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Osteoarthritis Pain Discovery, What It Could Mean and What To Do

Osteoarthritis Pain Discovery

For the estimated 27 million people in the United States and millions more around the world who have osteoarthritis, pain is a way of life. Scientists at Rush University Medical Center and Northwestern University appear to have come closer to understanding osteoarthritis pain with their discovery of the activity of certain molecules.

Osteoarthritis pain is a challenge to treat

Treatment of osteoarthritis continues to be a challenge to treat, even though it has been the subject of much research. The painful, often debilitating disease most often affects the knees, hands, and hips, and is a leading cause of disability.

The authors of one of the latest studies have identified specific molecules that appear to be critical for the development of the pain associated with the disease, and which is the source of much of the distress and dysfunction caused by osteoarthritis.

The culprit molecules, which were studied in animal models, are monocyte chemoattractant protein (MCP)-1 and its receptor, chemokine receptor 2 (CCR2). This study focused on osteoarthritis of the knee, which will affect about 50 percent of people in their lifetime.

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According to Dr. Anne-Marie Malfait, the study’s lead author and associate professor of biochemistry and of internal medicine at Rush, the study provided a “longitudinal ‘read-out’ of the development of OA [osteoarthritis] pain and pain-related behaviors.” Previous research has indicated that MCP-1/CCR2 are important players in the development of pain after injury to nerves.

Malfait’s team found that “increased expression of both MCP-1 and its receptor CCR2 may mediate increased pain signaling,” but that blocking the CCR2 receptor helped stop pain behavior in the mice. This discovery is “an important contribution to the field of osteoarthritis research,” according to Dr. Joshua Jacobs, professor and chairman of orthopedic surgery at Rush University Medical Center, and could lead to the development of new treatment options for the disease.

Treating osteoarthritis
Although the latest discovery concerning osteoarthritis may promote investigation into new treatments for the disease, individuals who suffer with the pain of the disease need effective choices now. Treatment options for osteoarthritis cover a range of conventional medications and alternative/complementary options, including lifestyle choices.

  • Commonly used oral medications to manage osteoarthritis pain include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen (available over-the-counter and by prescription), and COX-2 inhibitors. Narcotics also are available but are associated with a greater possibility of side effects than other drugs.
  • Cortisone injections may be given to relieve joint pain, as may injections of hyaluronic acid derivatives.
  • Omega-3 fatty acids have shown some positive effect in reducing inflammation in some studies
  • A 2010 study from Germany suggests that the sex hormones estrogen and testosterone may have a role in relieving osteoarthritis symptoms by regenerating cartilage.
  • Physical exercise is beneficial for people who have osteoarthritis, and tai chi is a form that has demonstrated a positive effect.
  • Another lifestyle choice is to maintain a healthy weight, as being overweight places excessive stress on the joints and makes the pain worse
  • Anti-inflammatory foods, such as celery, lemon, mustard, garlic, and onions should be part of a healthful diet
  • Application of cold packs can relieve muscle spasms while heat can relieve stiffness
  • Topical OTC creams, including those that contain aspirin-like ingredients, may provide some temporary relief by numbing the pain with a cool or hot sensation

Research of potential treatments for osteoarthritis is ongoing. In the meantime, however, patients must choose from the available treatment options to help them manage and cope with osteoarthritis pain.

Centers for Disease Control and Prevention
Global Burden of Osteoarthritis in the year 2000 (Symmons, Mathers, Pfleger, 2006)
Miller RE et al. CCR2 chemokine receptor signaling mediates pain in experimental osteoarthritis. Proceedings of the National Academy of Science USA 2012 Dec 11; 109(50): 20602-7
Rush University Medical Center

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