PT  - JOURNAL ARTICLE
AU  - PHILIP J. MEASE
AU  - SYLVIA HANNA
AU  - ELIJAH P. FRAKES
AU  - ROY D. ALTMAN
TI  - Pain Mechanisms in Osteoarthritis: Understanding the Role of Central Pain and Current Approaches to Its Treatment
AID  - 10.3899/jrheum.100759
DP  - 2011 Aug 01
TA  - The Journal of Rheumatology
PG  - 1546--1551
VI  - 38
IP  - 8
4099  - http://www.jrheum.org/content/38/8/1546.short
4100  - http://www.jrheum.org/content/38/8/1546.full
SO  - J Rheumatol2011 Aug 01; 38
AB  - 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).