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Pain Is Not A Symptom Of Osteoarthritis, Pain Causes Osteoarthritis

Discussion in 'General Issues and Discussion Forum' started by NewsBot, Sep 29, 2008.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1

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    Science Daily are reporting:
    Pain Is Not A Symptom Of Arthritis, Pain Causes Arthritis, Study Shows
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    Link to story
     
  2. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Spinal interleukin-1 in a mouse model of arthritis and joint pain
    Paolo M. Fiorentino, Ross H. Tallents, Jen-Nie H. Miller, Sabine M. Brouxhon, M. Kerry O'Banion, J. Edward Puzas, Stephanos Kyrkanides
    Arthritis & Rheumatism; Volume 58, Issue 10, Date: October 2008, Pages: 3100-3109
     
  3. Admin2

    Admin2 Administrator Staff Member

  4. pgcarter

    pgcarter Well-Known Member

    Not surprising really, even my very superficial 12 months dabbling in the field showed that our current understanding of OA is not very comprehensive. I am sure that 100 yrs down the track what we call OA will be a number of different conditions triggered and mediated in a variety of ways.
    regards Phill
     
  5. drsarbes

    drsarbes Well-Known Member

    This study must have been headed up by Dr. Obvious!!
     
  6. Bruce Williams

    Bruce Williams Well-Known Member

    "Our study results confirm that joints can export inflammation in the form of higher IL-1β along sensory nerve pathways to the spinal cord, and that higher IL-1β inflammation in the spinal cord is sufficient in itself to create osteoarthritis in peripheral joints," Kyrkanides said. "We believe this to be a vitally important process contributing to orthopaedic and neurological diseases in which inflammation is a factor."

    Maybe I"m not getting this right, but I think their conclusion is crap.

    We are supposed to belive that inflammation travels along the spinal cord to then "infect" perfipheral joints with inflammation / arthritis?

    Lack of motion in a joint, or improper motion of a joint causes arthritis / arthrosis and pain / inflammation. I find it hard to reason it any other way.

    I have no problem with the notion " you don't limp because you hurt, you hurt becase you limp."
    i just feel they are missing a step or two in why these findings are important.


    Bruce
     
    Last edited: Oct 2, 2008
  7. David Wedemeyer

    David Wedemeyer Well-Known Member

    I feel that they are being indiscriminant and imprecise in their terminology of this study.

    OA is not classified as an inflammatory arthritide as is RA, therefore it is not a truly rheumatic cause of the bony changes associated with the inflammatory arthritides. I also feel that terms such as degenerative 'arthritis' also need to be updated. There are often degenerative changes in OA without inflammation and symptoms whereas in the inflammatory arthritic conditons this is a hallmark feature of an acute complaint.

    I may be wrong but I think that what they were trying to prove is that in OA that through the inflammatory cascade, PGE, archadonic acid, cytokines that bony changes can be initiated in in the glia in response to this tissue level inflammatory component?

    I see this frequently in sprain acceleration/deceleration patients from motor vehicle accident trauma. Local inflammation as described above initiates a cellular 'glue' that limits ROM and function to protect the injured spinal joints. This matrix is much like a scab on the dermis from a deep cut; less tensile strength, less flexibility, more prone to re-injury and more highly innervated = sensitive and often painful.

    I have reviewed numerous films of patients who either had no physical medicine treatment following such an even or events or have had multiple traumatic events (rugby players come to mind) and many have long-term bony changes but no inflammation. Hmm.
     
  8. Bruce Williams

    Bruce Williams Well-Known Member

    David;

    does this not still potentially come back to the thought that if you start limping due to arthritis, or arthrosis of a foot joint, that over time you can alter your gait adn thereby cause back or hip or knee pain???

    Bruce
     
  9. David Wedemeyer

    David Wedemeyer Well-Known Member

    I absolutely agree Bruce, we've all witnessed this in practice. I think we would also agree that via the current theory of DJD that altered joint function causes bony changes.

    It appears that what these authors are saying is that pain is the catalyst that precludes degenerative changes, although we believe currently that those changes produce the pain of OA and not the other way around?

    Does nociception have a role in initiating degenerative changes via the inflammatory cascade?

    Very chicken vs. egg
     
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