Central pain contributions in osteoarthritis: next steps for improving recognition and treatment?

There is increasing recognition that central pain sensitivity plays an important role in pain severity among patients with osteoarthritis. Murphy and colleagues identified clusters of patients with osteoarthritis according to pain severity and accompanying symptoms, and one of these groups appeared to have a greater degree of centrally mediated pain. This observation provides some evidence that patients with greater central pain contributions can be identified in routine clinical settings, but brief, evidence-based strategies are still needed to more readily and systematically identify these patients. There is also a need to develop new strategies and to further evaluate existing therapies (pharmacological and nonpharmacological) that target central aspects of osteoarthritis pain.