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Autonomic Nervous System Dysregulation and Osteoarthritis Pain: Mechanisms, Measurement, and Future Outlook

  • Osteoarthritis (M Goldring and T Griffin, Section Editors)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The autonomic nervous system is an important regulator of stress responses and exhibits functional changes in chronic pain states. This review discusses potential overlap among autonomic dysregulation, osteoarthritis (OA) progression, and chronic pain. From this foundation, we then discuss preclinical to clinical research opportunities to close gaps in our knowledge of autonomic dysregulation and OA. Finally, we consider the potential to generate new therapies for OA pain via modulation of the autonomic nervous system.

Recent Findings

Recent reviews provide a framework for the autonomic nervous system in OA progression; however, research is still limited on the topic. In other chronic pain states, functional overlaps between the central autonomic network and pain processing centers in the brain suggest relationships between concomitant dysregulation of the two systems. Non-pharmacological therapeutics, such as vagus nerve stimulation, mindfulness-based meditation, and exercise, have shown promise in alleviating painful symptoms of joint diseases, and these interventions may be partially mediated through the autonomic nervous system.

Summary

The autonomic nervous system appears to be dysregulated in OA progression, and further research on rebalancing autonomic function may lead to novel therapeutic strategies for treating OA pain.

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Funding

Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Number R01AR071431, R01AR071431S01, R01AR071431S02, and F31 AR077996. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. J. Crayton Pruitt Family Department of Biomedical Engineering, Biomedical Sciences Building, University of Florida, 1275 Center Drive, Gainesville, FL, 32610, USA

    Taylor D. Yeater, Carlos J. Cruz & Kyle D. Allen

  2. Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, FL, USA

    Taylor D. Yeater, Carlos J. Cruz, Yenisel Cruz-Almeida & Kyle D. Allen

  3. Department of Community Dentistry & Behavioral Sciences, University of Florida, Gainesville, FL, USA

    Yenisel Cruz-Almeida

  4. Department of Neuroscience, University of Florida, Gainesville, FL, USA

    Yenisel Cruz-Almeida

  5. Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, USA

    Kyle D. Allen

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  1. Taylor D. Yeater
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Correspondence to Kyle D. Allen.

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Yeater, T.D., Cruz, C.J., Cruz-Almeida, Y. et al. Autonomic Nervous System Dysregulation and Osteoarthritis Pain: Mechanisms, Measurement, and Future Outlook. Curr Rheumatol Rep 24, 175–183 (2022). https://doi.org/10.1007/s11926-022-01071-9

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