Background: Neuropathic mechanisms are considered to play a role in development of pain in knee 
osteoarthritis (OA). Some OA patients developed sensitized central nociceptive circuits that enhance pain 
during various states of peripheral tissue insult. Method: 70 patients with primary knee OA were enrolled 
in this study. Antero-posterior knee radiographs were done using the Kellgren Lawrence scale. Pain 
severity was assessed by Numerical rating scale (NRS), neuropathic pain was assessed by Douleur 
Neuropathique en 4 (DN4) questionnaire and functional status was assessed by the Western Ontario and 
McMaster Universities Osteoarthritis Index (WOMAC) scale. Results: 52.9% of the patients had 
neuropathic pain according to DN4 scale. The mean pain WOMAC score and WOMAC physical 
function score were significantly higher in patients with neuropathic pain when compared to patients with 
non-neuropathic pain; 9.86 ± 2.1 versus 6.79 ± 3.59, P <0.0001 and 44.24 ± 5.43 versus 39.39 ± 10.36, P
= 0.015 respectively. DN4 score had a significant positive correlation with WOMAC pain (r=0.459,
P<0.001), stiffness (r=0.258, P=0.031) and physical function (r=0.307, P=0.01). Conclusion: Chronic
pain with OA has neuropathic components. Neuropathic pain is a factor that increases pain and disability 
and disrupts functional status in osteoarthritis patients.