Emily J Bartley1, Shreela Palit2, Roland Staud3. 1. Department of Community Dentistry and Behavioral Science, Pain Research & Intervention Center of Excellence, University of Florida, 1395 Center Drive, Room D2-13, PO Box 100404, Gainesville, FL, 32610, USA. EBartley@dental.ufl.edu. 2. The University of Tulsa, Department of Psychology, 800 South Tucker Drive, Tulsa, OK, 74104, USA. 3. College of Medicine, Pain Research & Intervention Center of Excellence, University of Florida, PO Box 100221, Gainesville, FL, 32610, USA.
Abstract
PURPOSE OF REVIEW: Osteoarthritis (OA) is one of the most common and disabling forms of arthritis worldwide, with joint pain being a primary symptom. Given that clinical symptoms often show poor concordance with tissue damage in OA, processes other than joint remodeling likely play a role in the condition. Using the biopsychosocial model of pain as a guiding framework, the purpose of this review is to highlight the extra-articular mechanisms that contribute to pain and dysfunction in OA, with a specific focus on resilience. RECENT FINDINGS: Whereas previous research has mostly focused on risk factors for worsening of OA pain, recently emerging evidence places greater emphasis on the identification of protective mechanisms that enhance pain adaptation and palliate the negative effects of joint pain. In view of this new and important research, more emphasis should be placed on endogenous pain modulation and, in particular, pain attenuation. The result of such work could serve as a basis for optimizing treatment in the OA population.
PURPOSE OF REVIEW: Osteoarthritis (OA) is one of the most common and disabling forms of arthritis worldwide, with joint pain being a primary symptom. Given that clinical symptoms often show poor concordance with tissue damage in OA, processes other than joint remodeling likely play a role in the condition. Using the biopsychosocial model of pain as a guiding framework, the purpose of this review is to highlight the extra-articular mechanisms that contribute to pain and dysfunction in OA, with a specific focus on resilience. RECENT FINDINGS: Whereas previous research has mostly focused on risk factors for worsening of OA pain, recently emerging evidence places greater emphasis on the identification of protective mechanisms that enhance pain adaptation and palliate the negative effects of joint pain. In view of this new and important research, more emphasis should be placed on endogenous pain modulation and, in particular, pain attenuation. The result of such work could serve as a basis for optimizing treatment in the OA population.
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