Current Rheumatology Reports

, Volume 14, Issue 6, pp 576–582 | Cite as

The Role of the Central Nervous System in Osteoarthritis Pain and Implications for Rehabilitation

  • Susan L. Murphy
  • Kristine Phillips
  • David A. Williams
  • Daniel J. Clauw


It has been known for some time that central nervous system (CNS) pain amplification is present in some individuals with osteoarthritis; the implications of this involvement, however, are just starting to be realized. In the past year, several research reviews have focused on evidence supporting shared mechanisms across chronic pain conditions for how pain is generated and maintained in the CNS, irrespective of the underlying structural pathology. This review article focuses on current literature describing CNS amplification in osteoarthritis by discussing peripheral sensitization, central sensitization, and central augmentation, and the clinical manifestation of central augmentation referred to as centralized pain, and offers considerations for rehabilitation treatment and future directions for research.


Osteoarthritis OA Pain modulation Rehabilitation Central sensitization Central augmentation Pain processing Treatment Physical therapy Occupational therapy Central nervous system 


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Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2012

Authors and Affiliations

  • Susan L. Murphy
    • 1
    • 2
    • 3
  • Kristine Phillips
    • 4
    • 5
  • David A. Williams
    • 6
    • 7
  • Daniel J. Clauw
    • 7
    • 8
  1. 1.Department of Physical Medicine and RehabilitationUniversity of MichiganAnn ArborUSA
  2. 2.Geriatric Research Education and Clinical Center (GRECC)Veterans Affairs Ann Arbor Health Care SystemAnn ArborUSA
  3. 3.Ann ArborUSA
  4. 4.Department of Internal MedicineDivision of Rheumatology, University of MichiganAnn ArborUSA
  5. 5.Ann ArborUSA
  6. 6.Departments of AnesthesiologyMedicine, Psychiatry, and Psychology, University of MichiganAnn ArborUSA
  7. 7.Chronic Pain and Fatigue Research CenterUniversity of MichiganAnn ArborUSA
  8. 8.Departments of AnesthesiologyMedicine, and Psychiatry, University of MichiganAnn ArborUSA

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