Tumor necrosis factor alpha (TNF-α) has been implicated in both inflammation and neuropathy, by disrupting the pro- and anti-inflammatory homeostasis and stimulating nerve growth factor expression.[1] It has also been implicated in structural disease progression.[2] Moreover, in an animal based study anti-TNF treatment could reverse cartilage degradation.[3] Therefore, anti-TNF agents, such as adalimumab, may be beneficial in controlling TNF-mediated pathogenesis with localized action when administered via an intra-articular route. Here, TNF is linked to neuropathy.