Central Hypersensitivity in Chronic Musculoskeletal Pain - 06/05/15

Doi : 10.1016/j.pmr.2014.12.002

Michele Curatolo, MD, PhD ^a,^b,^⁎ , Lars Arendt-Nielsen, PhD, Dr Med Sci ^b
^a Department of Anesthesiology and Pain Medicine, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA
^b Center for Sensory Motor Interaction, Department of Health Science and Technology, School of Medicine, University of Aalborg, Fredrik Bajers Vej 7, Bld. D3, Aalborg 9220, Denmark

^∗Corresponding author. Department of Anesthesiology and Pain Medicine, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195.

Résumé

Clinical research has consistently detected alteration in central pain processing leading to hypersensitivity. Most methods used in humans are reliable and have face validity to detect widespread central hypersensitivity. However, construct validity is difficult to investigate due to lack of gold standards. Reference values in the pain-free population have been generated, but need replication. Research on pain biomarkers that reflect specific central hypersensitivity processes is warranted. Few studies have analyzed the prognostic value of central hypersensitivity. Most medications acting at central level and some non-pharmacological approaches, including psychological interventions, are likely to attenuate central hypersensitivity.

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Keywords : Chronic pain, Central sensitization, Hyperalgesia, Quantitative sensory tests