Central sensitization in fibromyalgia and other musculoskeletal disorders.
Central sensitization in fibromyalgia and other musculoskeletal disorders.
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DOI：
10.1007/s11916-003-0034-0
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发表时间：
2003-10-01
影响因子：
3.7
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
肌肉痛觉过敏和牵涉痛在慢性肌肉骨骼疼痛中起着重要作用。需要有关所涉及的基本机制的新知识和更好的临床评估肌肉疼痛的方法来修改和优化治疗方案。肌肉敏感性增加表现为通常非伤害性刺激（异常性疼痛）引起的疼痛、伤害性刺激引起的疼痛强度增加（痛觉过敏）或伴有相关体感变化的牵涉疼痛区域增加。致敏的一些表现，例如慢性肌肉骨骼疼痛患者的牵涉肌肉疼痛区域扩大，可以从显示致敏节外扩散的动物实验来解释。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外周和中枢敏化引起的，这可能在从急性疼痛到慢性疼痛的转变中发挥作用。
Muscle hyperalgesia and referred pain play 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 treatment regimens. Increased muscle sensitivity is manifested as pain evoked by a normally non-nociceptive stimulus (allodynia), increased pain intensity evoked by nociceptive stimuli (hyperalgesia), or increased referred pain areas with associated somatosensory changes. Some manifestations of sensitization, such as expanded referred muscle pain areas in patients with chronic musculoskeletal pain, can be explained from animal experiments showing extrasegmental spread of sensitization. An important part of the pain manifestations (eg, tenderness and referred pain) related to chronic musculoskeletal disorders may result from peripheral and central sensitization, which may play a role in the transition from acute to chronic pain.