In many studies of osteoarthritis treatment, there is an improvement in pain relief when a dummy ‘placebo’ treatment is compared to no treatment at all, but there is very little extra improvement when the real treatment is compared to placebo. This response to placebo varies greatly from patient to patient. Identifying the characteristics of a person whom will best respond to placebo treatment, along with the factors that will predict a beneficial placebo response, will help design future pain relief studies. Further information
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
The Arthritis Research UK Pain Centre was launched in 2010, following an award of £5.5 million from Arthritis Research UK, the University of Nottingham and Nottingham University Hospitals NHS Trust. It has now been successful in gaining a further £2 million from Arthritis Research UK to support the unique research activities to combat the pain of arthritis. Further information
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
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
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 information
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
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
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
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
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 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
One of the challenges is osteoarthritis (OA) is trying to understand the cause of pain, how it originates and the mechanisms involved in its progression. OA affects not only the cartilage, but also other tissues within the joint including bone. Changes within the bone are key to the development of OA whilst also linked to knee pain. Osteoclasts are cells responsible for the breakdown of bone and in OA, the activity of osteoclasts are increased. Osteoclasts release biological molecules, cathepsin K and TRAcp5b which aid in bone breakdown. Further information
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