Neuropathic Pain in Osteoarthritis

Osteoarthritis is a common disease among joint diseases and all chronic diseases. Knee osteoarthritis affects a large population of the society and causes disability. Pain is the main symptom of osteoarthritis. Clinicians must aim to understand the underlying mechanisms of pain and to develop suitable treatment methods. Recent investigations have improved our knowledge of the pathophysiology of pain due to osteoarthritis. Local joint inflammation and structural changes in the joint affect the nociceptive process. Osteoarthritis pain includes central mechanisms in addition to peripheral mechanisms. Studies have reported that, type of pain due to osteoarthritis transforms from nociceptive into neuropathic type by the progression of disease. This makes the respond to conventional treatment to be harder. Although various conservative and interventional treatments are used, the management of osteoarthritis pain is stil contradictory.. Ineffective pain management increases osteoarthritis-related disability. Determining the osteoarthritis patients with neuropathic pain as a spesific group,will help clinicians to suceed more in management of the symptoms. Increased evidence of neuropathic component in osteoarthritis leads to the use of centrally acting drugs in the treatment of osteoarthritis pain. These medicines can be beneficial for pain management. The purpose of this review is to clarify the underlying pathophysiological mechanism of complex pain of osteoarthritis and to develop new treatment strategies. If the pain phenotype of osteoarthritis is classified clinically in the correct way, pain management will be able to work more efficiently and osteoarthritis pain can be controlled with treatments targeting neuropathic pain. This review includes neuropathic pain mechanisms, diagnosis and treatment of the osteoarthritis