Inclusion Criteria:
* knee osteoarthritis/or back pain of at least six months duration, experience pain on more days than not, with moderate pain at baseline (i.e., \> 3/6 in the Visual Descriptor Scale), and who have elevated levels of plasma Imterleukin-6 (\>2.5 pg/ml) will be considered for participation.
Exclusion Criteria:
* Hypersensitivity to OT or vasopressin,
* history of hyponatremia, syndrome of inappropriate antidiuretic hormone secretion, or psychogenic polydipsia,
* on vasoconstrictors such as desmopressin, pseudoephedrine, or antidiuretic medication,
* low sodium and high osmolality levels,
* excessive smoking,
* excessive drinking,
* muscle pain as a result of systemic disease,
* significant nasal pathology,
* previous or concurrent use of narcotics delivered intranasally (e.g., cocaine),
* gastroparesis.
* individuals with heart problems (e.g., cardiomyopathy, history of myocardial infarction, arrhythmias, prolonged QT interval)
* Participants will also be excluded if they have concurrent medical or arthritic conditions that could confound symptomatic knee osteoarthritis-related outcomes or coexisting disease that could preclude successful completion of the protocol including:
* systemic rheumatic condition (e.g. rheumatoid arthritis, systemic lupus erythematosus, fibromyalgia);
* a history of clinically significant surgery to the index knee;
* uncontrolled hypertension (\>150/95);
* poorly controlled diabetes (HbA1c\>7%);
* neurological disease (e.g., Parkinson's, Multiple Sclerosis);
* cardiovascular or peripheral arterial disease;
* serious psychiatric disorder requiring hospitalization within the past twelve months or characterized by active suicidal ideation;
* diminished cognitive function that would interfere with completion of study procedures (i.e., Montreal Cognitive Assessment score \< 25)\]; and
* large pieces of metal in the body or metal in the face or neck,
* claustrophobia,
* major medical surgery in the past two months,
* history of brain surgery or any serious brain condition like aneurysm, stroke, or seizures\].
* pregnant individuals will be excluded