Review article
https://doi.org/10.20471/acc.2023.62.s4.15
Central Sensitization in Patients with Chronic Musculoskeletal Pain
Snežana Tomašević-Todorović
orcid.org/0009-0009-0136-4424
; University of Novi Sad, Faculty of Medicine Novi Sad, Medical Rehabilitation Clinic, University Clinical Center of Vojvodina, Novi Sad, Serbia
Tijana Spasojević
; University of Novi Sad, Faculty of Medicine Novi Sad, Medical Rehabilitation Clinic, University Clinical Center of Vojvodina, Novi Sad, Serbia
Abstract
Central sensitization is the mechanism of nociplastic pain and leads to an overemphasized
response to a painful stimulus (hyperalgesia) or pain to stimuli that do not otherwise cause pain
(allodynia). Persistent nociceptive pain is a risk factor for nociplastic pain, which can often occur in isolation
or combination with other types of pain, most often in patients with chronic musculoskeletal pain
(osteoarthritis, lumbar and cervical syndrome, fibromyalgia, rheumatoid arthritis, complex regional pain
syndrome, tendinopathy, etc.). Diagnosis of central sensitization is established through clinical examination,
questionnaires and quantitative sensory testing (QST), which serves to assess and quantify sensory
functions, i.e., determine the threshold for detection of sensory stimuli (heat-cold, pressure, vibration).
Conditioned Pain Modulation (CPM) testing is important for clarifying pain modulation profiles, which
can be pro-nociceptive (less effective CPM facilitation) and anti-nociceptive (effective, inhibitory CPM
effect). In the pronociceptive modulation profile that is common in patients with musculoskeletal disorders,
there is a higher risk of developing chronic pain, a higher prevalence of pain conditions and higher
pain associated with injury. CPM testing is also important in the individualization of drug therapy for
pain, based on predicting the effectiveness of drugs in the treatment.
Keywords
central sensitization; conditional pain modulation; musculoskeletal pain
Hrčak ID:
316572
URI
Publication date:
1.11.2023.
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