensive step in the process. Given the known mechanistic dissociations between spontaneous and evoked pain, and the primacy of the former as a clinical problem, we believe that widespread adoption of spontaneous pain measures such as the Rat Grimace Scale might lead to more successful translation of basic science findings into clinical application.

Symptomatic osteoarthritis (OA) causes substantial physical and psychosocial disability. This article delineates the characteristic symptoms and signs associated with OA and how they can be used to make the clinical diagnosis. The predominant symptom in most patients is pain. The remainder of the article focuses on what is known about the causes of pain in OA and factors that contribute to its severity. Much has been learned during recent years, but much of this puzzle remains unexplored or inadequately understood.

OA is a painful joint disease that predominantly affects the elderly. Pain is the primary symptom of OA, and it can present as either intermittent or constant. OA pain mechanisms are complex and have only recently been determined. Both peripheral and central processes are involved in creating the OA pain experience, making targeted therapy problematic. Nociceptive, inflammatory and neuropathic pains are all known to occur in OA, but to varying degrees in a patient- and time-specific manner. A better understanding of these multifactorial components of OA pain will lead to the development of more effective and safer pain treatments.

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Objective. To investigate the involvement of transient receptor potential ankyrin 1 (TRPA1) in inflammatory hyperalgesia mediated by tumor necrosis factor ␣ (TNF␣) and joint inflammation.Methods. Mechanical hyperalgesia was assessed in CD1 mice, mice lacking functional TRP vanilloid 1 (TRPV1 ؊/؊ ) or TRPA1 (TRPA1 ؊/؊ ), or respective wildtype (WT) mice. An automated von Frey system was used, following unilateral intraplantar injection of TNF␣ or intraarticular injection of Freund's complete adjuvant (CFA). Knee swelling and histologic changes were determined in mice treated with intraarticular injections of CFA.Results. TNF␣ induced cyclooxygenase-independent bilateral mechanical hyperalgesia in CD1 mice. The selective TRPV1 receptor antagonist SB-366791 had no effect on mechanical hyperalgesia when it was coinjected with TNF␣, but intrathecally administered SB-366791 attenuated bilateral hyperalgesia, indicating the central but not peripheral involvement of TRPV1 receptors. A decrease in pain sensitivity was also observed in TRPV1 ؊/؊ mice. Intraplantar coadministration of the TRPA1 receptor antagonist AP-18 with TNF␣ inhibited bilateral hyperalgesia. Intrathecal treatment with AP-18 also reduced TNF␣-induced hyperalgesia. CFA-induced mechanical hyperalgesia in CD1 mice was attenuated by AP-18 (administered by intraarticular injection 22 hours after the administration of CFA). Furthermore, intraarticular CFA-induced ipsilateral mechanical hyperalgesia was maintained for 3 weeks in TRPA1 WT mice. In contrast, TRPA1 ؊/؊ mice exhibited mechanical hyperalgesia for only 24 hours after receiving CFA.Conclusion. Evidence suggests that endogenous activation of peripheral TRPA1 receptors plays a critical role in the development of TNF␣-induced mechanical hyperalgesia and in sustaining the mechanical hyperalgesia observed after intraaarticular injection of CFA. These results suggest that blockade of TRPA1 receptors may be beneficial in reducing the chronic pain associated with arthritis.Sensory nerves consisting of C and A␦ nerve fibers innervate joints and skin and are often located in close association with blood vessels (1-3). Nerve stimulation in inflamed joints is considered to play a primary role in arthritis-related pain, and sensory afferent nerves have been located in joints, where they terminate in subsynovial connective tissue (4). Certain members of the transient receptor potential (TRP) receptor family, which are expressed on sensory nerves, are involved as key molecular integrators in the initiation and maintenance of joint pain, although the precise mechanisms involved are unclear (5,6).

The nonpsychoactive cannabis-derivative cannabidiol (CBD) reduced nociceptor activity and pain in end-stage osteoarthritis. Prophylactic treatment with CBD prevented joint neuropathy and chronic neuropathic pain.

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