Muscle pain: Sensory implications and interaction with motor control
Muscle pain: Sensory implications and interaction with motor control
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DOI：
10.1097/ajp.0b013e31815b608f
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发表时间：
2008-05-01
影响因子：
2.9
通讯作者：
Graven-Nielsen, Thomas
中科院分区：
文献类型：
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作者：
Arendt-Nielsen, Lars;Graven-Nielsen, Thomas
肌肉痛敏和牵涉痛在慢性肌肉骨骼系统疼痛中起着重要作用。需要对所涉及的基本机制和更好的临床评估肌肉疼痛的方法有新的认识，以修改和优化治疗方案。增加的肌肉敏感性表现为（1）由正常非伤害性刺激诱发的疼痛（异常性疼痛），（2）由伤害性刺激诱发的疼痛强度增加（痛觉过敏），或（3）伴随相关躯体感觉变化的牵涉疼痛区域增加。定量感觉测试提供了可能性，以评估这些表现在一个标准化的方式在患者患有肌肉骨骼疼痛或健康志愿者。一些表现的敏化，如扩大涉及肌肉疼痛领域的慢性肌肉骨骼疼痛患者，可以解释从动物实验显示超节段传播的敏化。与慢性肌肉骨骼疾病相关的疼痛表现（例如压痛和牵涉痛）的一个重要部分可能是由于外周和中枢致敏，这在急性疼痛向慢性疼痛的转变中起作用。近年来，肌肉疼痛可以干扰运动控制策略，并且在休息，静态收缩和动态条件下可以看到不同的相互作用模式。
Muscle hyperalgesia and referred pain plays an important role in chronic musculoskeletal pain. New knowledge on the involved basic mechanisms and better methods to assess muscle pain in the clinic are needed to revise and optimize the treatment regimes. Increased muscle sensitivity is manifested as (1) pain evoked by a normally non-nociceptive stimulus (allodynia), (2) increased pain intensity evoked by nociceptive stimuli (hyperalgesia), or (3) increased referred pain areas with associated somatosensory changes. Quantitative sensory testing provides the possibility to evaluate these manifestations in a standardized way in patients suffering from musculoskeletal pain or in healthy volunteers. Some manifestations of sensitisation, such as expanded referred muscle pain areas in chronic musculoskeletal pain patients, can be explained from animal experiments showing extrasegmental spread of sensitisation. An important part of the pain manifestations (eg, tenderness and referred pain) related to chronic musculoskeletal disorders may be due to peripheral and central sensitization, which play a role in the transition from acute to chronic pain. In recent years, it has become evident that muscle pain can interfere with motor control strategies and different patters of interaction are seen during rest, static contractions, and dynamic conditions.