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

Author: Taylor D Yeater1,2, Carlos J Cruz1,2, Yenisel Cruz-Almeida2,3,4, Kyle D Allen5,6,7
Affiliation: <sup>1</sup> J. Crayton Pruitt Family Department of Biomedical Engineering, Biomedical Sciences Building, University of Florida, 1275 Center Drive, Gainesville, FL, 32610, USA. <sup>2</sup> Pain Research &amp; Intervention Center of Excellence, University of Florida, Gainesville, FL, USA. <sup>3</sup> Department of Community Dentistry &amp; Behavioral Sciences, University of Florida, Gainesville, FL, USA. <sup>4</sup> Department of Neuroscience, University of Florida, Gainesville, FL, USA. <sup>5</sup> J. Crayton Pruitt Family Department of Biomedical Engineering, Biomedical Sciences Building, University of Florida, 1275 Center Drive, Gainesville, FL, 32610, USA. kyle.allen@bme.ufl.edu. <sup>6</sup> Pain Research &amp; Intervention Center of Excellence, University of Florida, Gainesville, FL, USA. kyle.allen@bme.ufl.edu. <sup>7</sup> Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL, USA. kyle.allen@bme.ufl.edu.
Conference/Journal: Curr Rheumatol Rep
Date published: 2022 Apr 14
Other: Special Notes: doi: 10.1007/s11926-022-01071-9. , Word Count: 203


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. 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.

Keywords: Autonomic nervous system; Neuro-immune axis; Osteoarthritis; Pain.

PMID: 35420372 DOI: 10.1007/s11926-022-01071-9