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Osteoarthritis: an exemplar of why hurt doesn’t mean harm

Posted by Nicholas Dang on
Osteoarthritis: an exemplar of why hurt doesn’t mean harm

One of the most pervasive misconceptions in health is that pain means injury or damage.

The truth is that pain is poorly correlated with damage (hurt doesn’t always mean harm).

Not convinced?

What could explain the following research on knee pain and osteoarthritis (OA)?

  • Many people have knee OA on imaging but no symptoms: 4‒14% of asymptomatic adults <40 years and 19‒43% of asymptomatic adults ≥40 years have knee OA on MRI.1
  • People with low pain can have more severe OA on X-ray, while people with high pain can have less severe OA on X-ray.2
  • People with OA can improve pain and function by exercising more.3
  • OA is more common in non-runners (10.2% have hip or knee OA) than recreational runners (3.5% have hip or knee OA).4

Tissue changes – such as osteoarthritis – can be one of numerous factors contributing to pain, but there’s always more to pain than what you see on a scan.

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References:

  1. Culvenor et al. (2019) (PMID: 29886437)
  2. Finan et al. (2013) (PMID: 22961435)
  3. Fransen et al. (2015) (PMID: 26405113)
  4. Alentorn-Geli et al. (2017) (PMID: 28504066)
  5. Image source: https://commons.m.wikimedia.org/wiki/File:Knee_Osteoarthritis.svg

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