Central sensitization in fibromyalgia and other musculoskeletal disorders
Abstract
Muscle hyperalgesia and referred pain play an important role in chronic musculoskeletal pain. New knowledge on the involved basic mechanisms and better methods to assess muscle pain in the clinic are needed to revise and optimize treatment regimens. Increased muscle sensitivity is manifested as pain evoked by a normally non-nociceptive stimulus (allodynia), increased pain intensity evoked by nociceptive stimuli (hyperalgesia), or increased referred pain areas with associated somatosensory changes. Some manifestations of sensitization, such as expanded referred muscle pain areas in patients with chronic musculoskeletal pain, can be explained from animal experiments showing extrasegmental spread of sensitization. An important part of the pain manifestations (eg, tenderness and referred pain) related to chronic musculoskeletal disorders may result from peripheral and central sensitization, which may play a role in the transition from acute to chronic pain.
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The pathophysiology of fibromyalgia syndrome seems to be related to sensitization of central nervous system processes, which underlie alterations in pain perception, deficient pain inhibition, temporal summation of pain, and other indicators of pain sensitization.
“Regarding the etiopathophysiology of FMS, while its etiology remains unknown, the pathophysiology of this chronic condition seems to be related to the sensitization of CNS processes, e.g., [5,22,23], which underlie the alterations in pain perception displayed by these patients, (e.g., allodynia and hyperalgesia) [24], deficient pain inhibition [25], temporal summation of pain [26] and other”
From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [24]
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Acidic buffer induced muscle pain evokes referred pain and mechanical hyperalgesia in humans
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Neuropathic Features of Joint Pain: A Community‐Based Study
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Induction and assessment of muscle pain, referred pain, and muscular hyperalgesia
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Self-citationFibromyalgia: Harmonizing Science with Clinical Practice Considerations
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Fibromyalgia: Present to future
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Effects of Gabapentin on Experimental Somatic Pain and Temporal Summation
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Self-citationPredictors of Osteoarthritis Pain: the Importance of Resilience
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Nijs, J., Yılmaz, S. T., Elma, Ö., Tatta, J., Mullie, P., Vanderweeën, L., Clarys, P., Deliens, T., Coppieters, I., Weltens, N., et al. (2020) · Expert Opinion on Therapeutic Targets · doi:10.1080/14728222.2020.1784142 · Cited by 62 · see citing works
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Joint pain: more to it than just structural damage?
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Self-citationHigh Prevalence of Pain Sensitization in Knee Osteoarthritis: A Meta-Analysis with Meta-Regression
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Duarte, F. C. K., West, D. W. D., Linde, L. D., Hassan, S. I., & Kumbhare, D. A. (2021) · Current Rheumatology Reports · doi:10.1007/s11926-021-01024-8 · Cited by 50 · see citing works
Bedside Testing for Chronic Pelvic Pain: Discriminating Visceral from Somatic Pain
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Viscero‐somatic reflexes in referred pain areas evoked by capsaicin stimulation of the human gut
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Self-citationSamartin-Veiga, N., Pidal-Miranda, M., González-Villar, A. J., Bradley, C., Garcı́a-Larrea, L., O’Brien, A. T., & Carrillo‐de‐la‐Peña, M. T. (2021) · Pain · doi:10.1097/j.pain.0000000000002493 · Cited by 46 · see citing works
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Pressure-induced referred pain is expanded by persistent soreness
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Self-citationGalvez-Sánchez, C. M., Montoro, C. I., Moreno-Padilla, M., Reyes del Paso, G. A., & de la Coba, P. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10122706 · Cited by 45 · see citing works
“, allodynia and hyperalgesia) [24], deficient pain inhibition [25], temporal summation of pain [26] and other indicators of pain sensitization [25–27].”
BackgroundChanges in Pain Sensitization After Bariatric Surgery
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Age Interactions on Pain Sensitization in Patients With Severe Knee Osteoarthritis and Controls
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Central motor control failure in fibromyalgia: a surface electromyography study
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The transition of reported pain in different body regions – a one-year follow-up study
Gummesson, C., Isacsson, S., Isacsson, A., Andersson, H. I., Ektor-Andersen, J., Östergren, P., Hanson, B. S., & the Malmö Shoulder-Neck Study group (2006) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-7-17 · Cited by 40 · see citing works
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Fibromyalgia: Present to future
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Clinical approach to patients with neuropathic pain.
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Experimental hypoglycemia is a human model of stress-induced hyperalgesia
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Chronic Pain and Surgery: A Review of New Insights from Sensory Testing
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Facilitatory and inhibitory pain mechanisms are altered in patients with carpal tunnel syndrome
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Phenotypes of Women with and Without Endometriosis and Relationship with Functional Pain Disability
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Analgesic effects of 5‐HT3receptor antagonists
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Early Factors Associated with the Development of Chronic Pain in Trauma Patients
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People with musculoskeletal shoulder pain demonstrate no signs of altered pain processing.
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High Rate of Pain Sensitization in Musculoskeletal Shoulder Diseases
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- Authors
- Arendt-Nielsen, L., & Graven-Nielsen, T.
- Venue
- Current Pain and Headache Reports
- Published
- 2003-10
- Volume
- 7
- Issue
- 5
- Pages
- 355-361
- ISSN
- 1531-3433 (ISSN-L)
- 1534-3081
- OpenAlex
- W2161320464
- Cited by
- 219
- References
- 80
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 16 · 2023: 8 · 2022: 7 · 2021: 12 · 2020: 8 · 2019: 7 · 2018: 8 · 2017: 8 · 2016: 4 · 2015: 9 · 2014: 6 · 2013: 11 · 2012: 10
- FWCI
- 1.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Pain and Headache Reports (publishedVersion)
- PubMed (publishedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Funders
- Danmarks Grundforskningsfond
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- central sensitization, fibromyalgia, chronic musculoskeletal pain, muscle hyperalgesia, referred pain, allodynia, transition from acute to chronic pain
- MeSH terms
- Fibromyalgia, Humans, Musculoskeletal Diseases, Nerve Endings, Neuropeptides, Nociceptors, Pain
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