The Challenge of Pain for Patients with OA

Research to date supports a comprehensive approach to the evaluation of the OA illness experience, incorporating the quality, intensity, and predictability of the pain as well as its impact on fatigue, mood, sleep, and disability. A greater understanding of the relative efficacy and effectiveness of OA treatment options on each of these symptoms has potential to improve selection of the best therapies for an individual patient. Recognition of, and attention to, the influence of contextual factors on the OA illness experience, in particular coping skills and social support, may further reduce the impact of the disease. Finally, disordered sleep and mood and the presence of pain sensitization should be considered as alternative treatment targets, particularly among patients for whom first-line OA pain medications, e.g., NSAIDs, cannot be safely used.