THE PAIN-ADAPTATION MODEL - A DISCUSSION OF THE RELATIONSHIP BETWEEN CHRONIC MUSCULOSKELETAL PAIN AND MOTOR-ACTIVITY
THE PAIN-ADAPTATION MODEL - A DISCUSSION OF THE RELATIONSHIP BETWEEN CHRONIC MUSCULOSKELETAL PAIN AND MOTOR-ACTIVITY
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DOI：
10.1139/y91-102
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发表时间：
1991-05-01
影响因子：
2.1
通讯作者：
STOHLER, CS
中科院分区：
文献类型：
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作者：
LUND, JP;DONGA, R;STOHLER, CS
对5种慢性肌肉骨骼疼痛（颞下颌关节紊乱病、肌肉紧张性头痛、纤维肌痛、慢性下背痛和运动后肌肉酸痛）的运动功能进行了综述。 得出的结论是，这些数据不支持普遍持有的观点，即这些疾病的疼痛是由某种形式的紧张性肌肉活动过度维持的。 相反，似乎很明显，在这些条件下，激动剂肌肉的活动往往会因疼痛而减少，即使这不是由肌肉本身引起的。 另一方面，疼痛引起拮抗剂活性水平的小幅增加。 由于这些变化，力的产生以及受影响的身体部位的运动范围和速度通常会减少。 为了解释这种行为的变化是如何发生的，我们提出了一个神经生理学模型的基础上提供的高阈值的感觉传入兴奋性和抑制性中间神经元的相位调制。 我们认为，“功能障碍”是几种类型的慢性肌肉骨骼疼痛的特征是一种正常的保护性适应，而不是疼痛的原因。
Articles describing motor function in five chronic musculoskeletal pain conditions (temporomandibular disorders, muscle tension headache, fibromyalgia, chronic lower back pain, and postexercise muscle soreness) were reviewed. It was concluded that the data do not support the commonly held view that the pain of these conditions is maintained by some form of tonic muscular hyperactivity. Instead, it seems clear that in these conditions the activity of agonist muscles is often reduced by pain, even when this does not arise from the muscle itself. On the other hand, pain causes small increases in the level of activity of the antagonist. As a consequence of these changes, force production and the range and velocity of movement of the affected body part are often reduced. To explain how such changes in the behaviour come about, we propose a neurophysiological model based on the phasic modulation of excitatory and inhibitory interneurons supplied by high-threshold sensory afferents. We suggest that the "dysfunction" that is characteristic of several types of chronic musculoskeletal pain is a normal protective adaptation and is not a cause of pain.