143
Views
0
CrossRef citations to date
0
Altmetric
Review

Central Pain Processing in Osteoarthritis: Implications for Treatment

&
Pages 45-56 | Published online: 19 Dec 2013

References

  • Felson DT . The sources of pain in knee osteoarthritis. Curr. Opin. Rheumatol.17(5) , 624–628 (2005).
  • Yusuf E , KortekaasMC, WattI, HuizingaTW, KloppenburgM. Do knee abnormalities visualised on MRI explain knee pain in knee osteoarthritis? A systematic review. Ann. Rheum. Dis.70(1) , 60–67 (2011).
  • Schaible HG . Peripheral and central mechanisms of pain generation. Handb. Exp. Pharmacol.177 , 3–28 (2007).
  • Woolf CJ , SalterMW. Neuronal plasticity: increasing the gain in pain. Science288(5472) , 1765–1769 (2000).
  • Woolf CJ . Central sensitization: implications for the diagnosis and treatment of pain. Pain152(Suppl. 3) , S2–S15 (2011).
  • Woolf CJ , ThompsonSW. The induction and maintenance of central sensitization is dependent on N-methyl-d-aspartic acid receptor activation; implications for the treatment of post-injury pain hypersensitivity states. Pain44(3) , 293–299 (1991).
  • Dickenson AH , SullivanAF. Evidence for a role of the NMDA receptor in the frequency dependent potentiation of deep rat dorsal horn nociceptive neurones following C fibre stimulation. Neuropharmacology26(8) , 1235–1238 (1987).
  • Radhakrishnan V , HenryJL. Antagonism of nociceptive responses of cat spinal dorsal horn neurons in vivo by the NK-1 receptor antagonists CP-96, 345 and CP-99, 994, but not by CP-96, 344. Neuroscience64(4) , 943–958 (1995).
  • Sluka KA . Pain mechanisms involved in musculoskeletal disorders. J. Orthop. Sports Phys. Ther.24(4) , 240–254 (1996).
  • Price DD , HuJW, DubnerR, GracelyRH. Peripheral suppression of first pain and central summation of second pain evoked by noxious heat pulses. Pain3(1) , 57–68 (1977).
  • Ren K , DubnerR. Interactions between the immune and nervous systems in pain. Nat. Med.16(11) , 1267–1276 (2010).
  • O‘Callaghan JP , MillerDB. Spinal glia and chronic pain. Metabolism59(Suppl. 1) , S21–S26 (2010).
  • Heinricher MM , TavaresI, LeithJL, LumbBM. Descending control of nociception: specificity, recruitment and plasticity. Brain Res. Rev.60(1) , 214–225 (2009).
  • Calejesan AA , Ch‘angMH, ZhuoM. Spinal serotonergic receptors mediate facilitation of a nociceptive reflex by subcutaneous formalin injection into the hindpaw in rats. Brain Res.798(1–2) , 46–54 (1998).
  • Yunus MB . Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin. Arthritis Rheum.36(6) , 339–356 (2007).
  • Rahman W , BauerCS, BannisterK, Vonsy J-L, Dolphin AC, Dickenson AH. Descending serotonergic facilitation and the antinociceptive effects of pregabalin in a rat model of osteoarthritic pain. Mol. Pain5 , 45 (2009).
  • Legrain V , IannettiGD, PlaghkiL, MourauxA. The pain matrix reloaded: a salience detection system for the body. Prog. Neurobiol.93(1) , 111–124 (2011).
  • Smallwood RF , LairdAR, RamageAE et al. Structural brain anomalies and chronic pain: a quantitative meta-analysis of gray matter volume. J. Pain 14(7) , 663–675 (2013).
  • Farmer MA , BalikiMN, ApkarianAV. A dynamic network perspective of chronic pain. Neurosci. Lett.520(2) , 197–203 (2012).
  • Moreton BJ , WheelerM, WalshDA, LincolnNB. Rasch analysis of the intermittent and constant osteoarthritis pain (ICOAP) scale. Osteoarthritis Cartilage20(10) , 1109–1115 (2012).
  • Rolke R , MagerlW, CampbellKA et al. Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur. J. Pain 10(1) , 77–88 (2006).
  • Schiff E , EisenbergE. Can quantitative sensory testing predict the outcome of epidural steroid injections in sciatica? A preliminary study. Anesth. Analg.97(3) , 828–832 (2003).
  • Hsu YW , SommaJ, HungYC, TsaiPS, YangCH, ChenCC. Predicting postoperative pain by preoperative pressure pain assessment. Anesthesiology103(3) , 613–618 (2005).
  • Martinez V , FletcherD, BouhassiraD, SesslerDI, ChauvinM. The evolution of primary hyperalgesia in orthopedic surgery: quantitative sensory testing and clinical evaluation before and after total knee arthroplasty. Anesth. Analg.105(3) , 815–821 (2007).
  • Pavlakovic G , PetzkeF. The role of quantitative sensory testing in the evaluation of musculoskeletal pain conditions. Curr. Rheumatol. Rep.12(6) , 455–461 (2010).
  • Wylde V , PalmerS, LearmonthID, DieppeP. Somatosensory abnormalities in knee OA. Rheumatology (Oxford)51(3) , 535–543 (2012).
  • Graven-Nielsen T , Arendt-NielsenL. Peripheral and central sensitization in musculoskeletal pain disorders: an experimental approach. Curr. Rheumatol. Rep.4(4) , 313–321 (2002).
  • Arendt-Nielsen L , Graven-NielsenT. Translational musculoskeletal pain research. Best Pract. Res. Clin. Rheumatol.25(2) , 209–226 (2011).
  • Skljarevski V , RamadanNM. The nociceptive flexion reflex in humans – review article. Pain96(1–2) , 3–8 (2002).
  • Willer JC . Comparative study of perceived pain and nociceptive flexion reflex in man. Pain3(1) , 69–80 (1977).
  • Andersen OK , JensenLM, BrennumJ, Arendt-NielsenL. Modulation of the human nociceptive reflex by cyclic movements. Eur. J. Appl. Physiol. Occup. Physiol.70(4) , 311–321 (1995).
  • Arendt-Nielsen L , BrennumJ, SindrupS, BakP. Electrophysiological and psychophysical quantification of temporal summation in the human nociceptive system. Eur. J. Appl. Physiol. Occup. Physiol.68(3) , 266–273 (1994).
  • Harris AJ , DuxsonMJ, ButlerJE, HodgesPW, TaylorJL, GandeviaSC. Muscle fiber and motor unit behavior in the longest human skeletal muscle. J. Neurosci.25(37) , 8528–8533 (2005).
  • Desmeules JA , CedraschiC, RapitiE et al. Neurophysiologic evidence for a central sensitization in patients with fibromyalgia. Arthritis Rheum. 48(5) , 1420–1429 (2003).
  • Banic B , Petersen-FelixS, AndersenOK et al. Evidence for spinal cord hypersensitivity in chronic pain after whiplash injury and in fibromyalgia. Pain 107(1–2) , 7–15 (2004).
  • Clarke CF , LawrenceKS. Functional imaging for interpretation of pain pathways: current clinical application/relevance and future initiatives. Curr. Pain Headache Rep.17(2) , 311 (2013).
  • Henderson LA , PeckCC, PetersenET et al. Chronic pain: lost inhibition? J. Neurosci. 33(17) , 7574–7582 (2013).
  • Sofat N , EjinduV, KielyP. What makes osteoarthritis painful? The evidence for local and central pain processing. Rheumatology (Oxford)50(12) , 2157–2165 (2011).
  • Apkarian AV , BalikiMN, GehaPY. Towards a theory of chronic pain. Prog. Neurobiol.87(2) , 81–97 (2009).
  • Kulkarni B , BentleyDE, ElliottR et al. Arthritic pain is processed in brain areas concerned with emotions and fear. Arthritis Rheum. 56(4) , 1345–1354 (2007).
  • Baliki MN , SchnitzerTJ, BauerWR, ApkarianAV. Brain morphological signatures for chronic pain. PLoS ONE6(10) , e26010 (2011).
  • Ruscheweyh R , DeppeM, LohmannH et al. Pain is associated with regional grey matter reduction in the general population. Pain 152(4) , 904–911 (2011).
  • Murphy SL , LydenAK, PhillipsK, ClauwDJ, WilliamsDA. Subgroups of older adults with osteoarthritis based upon differing comorbid symptom presentations and potential underlying pain mechanisms. Arthritis Res. Ther.13(4) , R135 (2011).
  • Freynhagen R , BaronR, GockelU, TolleTR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr. Med. Res. Opin.22(10) , 1911–1920 (2006).
  • Gwilym SE , KeltnerJR, WarnabyCE et al. Psychophysical and functional imaging evidence supporting the presence of central sensitization in a cohort of osteoarthritis patients. Arthritis Rheum. 61(9) , 1226–1234 (2009).
  • Schaible HG , GrubbBD. Afferent and spinal mechanisms of joint pain. Pain55(1) , 5–54 (1993).
  • Hannan MT , FelsonDT, PincusT. Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J. Rheumatol.27(6) , 1513–1517 (2000).
  • Finan PH , BuenaverLF, BoundsSC et al. Discordance between pain and radiographic severity in knee osteoarthritis: findings from quantitative sensory testing of central sensitization. Arthritis Rheum. 65(2) , 363–372 (2013).
  • Wylde V , HewlettS, LearmonthID, DieppeP. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain152(3) , 566–572 (2011).
  • Baker PN , van der Meulen JH, Lewsey J, Gregg PJ; National Joint Registry For England and Wales. The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales. J. Bone Joint Surg. Br.89(7) , 893–900 (2007).
  • Lundblad H , KreicbergsA, JanssonKA. Prediction of persistent pain after total knee replacement for osteoarthritis. J. Bone Joint Surg. Br.90(2) , 166–171 (2008).
  • Arendt-Nielsen L , NieH, LaursenMB et al. Sensitization in patients with painful knee osteoarthritis. Pain 149(3) , 573–581 (2010).
  • Imamura M , ImamuraST, KaziyamaHHS et al. Impact of nervous system hyperalgesia on pain, disability, and quality of life in patients with knee osteoarthritis: a controlled analysis. Arthritis Rheum. 59(10) , 1424–1431 (2008).
  • Arendt-Nielsen L , YarnitskyD. Experimental and clinical applications of quantitative sensory testing applied to skin, muscles and viscera. J. Pain10(6) , 556–572 (2009).
  • Bajaj P , Graven-NielsenT, Arendt-NielsenL. Osteoarthritis and its association with muscle hyperalgesia: an experimental controlled study. Pain93(2) , 107–114 (2001).
  • Suokas AK , WalshDA, McWilliamsDF et al. Quantitative sensory testing in painful osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage 20(10) , 1075–1085 (2012).
  • Courtney CA , WittePO, ChmellSJ, HornbyTG. Heightened flexor withdrawal response in individuals with knee osteoarthritis is modulated by joint compression and joint mobilization. J. Pain11(2) , 179–185 (2010).
  • Lee YC , NassikasNJ, ClauwDJ. The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgia. Arthritis Res. Ther.13(2) , 211 (2011).
  • Kosek E , OrdebergG. Lack of pressure pain modulation by heterotopic noxious conditioning stimulation in patients with painful osteoarthritis before, but not following, surgical pain relief. Pain88(1) , 69–78 (2000).
  • Donovan-Rodriguez T , UrchCE, DickensonAH. Evidence of a role for descending serotonergic facilitation in a rat model of cancer-induced bone pain. Neurosci. Lett.393(2–3) , 237–242 (2006).
  • Gwilym SE , FilippiniN, DouaudG, CarrAJ, TraceyI. Thalamic atrophy associated with painful osteoarthritis of the hip is reversible after arthroplasty: a longitudinal voxel-based morphometric study. Arthritis Rheum.62(10) , 2930–2940 (2010).
  • Parks EL , GehaPY, BalikiMN, KatzJ, SchnitzerTJ, ApkarianAV. Brain activity for chronic knee osteoarthritis: dissociating evoked pain from spontaneous pain. Eur. J. Pain15(8) , 843.e1–14 (2011).
  • Hochman JR , FrenchMR, BerminghamSL, HawkerGA. The nerve of osteoarthritis pain. Arthritis Care Res. (Hoboken)62(7) , 1019–1023 (2010).
  • Hochman JR , GaglieseL, DavisAM, HawkerGA. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthritis Cartilage19(6) , 647–654 (2011).
  • Ohtori S , OritaS, YamashitaM et al. Existence of a neuropathic pain component in patients with osteoarthritis of the knee. Yonsei Med. J. 53(4) , 801–805 (2012).
  • Arendt-Nielsen L , Graven-NielsenT. Central sensitization in fibromyalgia and other musculoskeletal disorders. Curr. Pain Headache Rep.7(5) , 355–361 (2003).
  • Atzeni F , CazzolaM, BenucciM, Di Franco M, Salaffi F, Sarzi-Puttini P. Chronic widespread pain in the spectrum of rheumatological diseases. Best Pract. Res. Clin. Rheumatol.25(2) , 165–171 (2011).
  • Hawker GA , FrenchMR, WaughEJ, GignacMA, CheungC, MurrayBJ. The multidimensionality of sleep quality and its relationship to fatigue in older adults with painful osteoarthritis. Osteoarthritis Cartilage18(11) , 1365–1371 (2010).
  • Karaaslan Y , OzturkM, HaznedarogluS. Secondary fibromyalgia in Turkish patients with rheumatologic disorders. Lupus8(6) , 486 (1999).
  • Atzeni F , SalliS, BenucciM, Di Franco M, Alciati A, Sarzi-Puttini P. Fibromyalgia and arthritides. Reumatismo64(4) , 286–292 (2012).
  • Axford J , ButtA, HeronC et al. Prevalence of anxiety and depression in osteoarthritis: use of the Hospital Anxiety and Depression Scale as a screening tool. Clin. Rheumatology 29(11) , 1277–1283 (2010).
  • Snijders GF , Van Den Ende CH, Fransen J et al. Fatigue in knee and hip osteoarthritis: the role of pain and physical function. Rheumatology (Oxford)50(10) , 1894–1900 (2011).
  • Cazzola M , Sarzi Puttini P, Stisi S et al. Fibromyalgia syndrome: definition and diagnostic aspects. Reumatismo60(Suppl. 1) , 3–14 (2008).
  • Kato K , SullivanPF, EvengardB, PedersenNL. A population-based twin study of functional somatic syndromes. Psychol. Med.39(3) , 497–505 (2009).
  • Giesecke T , WilliamsDA, HarrisRE et al. Subgrouping of fibromyalgia patients on the basis of pressure-pain thresholds and psychological factors. Arthritis Rheum. 48(10) , 2916–2922 (2003).
  • Orzel-Gryglewska J . Consequences of sleep deprivation. Int. J. Occup. Med. Environ. Health23(1) , 95–114 (2010).
  • Kundermann B , SpernalJ, HuberMT, KriegJC, LautenbacherS. Sleep deprivation affects thermal pain thresholds but not somatosensory thresholds in healthy volunteers. Psychosom. Med.66(6) , 932–937 (2004).
  • Roehrs T , HydeM, BlaisdellB, GreenwaldM, RothT. Sleep loss and REM sleep loss are hyperalgesic. Sleep29(2) , 145–151 (2006).
  • Edwards RR , GraceE, PetersonS, KlickB, HaythornthwaiteJA, SmithMT. Sleep continuity and architecture: associations with pain-inhibitory processes in patients with temporomandibular joint disorder. Eur. J. Pain13(10) , 1043–1047 (2009).
  • Theis KA , HelmickCG, HootmanJM. Arthritis burden and impact are greater among U.S. women than men: intervention opportunities. J. Womens Health16(4) , 441–453 (2007).
  • Currie SR , WangJ. Chronic back pain and major depression in the general Canadian population. Pain107(1–2) , 54–60 (2004).
  • Carroll LJ , CassidyJD, CoteP. Depression as a risk factor for onset of an episode of troublesome neck and low back pain. Pain107(1–2) , 134–139 (2004).
  • Rosenberger PH , JoklP, IckovicsJ. Psychosocial factors and surgical outcomes: an evidence-based literature review. J. Am. Acad. Orthop. Surg.14(7) , 397–405 (2006).
  • Brander VA , StulbergSD, AdamsAD et al. Predicting total knee replacement pain: a prospective, observational study. Clin. Orthop. Relat. Res. (416) , 27–36 (2003).
  • Lingard EA , RiddleDL. Impact of psychological distress on pain and function following knee arthroplasty. J. Bone Joint Surg. Am.89(6) , 1161–1169 (2007).
  • Zhang W , DohertyM, LeebBF et al. EULAR evidence based recommendations for the management of hand osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann. Rheum. Dis. 66(3) , 377–388 (2007).
  • Conaghan PG , DicksonJ, Grant RL; Guideline Development Group. Care and management of osteoarthritis in adults: summary of NICE guidance. BMJ336(7642) , 502–503 (2008).
  • Eisenach JC , CurryR, RauckR, PanP, YakshTL. Role of spinal cyclooxygenase in human postoperative and chronic pain. Anesthesiology112(5) , 1225–1233 (2010).
  • Arnold LM , HudsonJI, WangF et al. Comparisons of the efficacy and safety of duloxetine for the treatment of fibromyalgia in patients with versus without major depressive disorder. Clin. J. Pain 25(6) , 461–468 (2009).
  • Arnold LM , ZhangS, PangalloBA. Efficacy and safety of duloxetine 30 mg/d in patients with fibromyalgia: a randomized, double-blind, placebo-controlled study. Clin. J. Pain28(9) , 775–781 (2012).
  • Arnold LM , ClauwDJ, WohlreichMM et al. Efficacy of duloxetine in patients with fibromyalgia: pooled analysis of 4 placebo-controlled clinical trials. Prim. Care Companion J. Clin. Psychiatry 11(5) , 237–244 (2009).
  • Abou-Raya S , Abou-RayaA, HelmiiM. Duloxetine for the management of pain in older adults with knee osteoarthritis: randomised placebo-controlled trial. Age Ageing41(5) , 646–652 (2012).
  • Chappell AS , OssannaMJ, Liu-SeifertH et al. Duloxetine, a centrally acting analgesic, in the treatment of patients with osteoarthritis knee pain: a 13-week, randomized, placebo-controlled trial. Pain 146(3) , 253–260 (2009).
  • Perrot S , JavierRM, MartyM, Le Jeunne C, Laroche F. Is there any evidence to support the use of anti-depressants in painful rheumatological conditions? Systematic review of pharmacological and clinical studies. Rheumatology (Oxford)47(8) , 1117–1123 (2008).
  • Hauser W , UrrutiaG, TortS, UceylerN, WalittB. Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome. Cochrane Database Syst. Rev.1 , CD010292 (2013).
  • Bouwense SA , OlesenSS, DrewesAM, PoleyJW, van Goor H, Wilder-Smith OH. Effects of pregabalin on central sensitization in patients with chronic pancreatitis in a randomized, controlled trial. PLoS ONE7(8) , e42096 (2012).
  • Crofford LJ , RowbothamMC, MeasePJ et al. Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 52(4) , 1264–1273 (2005).
  • Moore RA , StraubeS, WiffenPJ, DerryS, McquayHJ. Pregabalin for acute and chronic pain in adults. Cochrane Database Syst. Rev.3 , CD007076 (2009).
  • Jaffe M , LacobelisD, YoungJP et al. Post-hoc results show beneficial effects of pregabalin in patients with osteoarthritis of the hip. Presented at: American College of Rheumatology, PA, USA, 28 October–2 November 2000.
  • Kosek E , OrdebergG. Abnormalities of somatosensory perception in patients with painful osteoarthritis normalize following successful treatment. Eur. J. Pain4(3) , 229–238 (2000).
  • Graven-Nielsen T , WodehouseT, LangfordRM, Arendt-NielsenL, KiddBL. Normalization of widespread hyperesthesia and facilitated spatial summation of deep-tissue pain in knee osteoarthritis patients after knee replacement. Arthritis Rheum.64(9) , 2907–2916 (2012).
  • Brown MT , MurphyFT, RadinDM, DavignonI, SmithMD, WestCR. Tanezumab reduces osteoarthritic hip pain: results of a randomized, double-blind, placebo-controlled Phase III trial. Arthritis Rheum.65(7) , 1795–1803 (2013).
  • Kumar V , MahalBA. NGF – the TrkA to successful pain treatment. J. Pain Res.5 , 279–287 (2012).
  • Dray A , ReadSJ. Arthritis and pain. Future targets to control osteoarthritis pain. Arthritis Res. Ther.9(3) , 212 (2007).
  • Liu M , OhU, WoodJN. From transduction to pain sensation: defining genes, cells, and circuits. Pain152(Suppl. 3) , S16–S19 (2011).
  • Moss P , SlukaK, WrightA. The initial effects of knee joint mobilization on osteoarthritic hyperalgesia. Man. Ther.12(2) , 109–118 (2007).
  • Vance CG , RakelBA, BlodgettNP et al. Effects of transcutaneous electrical nerve stimulation on pain, pain sensitivity, and function in people with knee osteoarthritis: a randomized controlled trial. Phys. Ther. 92(7) , 898–910 (2012).
  • Tesarz J , SchusterAK, HartmannM, GerhardtA, EichW. Pain perception in athletes compared to normally active controls: a systematic review with meta-analysis. Pain153(6) , 1253–1262 (2012).
  • Davis AM , MacKayC. Osteoarthritis year in review: outcome of rehabilitation. Osteoarthritis Cartilage21(10) , 1414–1424 (2013).
  • Elkins G , JohnsonA, FisherW. Cognitive hypnotherapy for pain management. Am. J. Clin. Hypnosis54(4) , 294–310 (2012).
  • Vitiello MV , McCurrySM, ShortreedSM et al. Cognitive–behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the lifestyles randomized controlled trial. J. Am. Geriatr. Soc. 61(6) , 947–956 (2013).
  • Lami MJ , MartinezMP, SanchezAI. Systematic review of psychological treatment in fibromyalgia. Curr. Pain Headache Rep.17(7) , 345 (2013).
  • Morley S , EcclestonC, WilliamsA. Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain80(1–2) , 1–13 (1999).
  • Zhang W , RobertsonJ, JonesAC, DieppePA, DohertyM. The placebo effect and its determinants in osteoarthritis: meta-analysis of randomised controlled trials. Ann. Rheum. Dis.67(12) , 1716–1723 (2008).
  • Walsh DA , McWilliamsDF. Pain in rheumatoid arthritis. Curr. Pain Headache Rep.16(6) , 509–517 (2012).
  • Sullivan MD , BentleyS, FanMY, GardnerG. A single-blind, placebo run-in study of duloxetine for activity-limiting osteoarthritis pain. J. Pain10(2) , 208–213 (2009).
  • Frakes EP , RisserRC, BallTD, HochbergMC, WohlreichMM. Duloxetine added to oral nonsteroidal anti-inflammatory drugs for treatment of knee pain due to osteoarthritis: results of a randomized, double-blind, placebo-controlled trial. Curr. Med. Res. Opin.27(12) , 2361–2372 (2011).
  • Risser RC , HochbergMC, GaynorPJ, D‘SouzaDN, FrakesEP. Responsiveness of the Intermittent and Constant Osteoarthritis Pain (ICOAP) scale in a trial of duloxetine for treatment of osteoarthritis knee pain. Osteoarthritis Cartilage21(5) , 691–694 (2013).
  • Sullivan M , BentleyS, FanMY, GardnerG. A single-blind placebo run-in study of venlafaxine XR for activity-limiting osteoarthritis pain. Pain Med.10(5) , 806–812 (2009).
  • Ganvir P , BeaumontG, SeldrupJ. A comparative trial of clomipramine and placebo as adjunctive therapy in arthralgia. J. Int. Med. Res.8(Suppl. 3) , 60–66 (1980).
  • Cepeda MS , CamargoF, ZeaC, ValenciaL. Tramadol for osteoarthritis. Cochrane Database Syst. Rev.3 , CD005522 (2006).

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.