30% of Osteoarthritis Patients have Central Sensitization

After a previous perspective article summarizing (in a non-systematic manner) studies related to central sensitization in osteoarthritis (to read more about that one go to http://www.paininmotion.be/nieuws-osteoarthritis.html), compelling evidence emerges from a recent systematic review conducted by researchers of the Pain in Motion group. The review shows that hyperexcitability of the central nervous system plays a key role in this population. In particular, results from that systematic review show that central sensitization contributes specially to the clinical picture of a subgroup of subjects with chronic osteoarthritis-related pain (around 30% of osteoarthritis patients).

Potential involvement of central sensitization in chronic osteoarthritis-related pain has been demonstrated in the literature by means of presence of different objective (i.e. widespread hyperalgesia and allodynia, enhanced temporal summation, impaired descending inhibition) and subjective pain biomarkers (i.e. presence of centrally mediated symptoms, neuropathic pain descriptors), known to reflect central sensitization. Interestingly, findings from this study are similar as seen in other chronic pain conditions characterized by altered central pain processing, such as whiplash or chronic fatigue syndrome. The authors emphasize that the majority of the studies found in the review identified pain hypersensitivity within laboratory conditions, using costly and unattainable equipment for therapists. In fact, both clinical identification and treatment of central sensitization in osteoarthritis are still in its infancy so clinicians are urged to address these important issues in future studies.

Enrique Lluch

2014 Pain in Motion