Nervous system sensitisation in people with osteoarthritis of the knee: A prospective cohort study

Osteoarthritis is a degenerative disease commoningly affecting the large joints such as the hip or knee. Ostheoarthritis is one of the ten most disabling diseases in developed countries according to the World Health Organisation. Pain and loss of function are the main symptoms. Current treatments including anti-inflammatory drugs, surgery and some physiotherapy treatments are based on the assumption that osteoarthritic pain arises from the joint itself. Pain from damage to structures within and around the joint is known as nociceptive pain. When nociceptive pain is prolonged over several months, as occurs in osteoarthritis, changes to the nervous system can occur called nervous system sensitisation. People with nervous system sensitisation could benefit from more targeted treatments for their pain. The aims of this study are to investigate if people with knee osteoarthritis have pain as a result of nociceptive pain or nervous system sensitisation. The research will examine if physiotherapy treatment is as beneficial to people who are found to have nervous system sensitisation compared to those who do not. The study will also investigate the people with knee osteoarthritis who benefit least from treatment and if the reasons relate in any way to the nervous system being sensitised. Patients referred for physiotherapy will be recruited from two hospital orthopaedic clinics. An assessment will gather information from patients about pain symptoms and they will examined for signs of change in the nervous system. Questionnaires will measure pain, disability and quality of life. Patients will undergo usual physiotherapy treatment and they will be examined again after 3 and 6 months. This research has the potential to change how patients with osteoarthritis are examined and treated by health professionals. If nervous system sensitisation is found to contribute to osteoarthritic pain, future treatment could target the nervous system as well as the joint itself.

Award Date
26 April 2013
Award Value
€243,615
Principal Investigator
Ms Helen O'Leary
Host Institution
University College Dublin
Scheme
Research Training Fellowships for Health Professionals