Format

Send to

Choose Destination
Int J Clin Pract. 2016 Jan;70(1):31-44. doi: 10.1111/ijcp.12749. Epub 2015 Nov 11.

Predictive factors and clinical biomarkers for treatment in patients with chronic pain caused by osteoarthritis with a central sensitisation component.

Author information

1
Department of Physical Medicine and Rehabilitation, School of Medicine, University of Hacettepe University, Ankara, Turkey.
2
King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
3
Taichung Veterans General Hospital, Taichung, Taiwan.
4
Department of Anaesthesiology, Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, Hong Kong, China.
5
I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
6
Eli Lilly and Co, México City, México.
7
Seoul National University School of Medicine, Pain Management Center of the Seoul National University Hospital, Seoul, Korea.
8
Pain Clinic, National Cancer Institute, México DF, México.
9
Department of Orthopaedics, Phramongkutklao Army Hospital, Bangkok, Thailand.
10
Eli Lilly and Co, Budapest, Hungary.
11
Huashan Hospital, Fudan University, Shanghai, China.

Abstract

AIMS:

The aim of this non-systematic review was to provide a practical guide for clinicians on the evidence for central sensitisation in chronic osteoarthritis (OA) pain and how this pain mechanism can be addressed in terms of clinical diagnosis, investigation and treatment.

METHODS:

The authors undertook a non-systematic review of the literature including a MEDLINE search (search terms included central sensitisation, osteoarthritis, osteoarthrosis) for relevant and current clinical studies, systematic reviews and narrative reviews. Case reports, letters to the editor and similar literature sources were excluded. Information was organised to allow a pragmatic approach to the discussion of the evidence and generation of practical recommendations.

RESULTS:

There is good evidence for a role of central sensitisation in chronic OA pain in a subgroup of patients. Clinically, a central sensitisation component in chronic OA pain can be suspected based on characteristic pain features and non-pain features seen in other conditions involving central sensitisation. However, there are currently no diagnostic inventories for central sensitisation specific to OA. Biomarkers may be helpful for confirming the presence of central sensitisation, especially when there is diagnostic uncertainty. Several non-pharmacological and pharmacological treatments may be effective in OA patients with central sensitisation features. Multimodal therapy may be required to achieve control of symptoms.

DISCUSSION:

Clinicians should be aware of central sensitisation in patients with chronic OA pain, especially in patients presenting with severe pain with unusual features.

PMID:
26558538
PMCID:
PMC4738415
DOI:
10.1111/ijcp.12749
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center