Pain Centre Versus Arthritis

Lay Summaries

Investigating soluble epoxide hydrolase as a target for osteoarthritis pain

Research into the body’s natural anti-inflammation systems may highlight new drug targets for pain relief for people with osteoarthritis. Current treatments for osteoarthritis pain are often not good enough, and pain severely affects the lives of people with osteoarthritis. 

For further details, visit the summary page

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CAP-RA Study Protocol

Rheumatoid Arthritis (RA) is an autoimmune condition that mostly affects the joints and long-term pain, and fatigue are common problems. We believe the brain, spinal cord and nerves may make pain and fatigue worse by affecting the way the body feels pain - a process called central sensitization. 

Further information, including links to the article can be found on the summary page.


A review of the effectiveness of glucocorticosteroid treatments for painful rheumatoid arthritis

Pain is one of the main problems for people with active rheumatoid arthritis (RA), and glucocorticosteroids (GCs) are often used to treat this. The commonest GC is prednisolone, and others include dexamethasone, betamethasone and cortisone. GCs can be used to affect the whole body; which normally means taking a daily tablet, but can also be by intravenous infusion or injection into a muscle (these are known as systemic administration). It is currently believed that GCs relieve pain by reducing inflammation and joint swelling in people with RA. 

Find out more by checking out the summary.

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Joint pain, Arthritis and tendon problems. a man touching nee at pain point

New nerves growing through the bone and cartilage might be causing osteoarthritic knee pain

One of the enduring problems with osteoarthritis is that many people appear to have osteoarthritic changes in their joints but yet they don’t experience major amounts of pain making research targets difficult to identify.

For further information, and links to the article, please visit the summary page.


Does Osteoarthritis pose a risk of developing other long-term conditions?

Osteoarthritis is a long term joint problem, mostly prevalent among the elderly population. However,  any association of osteoarthritis with other long-term conditions has not been  studied in detail. 

To learn more about this study, please visit the summary page.

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Example of an image from the STORM tool

STORM - A new tool for scientists to study the physical changes underlying the development of long-lasting pain

The development of long-lasting pain involves changes in the strength of connections between the nerve cells that conduct sensory information from the body to the brain. One of the key goals in pain research is to identify how and when these connections are altered, in order to find ways to prevent or reverse this process and thus provide pain relief. A key site where this occurs is the spinal cord, where incoming information from the nerve fibres in the body are received by spinal nerve cells to encode the location and strength of a painful stimulus, before sending it on to the brain. 

To learn more about this, please visit the full summary


How do people with osteoarthritis or low back pain balance benefits and risks when choosing which medications to use for their pain

Anti-inflammatory tablets (such as ibuprofen) and opioids (such as codeine) are often used to treat the chronic pain of osteoarthritis or low back pain. However, pain relief might not outweigh the risk of side effects from such treatments.

Further details are available on the summary

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Ibuprofen gel or capsaicin cream, which one shall I use to treat my knee osteoarthritis pain?

Ibuprofen gel and capsaicin cream are two commonly used treatments for painful osteoarthritis of the knee. Based on previous studies involving hundreds of people, we know that they provide similar levels of pain relief on average. But does that mean that each person that tries the two treatments finds that they give the same amount of pain relief? Our clinical experience would suggest that it does not, however, no studies had tested this before. 

For further details, visit the summary page


Osteoarthritic knees are more prone to damage following painful inflammatory flares

The topmost concern of people with osteoarthritis (OA) is a reduction in joint pain but the mechanisms of OA pain are complex. People with OA experience “flares” of joint pain. Joint inflammation contributes to OA pain.  We show that OA joints are more sensitive to damage following painful inflammatory flares and the joint damage persists even after the resolution of joint pain. Preventing inflammatory flares may be particularly important in preventing symptoms and long-term joint damage in OA. 

For further information, please visit the article

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Creating a tool to improve osteoarthritis knee pain treatment

Key characteristics such as depression, have been suggested to act through the central nervous system to increase knee pain in osteoarthritis (OA).

This study found that in individuals with knee pain, higher scores for 8 different characteristics are linked to processes occurring within the central nervous system, called ‘central mechanisms’.

This research is important because using a simple questionnaire which addresses these 8 characteristics might allow clinicians to identify and effectively target treatment towards central mechanisms, thereby improving knee pain treatment in individuals.

For further information, please visit the publication



People with RA can be divided into subgroups, based upon their pain levels and inflammation.

This study challenged a popular viewpoint, that the inflammation in rheumatoid arthritis (RA) is fully responsible for the symptoms that are experienced.

This study implies that the troublesome symptoms of RA may not be wholly explained by inflammation. It is possible that people with RA might gain added benefits from pain management strategies.

Please visit the published article for further insite into this study.

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Erosive and osteoarthritic structural progression in early rheumatoid arthritis

It appears that osteoarthritis may be common in the hands and feet of people who have newly diagnosed rheumatoid arthritis.

Studying X-rays shows that both rheumatoid arthritis and osteoarthritis progress over the course of 3 years.

We found that people whose rheumatoid arthritis was slightly more “inflammatory” had worse erosions; and those people whose rheumatoid arthritis was more painful had less severe erosions. Further information


Identifying different groups of people with knee osteoarthritis

Different people with knee osteoarthritis (OA) often have different symptoms and joint structural changes and also respond differently to treatment.

We show that patients with OA can be classified into 3 groups based on differences in changes in the joint.

Subgrouping people with OA may allow for more effective personalised treatments to reduce pain and slow down disease progression. Further information

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Biological markers of bone breakdown predict pain and pain change in osteoarthritis

Changes within the bone are associated with the development of OA as well as knee pain.

Cells that are responsible for breaking down bone, release biological factors to help with this breakdown.

The amount of these cells and related factors were found to be higher in people with painful OA. Further information 


Improving methods to combine and summarise brain imaging studies

Functional brain imaging uses magnetic resonance imaging (MRI) to tell us about brain activity, for example during pain.

The ways of combining and summarizing results from previously published functional imaging studies can now be improved to help to analyse the results with greater certainty; this analysis is called coordinate based meta-analysis.  Further information



Surgical procedures may contribute to nerve damage and pain in knee osteoarthritis

Causes of pain from osteoarthritis are diverse and poorly understood.

Symptoms which are similar to pain from nerve damage such as burning pain or numbness, are common among patients with severe knee osteoarthritis.

Although these symptoms may be caused by osteoarthritis, in some patients such pain may arise from nerves damaged during surgery to repair the knee.  Further information


A study of the experience of living with knee osteoarthritis

Knee osteoarthritis is one of the most common types of arthritis, causing pain, disability as well as emotional distress.

However, there is limited research on the daily experience of living with knee osteoarthritis.

Understanding people's beliefs and how they can affect the outcome of treatment recommendations, should help healthcare professionals to provide information and education that will assist people in managing osteoarthritis.

Further details relating to this publication and the article are available here.  


Osteoarthritic knees are more sensitive to painful actions of nerve growth factor

Inflammation is known to be a key contributor to osteoarthritic joint pain.

Nerve growth factor (NGF), a naturally occurring molecule in our body, is essential for the maintenance and development of nerves, but NGF levels also increase in many painful conditions, especially those associated with inflammation.

Sensitivity to NGF is increased in osteoarthritic knees and treatments that reduce this sensitivity, have the potential to improve osteoarthritic pain.  Further information


Early treatment of bone breakdown inhibits the onset of pain and joint damage in osteoarthritis

It is not understood why osteoarthritis causes pain which, for many people, can be one of the most debilitating symptoms.

During the early stages of osteoarthritis, cells called osteoclasts break down bone in the joint.

Preventing the activity of these osteoclasts decreases pain and joint damage later in the disease, suggesting that bone is important in the generation of arthritis pain.  Further information


Risk factors for painful rheumatoid arthritis

Medication can often control inflammation in rheumatoid arthritis (RA), but the effects on pain are less certain.

By looking at the Early Rheumatoid Arthritis Network (ERAN) cohort study, it was possible to estimate which people were prone to experience more pain and feel worse at diagnosis.

This information will help further research into the causes of rheumatoid arthritis pain.  Further information


Measuring intermittent and constant osteoarthritis knee pain

Many pain questionnaires measure overall pain experienced by people.

Such tools may, however, fail to detect differences in the type of pain experienced.

A questionnaire that measures intermittent and constant pain is found to be an accurate measure of pain in people with knee osteoarthritis.  Further information 





In search of better tools to measure pain in people with osteoarthritis

More accurate tests are needed to explain why pain affects people differently.

Quantitative Sensory Testing (QST) is found to be good at detecting pain disorders in people with osteoarthritis.

Finding good techniques such as QST is important because it helps us understand different patterns of pain and match treatments to patients.  Further information


Work disability and State benefit claims in early rheumatoid arthritis; the ERAN cohort

Work disability and benefit claims are common in people with newly diagnosed rheumatoid arthritis with pain being a major factor in predicting their future job loss. 

Paying more attention to work disability during the initial assessment of people with rheumatoid arthritis could lead to interventions that reduce its impact in later disease.

Considering factors such as pain, vitality and reported disability has the potential to reduce subsequent work disability in people presenting with early rheumatoid arthritis. Further information 




Pain Centre Versus Arthritis

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