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Review
. 2025 Jul;43(7):1217-1229.
doi: 10.1002/jor.26082. Epub 2025 Apr 9.

Pain Assessment in Osteoarthritis: Present Practices and Future Prospects Including the Use of Biomarkers and Wearable Technologies, and AI-Driven Personalized Medicine

Affiliations
Review

Pain Assessment in Osteoarthritis: Present Practices and Future Prospects Including the Use of Biomarkers and Wearable Technologies, and AI-Driven Personalized Medicine

Shujaa T Khan et al. J Orthop Res. 2025 Jul.

Abstract

Osteoarthritis (OA) is a highly prevalent chronic joint disorder affecting ~600 million individuals worldwide and is characterized by complex pain mechanisms that significantly impair patient quality of life. Challenges exist in accurately assessing and measuring pain in OA due to variations in pain perception among individuals and the heterogeneous nature of the disease. Conventional pain assessment methods, such as patient-reported outcome measures and clinical evaluations, often fail to fully capture the heterogeneity of pain experiences among individuals with OA. This review will summarize and evaluate current methods of pain assessment in OA and highlight future directions for standardized pain assessment. We discuss the role of animal models in enhancing our understanding of OA pain pathophysiology and highlight the necessity of translational research to advance pain assessment strategies. Key challenges explored include identifying phenotypes of pain susceptibility, integrating biomarkers into clinical practice, and adopting personalized pain management approaches through the incorporation of multi-modal data and multilevel analysis. We underscore the imperative for continued innovation in pain assessment and management to improve outcomes for patients with OA.

Keywords: AI; assessment; biomarkers; clinical; osteoarthritis; pain; review.

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Conflict of interest statement

Eric T. Ricchetti discloses his involvement with AAOS, the American Board of Orthopaedic Surgery, and the American Shoulder and Elbow Surgeons as a board or committee member; Enovis as a recipient of IP royalties, a paid consultant, and a paid presenter or speaker; and the Journal of Shoulder and Elbow Surgery as part of the editorial or governing board. Nicolas S. Piuzzi discloses his roles with the American Association of Hip and Knee Surgeons, ISCT, and the Orthopaedic Research Society as a board or committee member; the Journal of Hip Surgery and Journal of Knee Surgery as part of the editorial or governing board; and research support from Osteal Therapeutics, Peptilogics, RegenLab, Signature Orthopaedics, and Zimmer. Additionally, he is a paid consultant for Pacira and Stryker. The other authors declare no conflicts of interest.

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