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Why can osteoarthritis be painless in its early stages?
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Osteoarthritis is often asymptomatic in its early stages because the condition involves the progressive deterioration of articular cartilage, a tissue that is naturally devoid of nerves.21
Because this cartilage lacks nerve endings, the initial structural changesāsuch as small cracks or variations in cartilage thicknessādo not immediately trigger pain signals. Pain typically develops only as the disease progresses, eventually leading to the erosion of the cartilage and the exposure of the underlying subchondral bone, which is sensitive. Once the protective cartilage wears away, the resulting bone-on-bone contact and associated joint inflammation become the primary sources of discomfort.231