Chronic primary musculoskeletal pain: a new concept of nonstructural regional pain.
Chronic primary musculoskeletal pain: a new concept of nonstructural regional pain.
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DOI：
10.1097/pr9.0000000000001024
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发表时间：
2022-09
期刊：
影响因子：
4.8
通讯作者：
中科院分区：
文献类型：
--
作者：
在没有可识别的组织异常的情况下可能发生局部肌肉骨骼疼痛的概念可能令人困惑。以前，这些区域性主诉通常被归类为肌筋膜疼痛综合征，或在伤害性疼痛概念正式化之前，被归类为具有神经性成分的肌肉骨骼疼痛，并且治疗以解剖学为重点。慢性原发性肌肉骨骼疼痛现在被确定为慢性原发性疼痛干类别与伤害性疼痛的机械描述符。许多先前诊断为肌筋膜疼痛的患者实际上可能患有慢性原发性肌肉骨骼疼痛，这需要管理模式向更集中的治疗策略转变。许多问题仍然存在，包括拟议的检查技术的验证，流行率，理想的治疗，以及医疗保健界的吸收和接受。这种新的分类应该受到欢迎，因为它解释了以前对物理集中治疗反应不佳的局部疼痛状况。
The concept that a regional musculoskeletal pain may occur in the absence of identifiable tissue abnormality may be puzzling. Previously these regional complaints were generally categorized as myofascial pain syndromes, or prior to the formalization of the nociplastic pain concept, as musculoskeletal pain with a neuropathic component, and treatments were anatomically focussed. Chronic primary musculoskeletal pain is now identified under the chronic primary pain stem category with the mechanistic descriptor of nociplastic pain. It is possible that many patients previously diagnosed with myofascial pain do in fact suffer from chronic primary musculoskeletal pain, requiring a paradigm shift in management towards more centrally directed treatment strategies. Many questions remain, including validation of the proposed examination techniques, prevalence, ideal treatment, and uptake and acceptance by the healthcare community. This new classification should be welcomed as an explanation for regional pain conditions that previously responded poorly to physically focussed treatments.