Osteoarthropathy in patients with neuropathic pain

Osteoarthiropathy may follow lesions both in peripheral and central nervous systems. Altered bone metabolism by neurotransmitters released from affected sensory or sympathetic nerves may be involved in the pathogenesis of osteoarthropathy. Inflammatory cytokines have significant effects on RANK/RANKL/osteoprotegrin system. Thus those cytokines released from Schwann cells and infiltrated macrophages after nerve injury may play important roles in the pathogenesis of bony changes. Glucocorticosteroids seem to be useful for treating osteoarthropathy through suppressing production of those cytokines. Diagnosis and treatment of neuropathic osteoarthropathy are important for alleviation of both pain and suffering in patients with neuropathic pain if they have osteoarthropathy.