Central regulation of pain in patients with joint disease and approaches to therapy

Filatova E.S.; rdes Sh.F.; Filatova E.G.

doi:https://doi.org/10.17116/terarkh20168812159-164

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Abstract:

The paper reviews investigations studies that have demonstrated that chronic pain syndrome is mixed in rheumatic diseases. The nervous system is involved in its pathogenesis with different frequency and different mechanisms. Under the influence of afferent pain impulses from damaged joints, there are changes in the excitability of spinal cord neurons, which is called central sensitization (CS). A number of patients have enhanced CS and clinical manifestations as neuropathic sensitive phenomena. The mixed model of the development of chronic pain in joint diseases and its presence along with nociceptive (inflammatory) and neuropathic pain components may explain the discrepancy between joint inflammatory and structural changes and pain intensity, the presence of distant pain and sensitive disorders in the areas outside the joint, and sometimes the efficiency of anti-inflammatory therapy. The presence of the neuropathic pain component serves as a rationale for combined therapy by adding centrally acting drugs, such as anticonvulsants.

Keywords:

neuropathic pain component

chronic pain syndrome

joint pain

rheumatoid arthritis

knee osteoarthritis

ankylosing spondylitis

pregabalin

Authors:

Filatova E.S.

FGBU "Nauchno-issledovatel'skiĭ institut revmatologii im. V.A. Nasonovoĭ" RAMN, Moskva

rdes Sh.F.

FGBU "Nauchno-issledovatel'skiĭ institut revmatologii im. V.A. Nasonovoĭ" RAMN, Moskva

Filatova E.G.

Moskovskaia meditsinskaia akademiia im. I.M. Sechenova

SPIN RSCI: 9172-7932
Scopus AuthorID: 7004339469
ORCID: 0000-0001-9978-4180

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