Arthritis Research UK Centre for Epidemiology, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, The Stopford Building, Oxford Road, Manchester, M13 9PT, UK. terence.o'
NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK. terence.o'
Curr Osteoporos Rep. 2018 Oct;16(5):611-616. doi: 10.1007/s11914-018-0477-1.
Osteoarthritis (OA) is a major cause of pain and disability worldwide. There is, however, a relatively poor correlation between the severity of OA based on plain radiograph changes and symptoms. In this review, we consider the mechanisms of pain in OA.
It is now widely recognised that OA is a disease of the whole joint. Data from large observational studies which have used magnetic resonance imaging (MRI) suggest that pain in OA is associated with a number of structural factors including the presence of bone marrow lesions (BMLs) and also synovitis. There is evidence also of alterations in nerve processing and that both peripheral and central nerve sensitisation may contribute to pain in OA. Identification of the causes of pain in an individual patient may be of benefit in helping to better target with appropriate therapy to help reduce their symptoms and improve function.
骨关节炎(OA)是全世界引起疼痛和残疾的主要原因。然而,基于普通 X 光片变化和症状的 OA 严重程度之间相关性相对较差。在本次综述中,我们将探讨 OA 疼痛的发生机制。
现在人们普遍认识到 OA 是一种整个关节的疾病。使用磁共振成像(MRI)的大型观察性研究的数据表明,OA 疼痛与许多结构因素相关,包括骨髓病变(BML)的存在以及滑膜炎。也有证据表明神经处理的改变,外周和中枢神经致敏都可能导致 OA 疼痛。确定个体患者疼痛的原因可能有助于更好地针对适当的治疗,以帮助减轻其症状并改善功能。