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Review
. 2022 Jun;24(6):175-183.
doi: 10.1007/s11926-022-01071-9. Epub 2022 Apr 14.

Autonomic Nervous System Dysregulation and Osteoarthritis Pain: Mechanisms, Measurement, and Future Outlook

Taylor D Yeater  1   2 , Carlos J Cruz  1   2 , Yenisel Cruz-Almeida  2   3   4 , Kyle D Allen  5   6   7
Affiliations
Review

Autonomic Nervous System Dysregulation and Osteoarthritis Pain: Mechanisms, Measurement, and Future Outlook

Taylor D Yeater et al. Curr Rheumatol Rep. 2022 Jun.

Abstract

Purpose of review: The autonomic nervous system is an important regulator of stress responses and exhibits functional changes in chronic pain states. This review discusses potential overlap among autonomic dysregulation, osteoarthritis (OA) progression, and chronic pain. From this foundation, we then discuss preclinical to clinical research opportunities to close gaps in our knowledge of autonomic dysregulation and OA. Finally, we consider the potential to generate new therapies for OA pain via modulation of the autonomic nervous system.

Recent findings: Recent reviews provide a framework for the autonomic nervous system in OA progression; however, research is still limited on the topic. In other chronic pain states, functional overlaps between the central autonomic network and pain processing centers in the brain suggest relationships between concomitant dysregulation of the two systems. Non-pharmacological therapeutics, such as vagus nerve stimulation, mindfulness-based meditation, and exercise, have shown promise in alleviating painful symptoms of joint diseases, and these interventions may be partially mediated through the autonomic nervous system. The autonomic nervous system appears to be dysregulated in OA progression, and further research on rebalancing autonomic function may lead to novel therapeutic strategies for treating OA pain.

Keywords: Autonomic nervous system; Neuro-immune axis; Osteoarthritis; Pain.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:
Crosstalk between the brain, joint, and autonomic nervous systems.
See this image and copyright information in PMC

References

    1. WHO Department of Health Statistics and Information Systems (2013) World Health Organization methods and data sources for global burden of disease estimates 2000–2011. Geneva
    1. Loeser RF, Goldring SR, Scanzello CR, Goldring MB (2012) Osteoarthritis: A disease of the joint as an organ. Arthritis and Rheumatism 64:1697–1707 - PMC - PubMed
    1. Finan PH, Buenaver LF, Bounds SC, Hussain S, Park RJ, Haque UJ, Campbell CM, Haythornthwaite JA, Edwards RR, Smith MT (2013) Discordance between pain and radiographic severity in knee osteoarthritis: Findings from quantitative sensory testing of central sensitization. Arthritis & Rheumatism 65:363–372 - PMC - PubMed
    1. Bannuru RR, Osani MC, Vaysbrot EE, et al. (2019) OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis and Cartilage 27:1578–1589 - PubMed
    1. Pre-Competitive Consortium for Osteoarthritis of the Osteoarthritis Research International (2016) Osteoarthritis: A Serious Disease, Submitted to the U.S. Food and Drug Administration.

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