title: Predictive factors and clinical biomarkers for treatment in patients with chronic pain caused by osteoarthritis with a central sensitisation component.
abstract: OBJECTIVE
  The aim of this non-systematic review was to provide a practical guide for clinicians on the evidence for central sensitisation in chronic osteoarthritis (OA) pain and how this pain mechanism can be addressed in terms of clinical diagnosis, investigation and treatment.
  
  
  METHODS
  The authors undertook a non-systematic review of the literature including a MEDLINE search (search terms included central sensitisation, osteoarthritis, osteoarthrosis) for relevant and current clinical studies, systematic reviews and narrative reviews. Case reports, letters to the editor and similar literature sources were excluded. Information was organised to allow a pragmatic approach to the discussion of the evidence and generation of practical recommendations.
  
  
  RESULTS
  There is good evidence for a role of central sensitisation in chronic OA pain in a subgroup of patients. Clinically, a central sensitisation component in chronic OA pain can be suspected based on characteristic pain features and non-pain features seen in other conditions involving central sensitisation. However, there are currently no diagnostic inventories for central sensitisation specific to OA. Biomarkers may be helpful for confirming the presence of central sensitisation, especially when there is diagnostic uncertainty. Several non-pharmacological and pharmacological treatments may be effective in OA patients with central sensitisation features. Multimodal therapy may be required to achieve control of symptoms.
  
  
  CONCLUSIONS
  Clinicians should be aware of central sensitisation in patients with chronic OA pain, especially in patients presenting with severe pain with unusual features.
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, University of Hacettepe University, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Akinci
authors.affiliation: King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
authors.forename: M
authors.initials: M
authors.lastname: Al Shaker
authors.affiliation: Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: M H
authors.initials: MH
authors.lastname: Chang
authors.affiliation: Department of Anaesthesiology, Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, Hong Kong, China.
authors.forename: C W
authors.initials: CW
authors.lastname: Cheung
authors.affiliation: I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
authors.forename: A
authors.initials: A
authors.lastname: Danilov
authors.affiliation: Eli Lilly and Co, México City, México.
authors.forename: H
authors.initials: H
authors.lastname: José Dueñas
authors.affiliation: Seoul National University School of Medicine, Pain Management Center of the Seoul National University Hospital, Seoul, Korea.
authors.forename: Y C
authors.initials: YC
authors.lastname: Kim
authors.affiliation: Pain Clinic, National Cancer Institute, México DF, México.
authors.forename: R
authors.initials: R
authors.lastname: Guillen
authors.affiliation: Department of Orthopaedics, Phramongkutklao Army Hospital, Bangkok, Thailand.
authors.forename: W
authors.initials: W
authors.lastname: Tassanawipas
authors.affiliation: Eli Lilly and Co, Budapest, Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Treuer
authors.affiliation: Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
mesh_terms: D015415:Biomarkers; D059333:Central Nervous System Sensitization; D059350:Chronic Pain / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D059225:Nociception; D010003:Osteoarthritis / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D010147:Pain Measurement; D012307:Risk Factors
chemical_list: D015415:Biomarkers