Cited by 377Pain Mechanisms and TreatmentsMusculoskeletal pain and rehabilitationFibromyalgia and Chronic Fatigue Syndrome Research

The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgia

Open access
Lee, Yvonne C, Nassikas, Nicholas J, Clauw, Daniel J·2011·Arthritis Research & Therapy

Abstract

Pain is a key component of most rheumatologic diseases. In fibromyalgia, the importance of central nervous system pain mechanisms (for example, loss of descending analgesic activity and central sensitization) is well documented. A few studies have also noted alterations in central pain processing in osteoarthritis, and some data, including the observation of widespread pain sensitivity, suggest that central pain-processing defects may alter the pain response in rheumatoid arthritis patients. When central pain is identified, different classes of analgesics (for example, serotonin-norepinephrine reuptake inhibitors, α2δ ligands) may be more effective than drugs that treat peripheral or nociceptive pain (for example, nonsteroidal anti-inflammatory drugs and opioids).

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Crossref · 10.1186/ar3306

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  • Poor sleep is linked to disrupted central pain processing, described as a diffuse hyperalgesia state in fibromyalgia, possibly from loss of descending analgesic activity and central sensitization.

    “Poor sleep is related to a disturbance of central painprocessing mechanisms, identified as a”

    From Efficacy of Combined Cognitive-Behavioral Therapy for Insomnia and Pain in Patients with Fibromyalgia: A Randomized Controlled Trial (2018) · cites this paper as Lee et al. 2011

    The Rheumatoid arthritis section (page unavailable) links sleep disturbance to pain thresholds at joint and nonjoint sites, indicating a central mechanism. The Fibromyalgia section (page unavailable) describes diffuse hyperalgesia that may partly reflect loss of descending analgesia and central sensitization. The paper does not specifically establish that poor sleep is linked to that diffuse hyperalgesic state in fibromyalgia. (LLM, conf=0.86)

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Research works printed but not linked: 1

  1. Yarnitsky D Granovsky Y Fadel S Sprecher E Granot M Endogenous analgesia and SSNRI towards individually tailored pain therapy Proceedings of the 12th World Congress on Pain: 2008; Glasgow, Scotland 2008 Seattle, WA: IASP Press

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Authors
Lee, Y. C., Nassikas, N. J., & Clauw, D. J.
Affiliations
  • Brigham and Women's Hospital (US)
  • University of Michigan (US)
Corresponding author
Lee, Yvonne C
Venue
Arthritis Research & Therapy
Published
2011
Volume
13
Issue
2
Pages
211
ISSN
1478-6354 (ISSN-L)
OpenAlex
W2140037651
Cited by
377
References
87
Citations by year
2026: 11 · 2025: 17 · 2024: 21 · 2023: 28 · 2022: 18 · 2021: 38 · 2020: 28 · 2019: 31 · 2018: 30 · 2017: 25 · 2016: 24 · 2015: 24 · 2014: 27 · 2013: 29 · 2012: 23
FWCI
2.82
Type
journal article
Language
en
Open access
Locations
  • Arthritis Research & Therapy (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR 057578, K23AR057578)
Topics
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords
chronic pain, central nervous system, rheumatoid arthritis, osteoarthritis, fibromyalgia, central sensitization, widespread pain, pain processing, serotonin-norepinephrine reuptake inhibitors, gabapentinoids, analgesic efficacy
MeSH terms
Animals, Arthritis, Rheumatoid, Central Nervous System, Fibromyalgia, Humans, Osteoarthritis, Chronic Pain

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