Breaking the Pain Cycle in Osteoarthritis: From Drugs to Rehabilitation

Dear Colleagues,

Osteoarthritis (OA) is one of the leading causes of chronic pain and disability worldwide, significantly impacting quality of life and healthcare systems. Despite its high prevalence, the management of OA pain remains challenging due to its multifactorial nature, involving not only structural joint damage but also inflammatory processes, neuromuscular dysfunction, and central pain sensitization.

In recent years, there has been a growing shift from a purely pharmacological approach toward a more comprehensive, multidisciplinary strategy. While conventional and emerging drug therapies—such as nonsteroidal anti-inflammatory drugs, intra-articular injections, and novel metabolic agents—continue to play a key role in symptom control, non-pharmacological interventions are increasingly being recognized as essential components of effective OA management.

Rehabilitation strategies, including therapeutic exercise, physical therapy modalities, and innovative technologies such as cryoultrasound and neuromodulation, are garnering attention for their potential to reduce pain, improve function, and possibly slow disease progression. Moreover, personalized medicine approaches are beginning to reshape treatment pathways by tailoring interventions to individual patient profiles.

This Special Issue aims to provide an updated and comprehensive overview of current and emerging strategies to “break the pain cycle” in osteoarthritis. We welcome original research articles, reviews, and clinical studies that explore the integration of pharmacological treatments with rehabilitation and other non-invasive approaches.

Topics of interest include, but are not limited to, the following:

• The pharmacological management of osteoarthritis pain;
• Rehabilitation and physiotherapy interventions;
• Innovative technologies (e.g., cryoultrasound therapy);
• Mechanisms of pain in OA, including central sensitization;
• Metabolic and systemic factors (e.g., obesity, GLP-1 pathways);
• Multimodal and personalized treatment strategies;
• Clinical outcomes and real-world evidence. 

By bringing together diverse perspectives, this Special Issue seeks to advance knowledge and promote more effective, patient-centered approaches to osteoarthritis care.

Dr. Alessandro Conforti
Guest Editor

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