Inclusion Criteria:  ACR Criteria for osteoarthritis Neuropathic pain Age over 65 DN4 cut off value is 4/10 Less than 30 minutes of morning stiffness Grade I and II Crepitus on active motion Bony tenderness Bony enlargement No palpable warmth of synovium  Exclusion Criteria:  Knee complain that require urgent medical attention (fracture and infection) Diabetes mellitus Patients with malignancies Neurological disorders Systematic musculoskeletal diseases (Parkinson's, rheumatoid arthritis etc) Incapability of understanding implication of participants