Voluntary wheel running provides pain relief but transiently exacerbates gait impairments in male and female mice with unilateral osteoarthritis

Abstract Objective Physical activity is a first-line therapeutic intervention for managing osteoarthritis-related pain and functional impairment. However, the growing literature questions the long-term relevance of exercise-induced improvements in patients, while pre-clinical research evidence base is limited by reliance on stressful, forced exercise paradigms which do not reflect voluntary engagement. Here, we aimed to investigate the effects of voluntary wheel running on the pain experience in mice with joint pain. Design We investigated the impact of free access to a running wheel on sensory, functional and affective outcomes following unilateral intra-articular injection of monoiodoacetate in single-housed male and female C57Bl/6J mice. Results Monoiodoacetate injection transiently reduced running activity in both sexes; however, females rapidly resumed and sustained high activity levels over a two-month period, while males showed a progressive decline in running distance. Active males and females showed improvements in the monoiodoacetate-induced hindpaw secondary mechanical hypersensitivity. Moreover, mechanical thresholds positively correlated with the distance ran after injury, suggesting a functional relationship between exercise and secondary pain relief. However, access to a wheel temporarily exacerbated several monoiodoacetate-induced gait impairments in both sexes. Finally, while there were no obvious effects of running on anxio-depressive-like behaviours or cognitive functioning, exercise significantly impacted stress-induced faecal output and phenotypic regulation of body weight. Conclusions Our findings suggest that persistent loading of an injured knee joint may compromise functional outcomes independently of pain relief away from the joint, underscoring a critical consideration for exercise-based therapeutic strategies in osteoarthritis.