Pain mechanisms in osteoarthritis: Understanding the role of central pain and current approaches to its treatment

Philip J. Mease, Sylvia Hanna, Elijah P. Frakes, Roy D. Altman

Research output: Contribution to journalReview article

91 Scopus citations

Abstract

In this literature review, the mechanisms underlying pain associated with osteoarthritis (OA) are discussed, along with evidence for the efficacy of medications thought to act centrally to relieve OA pain. We survey the cascade of events from inflammation to activation of nociceptive and neuropathic pathways, to the development and maintenance of central and peripheral sensitization. Preclinical and clinical evidence for the sensitization hypothesis is discussed, along with recently identified genetic variations that may increase sensitivity to pain in patients with OA. Evidence is presented for the efficacy of centrally acting analgesics for OA pain (opioids, antiepileptics, tricyclic antidepressants, and serotonin/norepinephrine receptor inhibitors). The Journal of Rheumatology

Original languageEnglish (US)
Pages (from-to)1546-1551
Number of pages6
JournalJournal of Rheumatology
Volume38
Issue number8
DOIs
StatePublished - Aug 1 2011

Keywords

  • Central sensitization
  • Neuropathic pain
  • Osteoarthritis
  • Pain

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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