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Arthritis Diet and Exercises

Arthritis: Why does it hurt?

hi guys welcome back to the Hawkes Physiotherapy YouTube channel in today’s video we will discuss what causes the pain in
osteoarthritis the obvious cause of pain relates to the fact that the articular
Cartilage has no nerve supply so weight bearing on the surface of the joint is
pain free however bone has lots of nerve and blood
supply so when cartilage is gone then it will hurt this is obviously true but
pain in osteoarthritis starts before cartilage actually exposes any bone but
why more recent evidence points to the fact that it is far more complex
for example chondrocyte cell death and production of new tissue has been
observed in osteoarthritis in an attempt to regenerate itself and increase in
protein synthesis by the chondrocytes has been seen this osteochondral
angiogenesis derived from the expression of growth factors has been theorized as
to the cause of pain in osteoarthritis according to Girbes et al 2013 muscle
spasm is also a factor as muscle will go into protective spasm in response to the
pain from the osteoarthritis itself and this will add to the overall pain
experienced this is why evidence shows a reduction in overall pain levels when
you treat the muscle especially the trigger points according to Girbes et al 2013 neuroplastic changes with chronic pain can also occur which is
when the nervous system physically changes itself and actually create it’s
own pain signal irrespective of the origin of the pain this is most evident
in phantom limb pain as the origin of the pain was the foot or limb but
removal of this doesn’t actually get rid of the pain the nerve pain is
highlighted when you consider the medications that are most effective at
various times with osteoarthritis first non-steroidal anti-inflammatory drugs
work best but they eventually become ineffective leading to the use of
gabapentin and amitriptyline which are nerve pain relieving medications also if
pain was simply from the joint itself then you would expect that a joint
replacement would cure the pain and this doesn’t happen in reality although it
can help baert et al 2016 found that 20% of patients undergoing a total knee
replacement are dissatisfied post surgically and complain a persisting
pain functional disability and a poor quality of life so as suggested earlier
the pain must be relatively non structural and from altered pain signals
by the central nervous system anyway stay tuned for the next video on
arthritis which will be on what are the treatments we want to keep making great
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