# Pain sensitization in a trial of physical therapy for osteoarthritis and meniscal tear

> **NIH NIH R21** · BRIGHAM AND WOMEN'S HOSPITAL · 2020 · $292,570

## Abstract

Knee osteoarthritis (OA) affects over 14 million persons in the US. Because there are no disease modifying
therapies, treatment focuses on pain. Several mechanisms underlie pain in OA including nociception, the
response to noxious stimuli in affected tissues, and pain sensitization and modulation in the central and
peripheral nervous systems. Sensitization and modulation can be assessed with quantitative sensory testing
(QST). The most frequently used QST tools include: pain pressure thresholds - the pain sensitivity of
individuals to standard pressure stimuli; conditioned pain modulation - the extent that descending inhibitory
pathways blunt the subjective experience of pain in the presence of a conditioning stimulus; and temporal
summation - the extent that pain sensitivity is increased with repetitive application of a standard stimulus.
There is great interest in developing distinct pain sensitization phenotypes based upon QST findings and
determining if these phenotypes are associated with treatment outcomes.
We propose to add an assessment of pain sensitization phenotypes to TeMPO (Treatment of Meniscal
Problems in OA), a multicenter randomized controlled trial (RCT) of exercise regimens for subjects with
symptomatic meniscal tear and knee OA. TeMPO will enroll 856 participants across four US centers. Subjects
undergo a musculoskeletal assessment at baseline and at three months; we will add QST testing to the
musculoskeletal assessment. We will develop distinct pain sensitization phenotypes based upon these
measures and assess the associations between pain sensitization phenotypes, adherence to exercise, and
treatment outcomes. Our work will pursue three aims.
1. Administer QST in TeMPO subjects at the baseline and three-month visits. We will use QST data to
 delineate distinct pain sensitization phenotypes in knee OA patients with symptomatic meniscal tears.
2. Examine whether pain sensitization phenotypes are associated with greater pain, muscle weakness and
 worse scores on performance measures.
3. Determine whether subjects with high pain sensitization phenotypes have lower adherence to exercise and
 less improvement in pain severity, strength, and performance tests following exercise. Assess whether
 lower exercise adherence explains suboptimal responses to exercise in persons with high pain
 sensitization phenotypes.
The data emerging from this proposal will advance our mechanistic understanding of the role of sensitization in
outcomes of rehabilitative OA treatment and will offer insights about tailoring treatment to pain phenotype.

## Key facts

- **NIH application ID:** 10015200
- **Project number:** 5R21AR076156-02
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Jeffrey Neil Katz
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $292,570
- **Award type:** 5
- **Project period:** 2019-09-12 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10015200

## Citation

> US National Institutes of Health, RePORTER application 10015200, Pain sensitization in a trial of physical therapy for osteoarthritis and meniscal tear (5R21AR076156-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10015200. Licensed CC0.

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