Central sensitization in fibromyalgia and other musculoskeletal disorders.
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.
Arendt-Nielsen
Lars
L
Laboratory for Human Experimental Pain Research, Center for Sensory-Motor Interaction, Aalborg University, Fredrik Bajers Vej 7, Building D3, DK-9220 Aalborg, Denmark. LAN@smi.auc.dk
Graven-Nielsen
Thomas
T
D005356:Fibromyalgia / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000503:physiopathology; D009411:Nerve Endings / Q000378:metabolism*; D009479:Neuropeptides / Q000378:metabolism*; D009619:Nociceptors / Q000502:physiology*; D010146:Pain / Q000209:etiology
D009479:Neuropeptides