Pain Treatment for Patients With Osteoarthritis and Central Sensitization

Osteoarthritis is one of the most common, disabling, and expensive pathologies of modern society. Among the primary aims of osteoarthritis management are pain control and functional ability improvement. The exact cause of osteoarthritis pain remains uncertain. In addition to the pathological changes in articular structures, changes in central pain processing or central sensitization appear to be involved in osteoarthritis pain. The latter calls for a broader approach to the management of patients with osteoarthritis. However, the scientific literature provides scant information dealing with the treatment of central sensitization, specifically in patients with osteoarthritis.

Interventions such as cognitive-behavioral therapy and neuroscience education potentially target cognitive-emotional sensitization (and descending facilitation), and centrally acting drugs and exercise therapy can improve endogenous analgesia (descending inhibition) in patients with osteoarthritis. The authors suggested that future studies should assess these new treatment avenues.