The role of central sensitization in the formation and maintenance of chronic pain in patients with joint diseases


DOI: https://dx.doi.org/10.18565/therapy.2021.1.90-96

Filatova E.S.

V.A. Nasonova Research Institute of Rheumatology, Moscow
Abstract. Chronic pain in rheumatic diseases (RD) has been associated for a long time exclusively with inflammatory and structural changes in the joints and surrounding tissues, considering it as predominantly nociceptive pain, i.e. associated with the activation of peripheral pain receptors. However, in RD, there is often a dissociation between the pain syndrome severity, structural changes in joints, and activity of the disease. This could be explained by the mixed nature of pain, when nociceptive pain is combined with functional disorders of the pain system caused by the phenomenon of central sensitization (CS). CS is a biological process associated with an increase of nociceptive system excitability and a significant decrease in the pain threshold. The development of CS is associated with more intense pain feelings, «neuropathic coloration» of pain, a greater frequency of depression and anxiety, as well as a frequent combination with fibromyalgia. The identification of the CS phenomenon is of great practical importance for the development of programs for complex pathogenetic therapy of chronic pain associated with musculoskeletal diseases.
Keywords: central sensitization, chronic pain, rheumatoid arthritis, osteoarthritis
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About the Autors

Ekaterina S. Filatova, PhD, researcher of the Laboratory of pathophysiology of pain and polymorphism of musculoskeletal diseases, V.A. Nasonova Research Institute of Rheumatology. Address: 115522, Moscow, 34А Kashirskoe highway. Tel.: +7 (916) 261-55-91. E-mail: Es-Filatova@mail.ru. ORCID: 0000-0002-2475-862

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