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Erschienen in:
Primär chronisch degenerative Erkrankungen: ein Lifestyle-Produkt Kapitel lesen Erstes Kapitel lesen

2022 | OriginalPaper | Buchkapitel

8. CPM und chronisch degenerative Erkrankungen und Schmerzsyndrome

verfasst von : Wolfgang Laube

Erschienen in: Schmerztherapie ohne Medikamente

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Bei muskuloskelettalen Schmerzen sind im MRI konsistent maladaptive Veränderungen sichtbar. Die Beurteilung einer zentralen Sensibilisierung variiert aber. Der CPM-Effekt steht für die Sensibilisierung und die Prognose von Therapiewirkungen.
Die ZNS-Sensibilisierung repräsentiert unabhängig von der Genese das fortgeschrittene Krankheitsstadium, indem das Gehirn einbezogen ist und die Schmerzen führend werden.
Bei chronischen muskuloskelettalen Schmerzen sind häufig sensorische Tests oder die CPM-Reaktion verändert, oder das MRT liefert Hinweise. Osteoarthrosen gehen mit einer generalisierten Hyperalgesie und geringem CPM-Index einher. Es gibt 4 Cluster des CLBP. Es werden myofaszial-nozizeptive, neuropathische und zentrale Schmerzen geklagt. Deshalb variiert die Beurteilung der zentralen Sensibilisierung. Über die Cluster ist sie feststellbar. Die Fibromyalgie ist durch die zentrale Sensibilisierung gekennzeichnet. Auch chronische Tendinopathien sind mit einer zentralen Sensibilisierung verbunden.
Literatur
Apkarian AV, Sosa Y, Sonty S, Levy RM, Harden RN, Parrish TB, Gitelman DR. Chronic back pain is associated with decreased prefrontal and thalamic gray matter density. J Neurosci. 2004;24:10410–5. [PubMed: 15548656].PubMedPubMedCentral
Arendt-Nielsen L, Morlion B, Perrot S, Dahan A, Dickenson A, Kress HG, Wells C, Bouhassira D, Mohr Drewes A. Assessment and manifestation of central sensitisation across different chronic pain conditions. Eur J Pain. 2018;22(2):216–41.PubMed
Baert IAC, Lluch E, Mulder T, Nijs J, Noten S, Meeus M. Does pre-surgical central modulation of pain influence outcome after total knee replacement? A systematic review. Osteoarthr Cartil. 2016;24(2):213–23.
Baraniuk JN, Whalen G, Cunningham J, Clauw DJ. Cerebrospinal fluid levels of opioid peptides in fibromyalgia and chronic low back pain. BMC Musculoskelet Disord. 2004;5:48.PubMedPubMedCentral
Baron R, Binder A, Attal N, Casale R, Dickenson AH, Treede RD. Neuropathic low back pain in clinical practice. Eur J Pain. 2016;20(6):861–73.PubMedPubMedCentral
Bosma RL, Mojarad EA, Leung L, Pukall C, Staud R, Stroman PW. FMRI of spinal and supra-spinal correlates of temporal pain summation in fibromyalgia patients. Hum Brain Mapp. 2016;37(4):1349–60.PubMedPubMedCentral
Bruehl S, Chung OY, Ward P, Johnson B, McCubbin JA. The relationship between resting blood pressure and acute pain sensitivity in healthy normotensives and chronic back pain sufferers: the effects of opioid blockade. Pain. 2002;100:191–201.PubMed
Burgmer M, Gaubitz M, Konrad C, Wrenger M, Hilgart S, Heuft G, Pfleiderer B. Decreased gray matter volumes in the cingulo-frontal cortex and the amygdala in patients with fibromyalgia. Psychosom Med. 2009;71(5):566–73.PubMed
Cagnie B, Coppieters I, Denecker S, Six J, Danneels L, Meeus M. Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI. Semin Arthritis Rheum. 2014;44(1):68–75.PubMed
Čeko M, Shir Y, Ouellet JA, Ware MA, Stone LS, Seminowicz DA. Partial recovery of abnormal insula and dorsolateral prefrontal connectivity to cognitive networks in chronic low back pain after treatment. Hum Brain Mapp. 2015;36(6):2075–92.PubMedPubMedCentral
Chung OY, Bruehl S, Diedrich L, Diedrich A, Chont M, Robertson D. Baroreflex sensitivity associated hypoalgesia in healthy states is altered by chronic pain. Pain. 2008;138:87–97.PubMed
Dworkin BR, Filewich RJ, Miller NE, Craigmyle N, Pickering TG. Baroreceptor activation reduces reactivity to noxious stimulation: implications for hypertension. Science. 1979;205(4412):1299–301.PubMed
Eckenrode BJ, Stackhouse SK. Improved pressure pain thresholds and function following noxious elecrical stimulation on a runner with chronic achilles tendinopaty: a case report. Int J Sports Phys Ther. 2015;10(3):354–62.PubMedPubMedCentral
Eckenrode BJ, Kietrys DM, Stackhouse SK. Pain sensitivity in chronic achilles tendinopathy. Int J Sports Phys Ther. 2019;14(6):945–56.PubMedPubMedCentral
Farinatti PT, Brandao C, Soares PP, Duarte AF. Acute effects of stretching exercise on the heart rate variability in subjects with low flexibility levels. J Strength Cond Res. 2011;25(6):1579–85.PubMed
Finan PH, Buenaver LF, Bounds SC, Hussain S, Park RJ, Haque UJ, Campbell CM, Haythornthwaite JA, Edwards RR, Smith MT. Discordance between pain and radiographic severity in knee osteoarthritis: findings from quantitative sensory testing of central sensitization. Arthritis Rheum. 2013;65(2):363–72. https://​doi.​org/​10.​1002/​art.​34646.CrossRefPubMed
Fiquerola MD, Loe WH, Barontini M. Plasma metenkephalin response to local treatment in patients with fibromyalgia. J Neurol Sci. 1997;150:S335.
Flynn T, Fritz J, Whitman J, Wainner R, Magel J, Rendeiro D, Butler B, Garber M, Allison S. A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with spinal manipulation. Spine. 2002;27:2835–43.PubMed
Gerhardt A, Eich W, Treede RD, Tesarz J. Conditioned pain modulation in patients with nonspecific chronic back pain with chronic local pain, chronic widespread pain, and fibromyalgia. Pain. 2017;158(3):430–9.PubMed
Ghione S. Hypertension-associated hypalgesia. Evidence in experimental animals and humans, pathophysiological mechanisms, and potential clinical consequences. Hypertension. 1996;28(3):494–504.PubMed
Goubert D, Meeus M, Willems T, De Pauw R, Coppieters I, Crombez G, Danneels L. The association between back muscle characteristics and pressure pain sensitivity in low back pain patients. Scand J Pain. 2018;18(2):281–93.PubMed
Grachev ID, Fredrickson BE, Apkarian AV. Abnormal brain chemistry in chronic back pain: an in vivo proton magnetic resonance spectroscopy study. Pain. 2000;89:7–18. [PubMed: 11113288].PubMed
Guasti L, Merlo B, Verga R, Cattaneo R, Gaudio G, Bianchi L, Zanzi P, Grandi AM, Bossi PM, Venco A. Effects of arithmetic mental stress test on hypertension-related hypalgesia. J Hypertens. 1995;13(12 Pt 2):1631–5.PubMed
Guasti L, Zanotta D, Mainardi LT, Petrozzino MR, Grimoldi P, Garganico D, Diolisi A, Gaudio G, Klersy C, Grandi AM, Simoni C, Cerutti S. Hypertension-related hypoalgesia, autonomic function and spontaneous baroreflex sensitivity. Auton Neurosci. 2002;99(2):127–33.PubMed
Gudala K, Bansal D, Vatte R, Ghai B, Schifano F, Boya C. High prevalence of neuropathic pain component in patients with low back pain: evidence from meta-analysis. Pain Physician. 2017;20(5):343–52.PubMed
Gwilym SE, Oag HCL, Tracey I, Carr AJ. Evidence that central sensitisation is present in patients with shoulder impingement syndrome and influences the outcome after surgery. J Bone Joint Surg (Br). 2011;93(4):498–502.
Haik MN, Evans K, Smith A, Henríquez L, Bisset L. People with musculoskeletal shoulder pain demonstrate no signs of altered pain processing. Musculoskelet Sci Pract. 2019;39:32–8.PubMed
Harris RE, Clauw DJ, Scott DJ, McLean SA, Gracely RH, Zubieta JK. Decreased central mu-opioid receptor availability in fibromyalgia. J Neurosci. 2007;27:10000–6.PubMedPubMedCentral
Heales LJ, Lim ECW, Hodges PW, Vicenzino B. Sensory and motor deficits exist on the non-injured side of patients with unilateral tendon pain and disability--implications for central nervous system involvement: a systematic review with meta-analysis. Br J Sports Med. 2014;48(19):1400–6.PubMed
Hodges P, Holm AK, Hansson T, Holm S. Rapid atrophy of the lumbar multifidus follows experimental disc or nerve root injury. Spine (Phila Pa 1976). 2006;31(25):2926–33.
Imamura M, Chen J, Matsubayashi SR, Targino RA, Alfieri FM, Bueno DK, Hsing WT. Changes in pressure pain threshold in patients with chronic nonspecific low back pain. Spine (Phila Pa 1976). 2013;38:2098–107. [PubMed: 24026153].
Indahl A, Kaigle AM, Reikeras O, Holm SH. Interaction between the porcine lumbar intervertebral disc, zygapophysial joints, and paraspinal muscles. Spine (Phila Pa 1976). 1997;22(24):2834–40.
Jensen KB, Kosek E, Petzke F, Carville S, Fransson P, Marcus H, Williams SC, Choy E, Giesecke T, Mainguy Y, Gracely R, Ingvar M. Evidence of dysfunctional pain inhibition in fibromyalgia reflected in rACC during provoked pain. Pain. 2009;144:95–100.PubMed
Kennedy DL, Kemp HI, Ridout D, Yarnitsky D, Rice AS. Reliability of conditioned pain modulation: a systematic review. Pain. 2016;157(11):2410–9.PubMedPubMedCentral
Khedr EM, Omran EAH, Ismail NM, El-Hammady DH, Goma SH, Kotb H, Galal H, Osman AM, Farghaly HSM, Karim AA, Ahmed GA. Effects of transcranial direct current stimulation on pain, mood and serum endorphin level in the treatment of fibromyalgia: a double blinded, randomized clinical trial. Brain Stimul. 2017;10:893–901.PubMed
Kjaer M, Bayer ML, Eliasson P, Heinemeier KM. What is the impact of inflammation on the critical interplay between mechanical signaling and biochemical changes in tendon matrix? J Appl Physiol (1985). 2013;115(6):879–83.
Kosek E, Hansson P. Modulatory influence on somatosensory perception from vibration and heterotopic noxious conditioning stimulation (HNCS) in fibromyalgia patients and healthy subjects. Pain. 1997;70:41–51.PubMed
Kosek E, Ordeberg G. Lack of pressure pain modulation by heterotopic noxious conditioning stimulation in patients with painful osteoarthritis before, but not following, surgical pain relief. Pain. 2000;88:69–78.PubMed
Kosek E, Ekholm J, Hansson P. Modulation of pressure pain thresholds during and following isometric contraction in patients with fibromyalgia and in healthy controls. Pain. 1996;64:415–23.PubMed
Kuppens K, Hans G, Roussel N, Struyf F, Fransen E, Cras P, Van Wilgen CP, Nijs J. Sensory processing and central pain modulation in patients with chronic shoulder pain: a case-control study. Scand J Med Sci Sports. 2018;28(3):1183–92.PubMed
Lannersten L, Kosek E. Dysfunction of endogenous pain inhibition during exercise with painful muscles in patients with shoulder myalgia and fibromyalgia. Pain. 2010;151:77–86.PubMed
Larsson R, Bernhardsson S, Nordeman L. Effects of eccentric exercise in patients with subacromial impingement syndrome: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2019;20(1):446.PubMedPubMedCentral
Laube W. Sensomotorik und Schmerz. Berlin: Springer;2020.
Laursen BS, Bajaj P, Olesen AS, Delmar C, Arendt-Nielsen L. Health related quality of life and quantitative pain measurement in females with chronic non-malignant pain. Eur J Pain. 2005;9:267–75. [PubMed: 15862476].PubMed
Lesher JM, Dreyfuss P, Hager N, Kaplan M, Furman M. Hip joint pain referral patterns: a descriptive study. Pain Med. 2008;9:22–5.PubMed
Lewis GN, Heales L, Rice DA, Rome K, McNair PJ. Reliability of the conditioned pain modulation paradigm to assess endogenous inhibitory pain pathways. Pain Res Manag. 2012;17(2):98–102.PubMedPubMedCentral
Luerding R, Weigand T, Bogdahn U, Schmidt-Wilcke T. Working memory performance is correlated with local brain morphology in the medial frontal and anterior cingulate cortex in fibromyalgia patients: structural correlates of pain-cognition interaction. Brain. 2008;131(Pt 12):3222–31.PubMed
Malfliet A, De Pauw R, Kregel J, Coppieters I, Meeus M, Roussel N, Danneels L, Cagnie B, Nijs J. Gender differences in the association of brain gray matter and pain-related psychosocial characteristics. Pain Physician. 2019;22(3):E191–203.PubMed
Meeus M, Roussel NA, Truijen S, Nijs J. Reduced pressure pain thresholds in response to exercise in chronic fatigue syndrome but not in chronic low back pain: an experimental study. J Rehabil Med. 2010;42:884–90. [PubMed: 20878051].PubMed
Moss P, Knight E, Wright A. Subjects with knee osteoarthritis exhibit widespread hyperalgesia to pressure and cold. PLoS One. 2016;11:e0147526.PubMedPubMedCentral
Mueck-Weymann M, Janshoff G, Mueck H. Stretching increases heart rate variability in healthy athletes complaining about limited muscular flexibility. Clin Auton Res. 2004;14(1):15–8.PubMed
Newcomb LW, Koltyn KF, Morgan WP, Cook DB. Influence of preferred versus prescribed exercise on pain in fibromyalgia. Med Sci Sports Exerc. 2011;43:1106–13.PubMedPubMedCentral
Noten S, Struyf F, Lluch E, D’Hoore M, Van Looveren E, Meeus M. Central pain processing in patients with shoulder pain: a review of the literature. Pain Pract. 2017;17(2):267–80.PubMed
Olsen RB, Bruhel S, Nielsen CS, et al. Hypertension prevalence and diminished blood pressure-related hypoalgesia in individuals reporting chronic pain in a general population: the Tromso study. Pain. 2013;154:257–62.PubMed
Olsen RB, Bruehl S, Nielsen CS, Rosseland LA, Eggen AE, Stubhaug A. Chronic pain and cardiovascular stress responses in a general population: the Tromsø Study. J Behav Med. 2014;37:1193–201.PubMed
Peters ML, Schmidt AJ, Van den Hout MA, Koopmans R, Sluijter ME. Chronic back pain, acute postoperative pain and the activation of diffuse noxious inhibitory controls (DNIC). Pain. 1992;50(2):177–87.PubMed
Plinsinga ML, Brink MS, Vicenzino B, van Wilgen CP. Evidence of nervous system sensitization in commonly presenting and persistent painful tendinopathies: a systematic review. J Orthop Sports Phys Ther. 2015;45(11):864–75.PubMed
Randich A, Maixner W. The role of sinoaortic and cardiopulmonary baroreceptor reflex arcs in nociception and stress-induced analgesia. Ann N Y Acad Sci. 1986;467:385–401.PubMed
Robinson ME, Craggs JG, Price DD, Perlstein WM, Staud R. Gray matter volumes of pain-related brain areas are decreased in fibromyalgia syndrome. J Pain. 2011;12(4):436–43.PubMed
Rodrigues P, Correa L, Ribeiro M, Silva B, Reis F, Nogueira L. Patients with impaired descending nociceptive inhibitory system present altered cardiac vagal control at rest. Pain Physician. 2018;21(4):E409–18.PubMed
Saccò M, Meschi M, Regolisti G, Detrenis S, Bianchi L, Bertorelli M, Pioli S, Magnano A, Spagnoli F, Giuri PG, Fiaccadori E, Caiazza A. The relationship between blood pressure and pain. J Clin Hypertens (Greenwich). 2013;15(8):600–5. https://​doi.​org/​10.​1111/​jch.​12145. Epub 2013 Jun 10.CrossRef
Sanchis MN, Lluch E, Nijs J, Struyf F, Kangasperko M. The role of central sensitization in shoulder pain: a systematic literature review. Semin Arthritis Rheum. 2015;44(6):710–6.PubMed
Scheele C, Nielsen S, Pedersen BK. ROS and myokines promote muscle adaptation to exercise. Trends Endocrinol Metab. 2009;20(3):95–9. Epub 2009 Mar 9.PubMed
Schmidt-Wilcke T, Leinisch E, Ganssbauer S, Draganski B, Bogdahn U, Altmeppen J, May A. Affective components and intensity of pain correlate with structural differences in gray matter in chronic back pain patients. Pain. 2006;125:89–97. [PubMed: 16750298].PubMed
Seminowicz DA, Wideman TH, Naso L, Hatami-Khoroushahi Z, Fallatah S, Ware MA, Jarzem P, Bushnell MC, Shir Y, Ouellet JA, Stone LS. Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function. J Neurosci. 2011;31:7540–50. [PubMed: 21593339].PubMedPubMedCentral
Shire AR, Stæhr TAB, Overby JB, Dahl MB, Jacobsen JS, Christiansen DH. Specific or general exercise strategy for subacromial impingement syndrome-does it matter? A systematic literature review and meta analysis. BMC Musculoskelet Disord. 2017;18(1):158.PubMedPubMedCentral
Singh L, Kaur A, Bhatti MS, Bhatti R. Possible molecular mediators involved and mechanistic insight into fibromyalgia and associated co-morbidities. Neurochem Res. 2019;44(7):1517–32.PubMed
Staud R, Vierck CJ, Cannon RL, et al. Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain. 2001;91:165–75. [PubMed: 11240089].PubMed
Sun YG, Lundeberg T, Yu LC. Involvement of endogenous beta-endorphin in antinociception in the arcuate nucleus of hypothalamus in rats with inflammation. Pain. 2003;104:55–63.PubMed
Tamcan O, Mannion AF, Eisenring C, Horisberger B, Elfering A, Müller U. The course of chronic and recurrent low back pain in the general population. Pain. 2010;150(3):451–7.PubMed
Tompra N, van Dieën JH, Coppieters MW. Central pain processing is altered in people with Achilles tendinopathy. Br J Sports Med. 2016;50(16):1004–7.PubMed
Tour J, Löfgren M, Mannerkorpi K, Gerdle B, Larsson A, Palstam A, Bileviciute-Ljungar I, Bjersing J, Martin I, Ernberg M, Schalling M, Kosek E. Gene-to-gene interactions regulate endogenous pain modulation in fibromyalgia patients and healthy controls-antagonistic effects between opioid and serotonin-related genes. Pain. 2017;158(7):1194–203.PubMedPubMedCentral
Vaerøy H, Nyberg F, Terenius L. No evidence for endorphin deficiency in fibromyalgia following investigation of cerebrospinal fluid (CSF) dynorphin A and Met-enkephalin-Arg6-Phe7. Pain. 1991;46:139–43.PubMed
Wilder-Smith OH, Tassonyi E, Arendt-Nielsen L. Preoperative back pain is associated with diverse manifestations of central neuroplasticity. Pain. 2002;97:189–94. [PubMed: 12044615].PubMed
Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(3 Suppl):S2–15.PubMed
Yang Q, Wang Z, Yang L, Xu Y, Chen LM. Cortical thickness and functional connectivity abnormality in chronic headache and low back pain patients. Hum Brain Mapp. 2017;38(4):1815–32.PubMedPubMedCentral
Yarnitsky D, Crispel Y, Eisenberg E, Granovsky Y, Ben-Nun A, Sprecher E, Best LA, Granot M. Prediction of chronic post-operative pain: pre-operative DNIC testing identifies patients at risk. Pain. 2008;138(1):22–8. Epub 2008 Jan 8.PubMed
Younger J, Mackey S. Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study. Pain Med. 2009;10:663–72.PubMed
Younger JW, Zautra AJ, Cummins ET. Effects of naltrexone on pain sensitivity and mood in fibromyalgia: no evidence for endogenous opioid pathophysiology. PLoS One. 2009;4:e5180.PubMedPubMedCentral
Youssef AM, Gustin SM, Nash PG, Reeves JM, Petersen ET, Peck CC, Murray GM, Henderson LA. Differential brain activity in subjects with painful trigeminal neuropathy and painful temporomandibular disorder. Pain. 2014;155:467–75. [PubMed: 24269492].PubMed
Metadaten
Titel
CPM und chronisch degenerative Erkrankungen und Schmerzsyndrome
verfasst von
Wolfgang Laube
Copyright-Jahr
2022
Verlag
Springer Berlin Heidelberg
Buch
Schmerztherapie ohne Medikamente

Print ISBN: 978-3-662-63845-3

Electronic ISBN: 978-3-662-63846-0

Copyright-Jahr: 2022

DOI
https://doi.org/10.1007/978-3-662-63846-0_8

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