Scientists Find Connection Between Osteoarthritis (OA) and Fibromyalgia
Scientists at the University of Manchester have discovered that the chronic pain which plagues osteoarthritis (OA) patients may be caused by abnormalities in how the brain interprets pain. This would suggest that therapies which target specific brain mechanisms (such as mindfulness-based talking therapies) would allow patients to cope with pain more efficiently.
Chronic pain is more common than many people realize– especially for people living with a condition like osteoarthritis. Widespread pain leaves patients increasingly disabled and makes routine function incredibly difficult. Normal daily routines and even sleep are constantly disrupted.
“The extent of pain experienced by sufferers of arthritis has always been thought to result from the direct consequences of joint destruction. However the extent of pain is often poorly related to the amount of damage and can spread to nearby regions of the body where there is no evidence of arthritic disease. We wanted to look at what might be causing this,” explained professor Anthony Jones, from The University of Manchester’s Human Pain Group.
“Currently it is not understood why patients with arthritis have such variability in how much pain they experience but, in spite of this, we continue to spend large sums of money using potentially damaging anti-inflammatory drugs.”
Is Osteoarthritis Chronic Pain Similar to Fibromyalgia Pain?
This research team wondered if the chronic pain suffered by many osteoarthritis patients was similar to the pain associated with fibromyalgia. Many aspects of this medical condition remain a mystery, but brain scans have shown that people with this syndrome process pain differently than the average person.
This prompted the Manchester team to study overlaps in how the brains of patients with osteoarthritis or fibromyalgia processed pain. They wanted to gain a better insight into why certain arthritis sufferer’s dealt with more pain than others.
(The results of this osteoarthritis clinical trial have been published in the European Journal of Neuroscience.)
Measuring the Brain’s Anticipation of Pain
The team measured brain waves responses as quick, painful laser pulses were applied to the skin of participants. The anticipation of the painful pulse caused an increase in activity within the insula cortex which predicted the intensity and extent of the pain felt by the participant.
“Increased activity in this brain area has been linked to a number of phenomena, including body perception and emotional processing, which might explain the greater pain perception in some patients,” explained Dr Christopher Brown, an associate in the Human Pain Research Group.
“Interestingly, responses during pain anticipation were reduced in an area at the front of the brain called the dorsolateral prefrontal cortex. These reduced responses corresponded to less ability to develop positive ways of coping with the pain in both groups of patients. We think that boosting activity either directly or indirectly in this area of the brain is likely to result in better coping and better control of pain responses in other areas of the brain.”
Shared Brain Mechanisms for OA and Fibro Patients
The results suggest that people with either one of these medical conditions share some of the same abnormalities when it comes to the way their brains anticipate pain. The Manchester team theorize that there are common brain mechanisms for both fibromyalgia and osteoarthritis.
More research will need to be conducted, but these early results are certainly telling. It would appear that allocating more resources towards developing a common therapeutic approach is warranted. Previous studies have shown that mindfulness-based talking therapies can alter the brain’s response to anticipated pain.
Additionally, targeted therapies that address these abnormal brain mechanisms instead of the conventional approach of targeting joint damage might be the next big advancement for OA medicine. It would certainly help reduce patients’ dependency on painkillers and anti-inflammatory medication.