Why do some people feel pain from osteoarthritis and others do not?

Mihaela B. Taylor, MD
Rheumatology
One reason why some people feel pain from osteoarthritis (OA) and others do not is because of the way in which the brain processes pain sensations. OA is a condition that damages cartilage and bone in a joint. But even if major damage can be seen on imaging tests, 30% to 50% of people will have no pain. That's because the brain has a checks-and-balances system that keeps pain localized to the area where it originates. Unfortunately, as OA worsens, the constant damage can cause the brain to lose its checks-and-balances system, and sensations of pain could spread.

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