Association Between Altered Somatosensation, Pain, and Knee Stability in Patients With Severe Knee Osteoarthrosis

Abstract

Severe OA may result in both hyperalgesia and hypoesthesia at the affected knee. Perceived instability during functional tasks may be mediated in part by pain in individuals with knee OA.

Pain sensitivity profiles in patients with advanced knee osteoarthritis

“…We know that patients with knee OA exhibit altered responses to most QST modalities compared to age-and sex-matched healthy controls, including reduced PPTs [20,27,30,35,58] and increased pressure [1] and heat [30] temporal summation. Even individuals with mild knee OA pain experience enhanced mechanical pain sensitivity compared to age- and sex-match controls [43].…”

Altered Central Sensitization and Pain Modulation in the CNS in Chronic Joint Pain

“…As a joint degeneration progresses, the pain system seems to go through a transition from localized joint hyperalgesia to spreading hyperalgesia (central sensitization) [9•, 10, 11•, 27,37,43], which is improved after successful and pain-free joint replacement surgery [32,44]. A higher degree of general sensitization (i.e., around the knee) has been shown to be related to higher levels of pain [9•, 28,45,46], disability, poorer quality of life [27], worse spreading sensitization [47], poorer outcome after total knee replacement surgery [48], and higher concentration of pro-inflammatory cytokines [37].…”

“…A higher degree of general sensitization (i.e., around the knee) has been shown to be related to higher levels of pain [9•, 28,45,46], disability, poorer quality of life [27], worse spreading sensitization [47], poorer outcome after total knee replacement surgery [48], and higher concentration of pro-inflammatory cytokines [37]. In addition, both widespread [44] and local allodynia [43,49] has been documented in OA patients compared with controls. Furthermore, increased facilitated temporal summation applied by either thermal [50] or mechanical stimuli [28,32] has been documented in OA patients compared with controls.…”

Movement restriction does not modulate sensory and perceptual effects of exercise-induced arm pain

“…We used DOMS as our experimental model because it evokes a perceptual experience that is comparable to that experienced clinically (Brandt et al 2014;Chien et al 2008;Kavchak et al 2012;O'Neill et al 2007;Stanton et al 2013). However, DOMS is associated with a particular physiological process and it is possible that the physiological processes that induce sensory and perceptual changes clinically are not captured by the DOMS model.…”

“…This includes alterations in sensory perception, such as increased perceptual and decreased pain thresholds (Chien et al 2008;Kavchak et al 2012;Puta et al 2013), as well as deficits in tactile acuity (i.e. the smallest distance between two points at which a person can tell that they are being touched by two points and not one) (Catley et al 2014;Luomajoki and Moseley 2011;Moseley 2008;Stanton et al 2013;Wand et al 2010).…”