Pain and OA

Pain is the most prevalent symptom among people with OA, and is the reason that most patients seek treatment.

• With progression of disease, pain can become persistent and night pain can disturb sleep.
• OA pain is experienced in varying severity by patients, and can wax and wane throughout the disease course.
• Some patients have minimal pain and can function almost normally, while others with a similar level of structural disease can experience severe pain and extensive disability.
• Sources of variability in the pain experience are currently poorly understood.

Pain is a complex interaction between noxious stimuli and peripheral and central nervous system responses. Psychosocial factors play a major role in mediating this interaction. ¹²

• Severity and character of the pain experience depends on individual’s unique social, cultural and personal state.
• Presence of pain impacts on mood, sleep and social participation.
• Fatigue, psychological distress and social context may augment the pain experience.
• People with poor self-efficacy and/or pain catastrophizing tend to experience greater pain and poorer clinical outcomes.
• Complexity of the pain experience may be why the effect of current treatments on OA pain is only modest at best.

_{(Adapted from Melzack, 1996)}¹²