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Pain is the most common reason that patients present to their doctor, yet how and where it arises in the joint remains unexplained. Some patients have chronic pain which is extremely debilitating and difficult to manage.

To date, our work in the Centre has revealed some interesting and unexpected results. For example, we have found that molecules that stimulate pain in the joint are actually made by the damaged cartilage itself, rather than the bone or lining layer (synovium) of the joint, as has been suggested in the past. This radically changes the currently held theory and forces us to think about pain generation and targeting in a different way.

The studies that are being done to understand the contribution of the central nervous system to how a patient experiences pain have helped us appreciate why some patients have very debilitating pain and others are more able to manage their pain. Identifying different sub-groups of patients will lead to tailor-made pain management strategies in clinic.

Working within the Oxford Musculoskeletal Pain Forum offers advantages in that it contains a mixture of those working on pre-clinical models as well as with patients and human tissues. Many members are clinically trained (orthopaedics, rheumatology, neurology) and clinical translation is the central unifying goal.

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