Central Hypersensitivity in Chronic Pain: Mechanisms and Clinical Implications

Curatolo, Michele; Arendt‐Nielsen, Lars; Petersen-Felix, Steen

doi:10.1016/j.pmr.2005.12.010

Cited by 154 publications

(138 citation statements)

References 90 publications

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“…Examples are manual therapy, muscle contraction techniques, thermotherapy, ultrasound and laser. These techniques are effective for nociceptive pain control, however they should be carefully used for neuropathic pain because they may increase nociceptive sensitization 9 .…”

Section: Peripheralmentioning

confidence: 99%

“…Applying techniques aiming at this effect depends on the level of tolerance of patients. For neuropathic pain, increased painful stimuli may have a negative effect on patients 9 .…”

Section: Spinal Cord Dorsal Hornmentioning

confidence: 99%

“…This negative cortical reorganization in painful conditions causes distorted pain perception, changing body sensory and motor scheme and leading to laterality problems 24,26 . It is believed that such changes help the maintenance of pain, of alertness and of central sensitization 9,26 . Physical therapy may positively reorganize the cortex through active and integrated modalities with cognitive behavioral approaches.…”

Section: Cerebral Cortexmentioning

confidence: 99%

“…Studies have shown that hormonal unbalance is a sensitization factor 5,9 . Hormones, such as growth hormones, have a critical role in pain modulation.…”

Section: Hormonalmentioning

confidence: 99%

“…Decreased testosterone, estrogen and progesterone have been the subject of still poorly conclusive studies. On the other hand, norepinephrine and cortisol, when constantly released, cause muscle hyperactivity throughout the body and maintenance of alertness 5,9 . Regular physical exercises, improved sleep quality, adequate feeding and enjoyable activities may be a way to look for the balance of such hormones and decrease central sensitization.…”

Section: Hormonalmentioning

confidence: 99%

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Mecanismos de ação e efeitos da fisioterapia no tratamento da dor

Gosling¹

2012

Rev. dor

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SUMMARY BACKGROUND AND OBJECTIVES:Along time, physical therapy has played an important role in the treatment of painful patients. Several neurophysiological mechanisms have been proposed to explain pain modulation via physical and cognitive behavioral approaches; however they have to be further explored by the physical therapist. This study aimed at reviewing major action mechanisms and effects of physical therapy techniques to manage pain. CONTENTS: There are studies on the action mechanisms and effects of physical therapy during pain processing stages in the nervous system. To organize information, mechanisms and theories were grouped in peripheral and central stations. Effects, however, were grouped in motor, sympathetic and hormonal systems, psychophysiological factors and placebo. CONCLUSION: Several mechanisms and effects may be influenced by physical therapy physical and cognitive behavioral techniques, thus contributing to the treatment of painful patients and helping the choice of techniques based on identified clinical mechanisms. Keywords: Pain, Pain perception, Physical therapy modalities. RESUMO JUSTIFICATIVA E OBJETIVOS:A fisioterapia vem ao longo dos anos mostrando um importante papel no tratamento de pacientes com dor. Diversos mecanismos neurofisiológicos já foram propostos para explicar a modulação da dor por meio de abordagens físicas e cognitivas comportamentais, porém necessitam ser mais bem explorados pelo fisioterapeuta. O objetivo deste estudo foi revisar os principais mecanismos de ação e efeitos das técnicas fisioterapêuticas para o tratamento da dor. CONTEÚDO: Estudos refletem sobre os mecanismos de ação e efeitos da fisioterapia durante as etapas de processamento da dor no sistema nervoso. Para organizar as informações, os mecanismos e teorias foram agrupados em estações periféricas e centrais. Já os efeitos foram agrupados nos sistemas motor, simpático e hormonal, efeitos psicofisiológicos e placebo. CONCLUSÃO: Diversos mecanismos e efeitos podem ser influenciados pelas técnicas físicas e cognitivas comportamentais da fisioterapia, contribuindo para o tratamento de pacientes com dor e facilitando a escolha das técnicas com base nos mecanismos clínicos identificados. Descritores: Dor, Modalidades de fisioterapia, Percepção da dor.

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Section: Peripheralmentioning

confidence: 99%

“…Applying techniques aiming at this effect depends on the level of tolerance of patients. For neuropathic pain, increased painful stimuli may have a negative effect on patients 9 .…”

Section: Spinal Cord Dorsal Hornmentioning

confidence: 99%

Section: Cerebral Cortexmentioning

confidence: 99%

“…Studies have shown that hormonal unbalance is a sensitization factor 5,9 . Hormones, such as growth hormones, have a critical role in pain modulation.…”

Section: Hormonalmentioning

confidence: 99%

Section: Hormonalmentioning

confidence: 99%

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