Mechanisms Underlying Bone and Joint Pain

Abstract

Purpose of Review. The goal of this review is to provide a broad overview of the current understanding of mechanisms underlying bone and joint pain. Recent Findings. Bone or joint pathology is generally accompanied by local release of pro-inflammatory cytokines, growth factors and neurotransmitters that activate and sensitize sensory nerves resulting in an amplified pain signal. Modulation of the pain signal within the spinal cord and brain that result in net increased facilitation is proposed to contribute to the development of chronic pain. Summary. Great strides have been made in our understanding of mechanisms underlying bone and joint pain that will guide development of improved therapeutic options for these patients. Continued research is required for improved understanding of mechanistic differences driving different components of bone and/or joint pain such as movement related pain compared to persistent background pain. Advances will guide development of more individualized and comprehensive therapeutic options.

Inflammation, angiogenesis and sensory nerve sprouting in the synovium of bony ankylosed and not bony ankylosed knees with end‐stage haemophilic arthropathy

“…Arthritis‐related bone and joint pain are known to be associated with mechanical stress, the infiltration of inflammatory mediators (such as IL‐1 and TNF‐α) and peripheral/central sensitization 12 . Peripheral algesia sensitization plays a key role in chronic pain which mainly involves direct stimulation of nociceptors by the previously mentioned inflammatory mediators, vascularization and neurotization in joints 13,14 . Inflammatory cytokines such as TNF‐α and IL‐1 can act on peripheral nociceptive neurons, in the synovium to lower their thresholds, resulting in increased sensitivity to pain‐related stimuli 15,16 …”

Palmitoylethanolamide: A Natural Compound for Health Management

“…Musculoskeletal pain makes a significant contribution to the global burden of disease [ 147 ]. Osteoarthritis (OA) is the leading form of joint pain and disability worldwide and may cause acute, recurring or chronic pain [ 148 ]. Although more prevalent in older adults, younger individuals are also susceptible [ 149 , 150 ].…”

“…In OA, joint pathology is primarily attributed to the progressive degradation of articular cartilage and a local imbalance of pro-inflammatory and pro-resolving mediators [ 151 , 152 ]. The local release of pro-inflammatory cytokines, growth factors, and neurotransmitters increases nociception [ 148 ], and OA patients often report symptoms of neuropathic pain, such as burning, tingling and numbness [ 153 ].…”

The Effect of a Dispersible Palmitoylethanolamide (Levagen+) Compared to a Placebo for Reducing Joint Pain in an Adult Population – A Randomised, Double-Blind Study

“…Joint pain is a common yet complex condition experienced by people of any age to varying degrees [1][2][3][4], it is a leading contributor of disability worldwide [5] and significantly contributes to the global burden of disease [6]. Pain can be felt in any joint of the body and can arise for a variety of reasons including; arthritis, infection, autoimmune disease and trauma [4,5,7,8]. Joint pain is often accompanied by restricted mobility, therefore limiting daily activities and reducing quality of life [4].…”

“…Joint pain is often accompanied by restricted mobility, therefore limiting daily activities and reducing quality of life [4]. A commonality of all joint pain is the existence of inflammation due to the local release of proinflammatory cytokines [5,8,9]. First line therapy to combat joint pain is over-the-counter pain-relieving medications, including paracetamol, non-steroidal anti-inflammatories and opioids [10].…”