Central sensitisation: causes, therapies, and terminology

Cayrol, Timothée; Broeke, Emanuel N. van den

doi:10.1016/s2665-9913(21)00176-4

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…CS is defined as the elevated responsiveness of nociceptive neurons in the CNS to normal or subthreshold afferent inputs as a result of CNS plasticity [ 20 ]. An increase in spontaneous neuronal activity causes pain hypersensitivity by lowering activation thresholds and expanding the receptive field [ 9 ].…”

Section: Reviewmentioning

confidence: 99%

Mechanisms of Peripheral and Central Sensitization in Osteoarthritis Pain

Ohashi¹,

Uchida²,

Fukushima³

et al. 2023

Cureus

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Pain, the primary symptom of osteoarthritis (OA), reduces both the quality and quantity of life for patients. The pathophysiology of OA pain is complex and often difficult to explain solely by radiological structural changes. One reason for this discrepancy is pain sensitization (peripheral sensitization [PS] and central sensitization [CS]) in OA. Thus, an understanding of pain sensitization is important when considering treatment strategies and development for OA pain. In recent years, pro-inflammatory cytokines, nerve growth factors (NGFs), and serotonin have been identified as causative agents that induce peripheral and central sensitization and are becoming therapeutic targets for OA pain. However, the characteristics of the clinical manifestations of pain sensitization elicited by these molecules remain unclear, and it is not well understood who among OA patients should receive the therapeutic intervention. Thus, this review summarizes evidence on the pathophysiology of peripheral and central sensitization in OA pain and the clinical features and treatment options for this condition. While the majority of the literature supports the existence of pain sensitization in chronic OA pain, clinical identification and treatment of pain sensitization in OA are still in their infancy, and future studies with good methodological quality are needed.

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Section: Reviewmentioning

confidence: 99%

Mechanisms of Peripheral and Central Sensitization in Osteoarthritis Pain

Ohashi¹,

Uchida²,

Fukushima³

et al. 2023

Cureus

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“…Here, exercise therapy for nociplastic pain and central sensitisation can be used to improve the condition of the neurophysiological system. Central sensitisation is defined as the increased sensitivity of the nociceptive neurons of the central nervous system [74], and, as such, exercise therapy can be used as a means to facilitate a desensitisation process. In this process, gradual exposure to stimuli of increasing strength (in this case, exercise) can be used to decrease sensitivity [75].…”

Section: Exercise Therapy For Chronic Nociplastic Neck Painmentioning

confidence: 99%

Exercise Therapy for Chronic Neck Pain: Tailoring Person-Centred Approaches within Contemporary Management

de Zoete

2023

JCM

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Exercise therapy is considered the best evidence-based approach for managing chronic neck pain. However, the implementation of exercise therapy presents several challenges. Systematic reviews indicate that it has modest effectiveness, while clinical practice guidelines offer limited guidance on the exercise parameters required to optimise clinical outcomes. Moreover, recommendations often fail to differentiate between different types of neck pain. This article addresses the challenges associated with the prescription of exercise for chronic neck pain and provides recommendations for exercise therapy specific to chronic nociceptive, neuropathic, and nociplastic neck pain. The goal of this article is to facilitate the implementation of high-value evidence-based exercise therapy for these distinct types of chronic neck pain with the aim to improve its outcomes and to reduce the related individual and societal burdens.

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“…CS can explain the absence of a clear source of nociceptive input and the resulting disability and severity. The World Health Organization recognizes pain as main cause of disability globally 4,5 . Features of central sensitization have been documented in numerous pain conditions including fibromyalgia, osteoarthritis, rheumatoid arthritis, upper extremity tendinopathies, headache and spinal pain [6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Central Sensitization in Patients with Chronic Musculoskeletal Pain

Tomašević-Todorović

2023

ACC

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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.

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Central sensitisation: causes, therapies, and terminology

Cited by 5 publications

References 5 publications

Mechanisms of Peripheral and Central Sensitization in Osteoarthritis Pain

Mechanisms of Peripheral and Central Sensitization in Osteoarthritis Pain

Exercise Therapy for Chronic Neck Pain: Tailoring Person-Centred Approaches within Contemporary Management

Central Sensitization in Patients with Chronic Musculoskeletal Pain

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