A Mechanism-Based Approach to the Management of Osteoarthritis Pain

Ezra Cohen, Yvonne C. Lee*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

28 Scopus citations


Pain from osteoarthritis (OA) affects millions of people worldwide, yet treatments are limited to acetaminophen, NSAIDs, physical therapy, and ultimately, surgery when there is significant disability. In recent years, our understanding of pain pathways in OA has developed considerably. Though joint damage and inflammation play a significant role in pain generation, it is now understood that both central and peripheral nervous system mechanisms exacerbate symptoms. Evolving management strategies for OA address central factors (e.g., sleep difficulties, catastrophizing, and depression) with treatments such as cognitive behavioral therapy and exercise. In addition, emerging data suggest that antibodies against peripheral signaling neuropeptides, such as nerve growth factor-1 (NGF-1), may significantly alleviate pain. However, concerns regarding potential adverse effects, such as rapidly progressive OA, still remain. A nuanced understanding is essential if we are to make headway in developing more effective treatments for OA.

Original languageEnglish (US)
Pages (from-to)399-406
Number of pages8
JournalCurrent Osteoporosis Reports
Issue number6
StatePublished - Sep 30 2015


  • Central sensitization
  • Musculoskeletal pain
  • NGF
  • Osteoarthritis
  • Pain mechanisms

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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