Osteosarcopenia and Pain: Do We Have a Way Out?

Abstract

Osteosarcopenia (OSP) is a geriatric syndrome characterized by the coexistence of osteoporosis and sarcopenia and associated with an increased risk of fragility fractures, disability, and mortality. For patients with this syndrome, musculoskeletal pain represents the most significant challenge since, in addition to limiting the individual’s functionality and promoting disability, it has a huge psychological burden involving anxiety, depression, and social withdrawal. Unfortunately, the molecular mechanisms involved in the development and persistence of pain in OSP have not yet been fully elucidated, although immune cells are known to play a key role in these processes. Indeed, they release several molecules that promote persistent inflammation and nociceptive stimulation, resulting in the gating of ion channels responsible for the generation and propagation of the noxious stimulus. The adoption of countermeasures to counteract the OSP progression and reduce the algic component appears to be necessary, providing patients with a better quality of life and greater adherence to treatment. In addition, the development of multimodal therapies, based on an interdisciplinary approach, appears to be crucial, combining the use of anti-osteoporotic drugs with an educational programme, regular physical activity, and proper nutrition to eliminate risk factors. Based on this evidence, we conducted a narrative review using the PubMed and Google Scholar search engines to summarize the current knowledge on the molecular mechanisms involved in the pain development in OSP and the potential countermeasures to be taken. The lack of studies addressing this topic highlights the need to conduct new research into the resolution of an ever-expanding social problem.

The Role of Marine n-3 Polyunsaturated Fatty Acids in Inflammatory-Based Disease: The Case of Rheumatoid Arthritis

“…As the disease develops, the cells of the synovial lining proliferate, forming an invasive pannus together with new blood vessels, which leads to the progressive destruction of cartilage and bone [72]. This condition can lead to a multifactorial syndrome named osteosarcopenia, which is characterized by muscle wasting and an increased risk of osteoporosis [73]. Synovial B cells are mainly localized in T-cell-B-cell aggregates, and their activation is endorsed by the expression of factors, including a proliferation-inducing ligand (APRIL), B-lymphocyte stimulator (BLyS) and CC and CXC chemokines [74].…”

Metallosis after Hip Arthroplasty Damages Skeletal Muscle: A Case Report

“…In such a context, the musculoskeletal tissue may be drastically affected by an aberrant concentration of metal ions and experience muscle atrophy and increased fat infiltration [4]. The deterioration of skeletal muscle tissue caused by metallosis due to arthroplasty surgery may accelerate the muscle mass loss that is generally observed in geriatric patients [10,11]. Indeed, generalized loss of muscle mass, strength, and function, a condition described as sarcopenia, is one of the main complications encountered in elderly patients undergoing orthopedic surgery [12].…”

Musculoskeletal Diseases: From Molecular Basis to Therapy

“…Interestingly, pain is significantly associated with osteoporosis and sarcopenia. Bonanni et al conducted a narrative review with the aim of summarizing the current knowledge on the molecular mechanisms involved in the pain development in osteosarcopenia and the potential countermeasures to be taken [3]. Today, there is no specific therapy for osteosarcopenia as well as for associated pain.…”

“…Today, there is no specific therapy for osteosarcopenia as well as for associated pain. Thus, the review highlighted the importance of developing strategies and therapies to counteract musculoskeletal pain in these patients other than preserving musculoskeletal structure/function and slowing down the progression of the syndrome [3].…”