[Stress-induced hyperalgesia (SIH) as a consequence of emotional deprivation and psychosocial traumatization in childhood : Implications for the treatment of chronic pain].
It is now widely recognized that in many chronic pain syndromes the intensity and severity of individually perceived pain does not correlate consistently with the degree of peripheral nervous system tissue damage or with the intensity of primary afferent or spinal nociceptive neurone activity. In particular, stress and anxiety exert modulatory influences on pain depending on the nature, duration and intensity of the stressor and developmental influences on the maturation of the stress as well as the pain system. In some chronic pain syndromes, e. g. fibromyalgia, TMD or somatoform disorders, no nociceptive or neuropathic input is detectable. We summarise the studies investigating the neural substrates and neurobiological mechanisms of stress-induced hyperalgesia (SIH) in animals and humans. The review provides new perspectives and challenges for the current and future treatment of chronic pain.
Dep. Psychosomatische Medizin, Klinik Barmelweid, CH-5017, Barmelweid/Aarau, Schweiz. ulrich.egle@barmelweid.ch.
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Egle
Kompetenzbereich für Psychosomatische Medizin, Univ.-Klinik für Allgemeine Innere Medizin, Inselspital Bern, Bern, Schweiz.
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N
Egloff
Univ.-Klinik für Neurologie, Inselspital Bern, Bern, Schweiz.
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von Känel
D000328:Adult; D000818:Animals; D002490:Central Nervous System / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D059350:Chronic Pain / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D004195:Disease Models, Animal; D004644:Emotions / Q000502:physiology*; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D007223:Infant; D008016:Life Change Events; D008297:Male; D009619:Nociceptors / Q000502:physiology; D010147:Pain Measurement; D011610:Psychosocial Deprivation; D019962:Reactive Attachment Disorder / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D013001:Somatoform Disorders / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology*
Attachment; Childhood traumatization; Fibromyalgia; Somatoform pain disorder; Stress induced hyperalgesia