Knee Joint Neural Sources and Pathways and Their Osteoarthritis Pathogenic Linkages and Pain Control Implications

Abstract

Background: Knee joint osteoarthritis, a widespread disabling disease with no known cause continues to produce considerable bouts of intractable pain and disability as a result of multiple disease associated health problems despite years of research. Aim: This paper examines if there is sufficient reason to believe one or more neural based abnormalities in the knee neural network may be involved or implicated in inducing and perpetuating at least some forms of knee joint osteoarthritis, but is often unrecognized and thus untreated or ignored. Methods: Peer reviewed data retrieved from several sources were examined to highlight and discuss the structural and functional nature of the knee joint nerves and their ramifications in various knee joint tissues, the spinal cord and central nervous system and motor control pathways. Results: Knee joint nerve pathways that are damaged or functioning abnormally can affect normal joint biomechanics, plus joint stability and thereby can influence the onset or perpetuation of knee joint pathology and exaggerated activation of pain fibers and cognitions. Conclusion: To improve the effectiveness of strategies designed to avert knee joint osteoarthritis pain and disability, attention to its possible ongoing neuropathology as well as possible declines in joint protective, perceptual and stability mechanisms in older vulnerable adults are indicated.