Neurogenic influences in arthritis.

Pain is a pivotal symptom faced by patients with rheumatic disease. Nevertheless, mechanisms of articular pain remain unclear and there is little correlation between pain, disability, and radiological change. ' Although a protective function for the pain sensory system has long been assumed, Wall and others have suggested that the system may also function to modify local responses to tissue trauma.23 In this review we describe the anatomy and physiology of articular nerves and speculate on how neurogenic mechanisms may play an important part in joint homeostasis in both health and disease.