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Central mechanisms in the maintenance of chronic widespread noninflammatory muscle pain - Source: Current Pain and Headache Reports, Oct 2008

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By Josimari M DeSantana and Kathleen A Sluka • www.ProHealth.com • September 4, 2008


Chronic widespread pain (CWP) conditions such as fibromyalgia and myofascial syndromes are characterized by generalized pain, tenderness, morning stiffness, disturbed sleep, and pronounced fatigue. However, CWP pathophysiology is still unclear.

 

A number of hypotheses have been proposed as the underlying pathophysiology of CWP: muscular dysfunction/ischemia, central sensitization, and a deficit in endogenous pain-modulating systems.

This article reviews the current and emerging literature about the pathophysiology and neurobiology of chronic widespread musculoskeletal pain.

• Widespread musculoskeletal pain results in changes in the central nervous system in human subjects and animal models.

• These changes likely reflect alterations in supraspinal modulation of nociception [modulation of the nervous system’s signal transmission above the spinal cord – i.e., in the brain], and include increases in excitatory and decreases in inhibitory modulation pathways.

• These alterations in excitation and inhibition likely drive changes observed in the spinal cord to result in central sensitization [sensitization of the entire central nervous system], and the consequent pain and hyperalgesia [increased sensitivity to pain].

Source: Current Pain and Headache Reports, Oct 2008;12(5):338-43. PMID: 18765138, by Desantana JM, Sluka KA. Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, USA. [E-mail: kathleen-sluka@uiowa.edu]





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