Mechanistic pain profiling helps to identify the nonresponders to standard pharmacological treatment, as explained in a study by Kristian Petersen et al. issued in 'PAIN'.

The knee osteoarthritis (OA) patients often complain of joint inflammation. The proinflammatory cytokines are responsible for sensitizing the peripheral and central pain pathways. This can be mechanistically assessed via the pressure pain thresholds and temporal summation of pain (TSP).
Nonsteroidal anti-inflammatory drugs (NSAIDs) combined with paracetamol is a recommended treatment for OA. This study hypothesised that evidence of central sensitisation would predict the inadequate responses to peripherally directed therapies in knee OA and hence, aimed to investigate the value of mechanistic pain profiling for predicting pain outcome of NSAIDs plus paracetamol treatment.

A total of 132 patients received ibuprofen 1200 mg/daily, paracetamol 3 g/daily, and pantoprazole 20 mg/daily for 3 weeks. Tolerance threshold, cuff pain detection, and TSP were evaluated before administration. Worst pain within the last 24 hours and during activity (visual analogue scales) were examined before the and after treatment.  

It was found that facilitated TSP was there at baseline in the nonresponders to the 3-weeks treatment as opposed to responders helped to recognise the identified facilitated TSP and low clinical pain scores as independent factors for the prediction of poor pain alleviation by the treatment.
The study researchers culminated, mechanistic pain profiling can predict the pain alleviation of NSAIDs and paracetamol. The facilitated TSP and low clinical pain scores before treatment are independent predictors of poor pain alleviation following NSAIDs and paracetamol. They further noted, "This study adds to the growing evidence that a subgroup of knee OA patients with manifested central sensitisation may need special management attention."