TY - JOUR T1 - Pain Mechanisms in Osteoarthritis: Understanding the Role of Central Pain and Current Approaches to Its Treatment JF - The Journal of Rheumatology JO - J Rheumatol SP - 1546 LP - 1551 DO - 10.3899/jrheum.100759 VL - 38 IS - 8 AU - PHILIP J. MEASE AU - SYLVIA HANNA AU - ELIJAH P. FRAKES AU - ROY D. ALTMAN Y1 - 2011/08/01 UR - http://www.jrheum.org/content/38/8/1546.abstract N2 - 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). ER -