Pain sensitivity and pain reactivity in osteoarthritis

Arthritis Care Res (Hoboken). 2011 Mar;63(3):320-7. doi: 10.1002/acr.20373. Epub 2010 Oct 18.


Objective: To assess experimental pain sensitivity and compare the inflammatory response to pain in 26 osteoarthritis (OA) patients and 33 age- and sex-matched controls from the general population in order to examine the nature of the association between pain and inflammation in OA.

Methods: The participants underwent psychophysical pain testing to assess pain sensitivity in response to heat, cold, and mechanical stimuli. Blood samples were taken at baseline and at 4 time points after testing to determine the effect of acute pain on C-reactive protein (CRP), interleukin-6 (IL-6), IL-1β, and tumor necrosis factor α levels.

Results: OA patients had lower pressure pain thresholds (P ≤ 0.003) and higher heat pain ratings (P ≤ 0.04) than controls across multiple body sites. OA patients had higher CRP levels than controls (P = 0.007). CRP levels did not change in response to pain testing. Although not statistically significant, OA patients tended to have higher IL-6 levels than controls (P = 0.12). IL-6 levels increased after pain testing in OA patients and controls (P < 0.0001), but the amount of increase was not different between the 2 groups. Among OA patients, heightened pain sensitivity was associated with elevated CRP and IL-6 levels (P ≤ 0.05).

Conclusion: Compared with controls, OA patients are more sensitive to experimental pain at multiple body sites. IL-6 levels in OA patients and controls exhibited reactivity to acute painful stimuli, increasing at similar rates after psychophysical pain testing.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arthralgia / diagnosis
  • Arthralgia / etiology*
  • Arthralgia / immunology
  • Arthralgia / physiopathology
  • C-Reactive Protein / metabolism
  • Case-Control Studies
  • Cold Temperature
  • Cross-Sectional Studies
  • Female
  • Hot Temperature
  • Humans
  • Inflammation Mediators / blood
  • Interleukin-1beta / blood
  • Interleukin-6 / blood
  • Linear Models
  • Male
  • Middle Aged
  • Osteoarthritis / complications*
  • Osteoarthritis / diagnosis
  • Osteoarthritis / immunology
  • Osteoarthritis / physiopathology
  • Pain Measurement
  • Pain Threshold*
  • Physical Stimulation
  • Time Factors
  • Tumor Necrosis Factor-alpha / blood


  • IL6 protein, human
  • Inflammation Mediators
  • Interleukin-1beta
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein