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Pain in OA in present because of Increase hemostatic pressure , Bone edema, Synovial inflammation ,Joint effusions and presence of Osteophytes. Anyway The understanding of the mechanisms that lead to chronic pain in osteoarthritis has evolved, but several aspects remain unclear. These include the contribution of sensitization of nociceptive pathways and other external factors in different stages of OA, the role of neuropathic pain, and the influence of disease phenotypes in the patterns of pain . Instead of a single structure or pathway responsible for pain onset or associated with its persistence, it is likely that the experience of pain has a multifactorial etiology