Future directions in painful knee osteoarthritis: harnessing complexity in a heterogeneous population.


Journal Article

This perspective article proposes a conceptual model for the pain experience for individuals diagnosed with knee osteoarthritis (OA). Pain in knee OA is likely a heterogeneous, multifactorial phenomenon that involves not only the OA disease process but also elements specific to patient psychology and pain neurophysiology. The relevant contributions to the pain experience for any individual patient remain difficult, if not impossible, to definitively determine, and the rationale for many clinical treatment decisions arises primarily from a mechanistic understanding of OA pathophysiology. The Osteoarthritis Research Society International (OARSI) recently identified "phenotyping" of OA pain as a research priority to "better target pain therapies to individual patients." This perspective article proposes that contributions from 3 domains--knee pathology, psychological distress, and pain neurophysiology--should be considered equally important in future efforts to understand pain phenotypes in knee OA. Ultimately, characterization of pain phenotypes may aid in the understanding of the pain experience and the development of interventions specific to pain for individual patients.

Full Text

Duke Authors

Cited Authors

  • Kittelson, AJ; George, SZ; Maluf, KS; Stevens-Lapsley, JE

Published Date

  • March 2014

Published In

Volume / Issue

  • 94 / 3

Start / End Page

  • 422 - 432

PubMed ID

  • 24179141

Pubmed Central ID

  • 24179141

Electronic International Standard Serial Number (EISSN)

  • 1538-6724

Digital Object Identifier (DOI)

  • 10.2522/ptj.20130256


  • eng

Conference Location

  • United States