Osteoarthritis pain has multiple sources

In osteoarthritis, pain can arise from various tissues within the joint and sometimes from nerve sensitivity, not just from worn cartilage. A radiographic finding, such as an X-ray, does not always correlate with the intensity of pain a person experiences.

Osteoarthritis is more than worn cartilage

Osteoarthritis is often described as a condition of "worn cartilage," but this explanation is overly simplified. Healthy articular cartilage does not have nerve endings that can transmit pain signals directly. However, this does not mean the pain is not real or imagined; rather, it indicates that the disease affects the entire joint, including the cartilage, synovial membrane, and subchondral bone.

Nervous structures around the joint contribute to pain

Dr. Victoria Tchaikovski, a sports physician, highlighted that several structures around the cartilage are innervated, including the synovium, subchondral bone, capsule, ligaments, periosteum, and certain parts of the meniscus. These tissues can become stressed, inflamed, or remodeled in an arthritic joint, which can activate nerve endings and contribute to pain.

Chemical changes in the joint also play a role

The chemical environment within the joint changes in osteoarthritis, with the release of inflammatory mediators and molecules such as NGF, which can influence nerve function and contribute to the sensation of pain. These factors add complexity to the understanding of how osteoarthritis causes discomfort.