Pain mechanisms for the practicing rheumatologist

IF 4.5 2区 医学 Q1 RHEUMATOLOGY Best Practice & Research in Clinical Rheumatology Pub Date : 2024-03-01 DOI:10.1016/j.berh.2024.101942
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Abstract

Pain in rheumatic diseases transcends the traditional nociceptive paradigm, incorporating complex interactions between nociceptive, neuropathic, and nociplastic mechanisms, as well as significant psychosocial factors. Advances in understanding chronic pain highlight the role of peripheral and central sensitization, and the emergence of nociplastic pain—a result of altered central nervous system processing. This modern perspective acknowledges the influence of mood disorders, environmental stressors, and cognitive patterns like catastrophizing, revealing the intricate interplay between biological, psychological, and social determinants of pain. Research emphasizes the brain's pivotal role in pain perception, underscoring the importance of comprehensive approaches that integrate medical, psychological, and social interventions to address the multifaceted nature of chronic pain in rheumatic diseases effectively.

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风湿病执业医师的疼痛机制。
风湿性疾病的疼痛超越了传统的痛觉范式,包含痛觉、神经病理性和非痛觉塑性机制之间复杂的相互作用,以及重要的社会心理因素。在理解慢性疼痛方面取得的进展凸显了外周和中枢敏化的作用,以及非可塑性疼痛的出现--中枢神经系统处理过程改变的结果。这种现代观点承认情绪障碍、环境压力和认知模式(如灾难化)的影响,揭示了疼痛的生物、心理和社会决定因素之间错综复杂的相互作用。研究强调了大脑在疼痛感知中的关键作用,强调了综合医疗、心理和社会干预措施的重要性,以有效解决风湿病慢性疼痛的多面性。
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来源期刊
CiteScore
9.40
自引率
0.00%
发文量
43
审稿时长
27 days
期刊介绍: Evidence-based updates of best clinical practice across the spectrum of musculoskeletal conditions. Best Practice & Research: Clinical Rheumatology keeps the clinician or trainee informed of the latest developments and current recommended practice in the rapidly advancing fields of musculoskeletal conditions and science. The series provides a continuous update of current clinical practice. It is a topical serial publication that covers the spectrum of musculoskeletal conditions in a 4-year cycle. Each topic-based issue contains around 200 pages of practical, evidence-based review articles, which integrate the results from the latest original research with current clinical practice and thinking to provide a continuous update. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. The review articles seek to address the clinical issues of diagnosis, treatment and patient management. Management is described in practical terms so that it can be applied to the individual patient. The serial is aimed at the physician in both practice and training.
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