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2022 | OriginalPaper | Buchkapitel

6. Mechanismen der endogenen Schmerzhemmung

verfasst von : Wolfgang Laube

Erschienen in: Schmerztherapie ohne Medikamente

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Die endogene Analgesie gehört zur Bewegung. Die „conditioned pain modulation“ ist das menschliche Korrelat der „diffuse noxious inhibitory control“, einer Hirnstammschleife der Schmerzhemmung, assoziiert mit dem Kortex. Die Periostreizung ist direkt auf die Aktivierung ausgerichtet. Weitere Mechanismen sind die Offset-Analgesie, die zeitliche Summation, der nozizeptive kutanomuskuläre Flexorreflex, ein Index der spinalen nozizeptiven Verarbeitung, und die „hypertension-associated hypoalgesia“. Die „exercise induced hypoalgesia“ (EIH) ist bei Gesunden ein Element stark ermüdender Belastungen. Der Mechanismus ist komplex. Es gibt Gemeinsamkeiten, aber keine Übereinstimmung mit der CPM. Die Belastungsparameter bestimmen die Beteiligung der Schmerzhemmmechanismen. Die Stressachse ist wesentlich dabei. Schmerzpatienten bilden häufig noch eine therapierelevante EIH aus. Die Schmerztoleranz beruht auf Belastungen, die die affektiv-emotionale und die bewertend-kognitive Schmerzkomponente ansprechen.
Literatur
Zurück zum Zitat Anderson T, Lane AR, Hackney AC. Cortisol and testosterone dynamics following exhaustive endurance exercise. Eur J Appl Physiol. 2016;116(8):1503–9.PubMedCrossRef Anderson T, Lane AR, Hackney AC. Cortisol and testosterone dynamics following exhaustive endurance exercise. Eur J Appl Physiol. 2016;116(8):1503–9.PubMedCrossRef
Zurück zum Zitat Bertolini GRF, Rosa CT, Silva LI, Meireles A, Rocha BP. Use of resistance exercise as a factor antagonized by naloxone of analgesia in acute knee synovitis in Wistar rats. Rev Bras Med Esporte. 2012;18:126–9.CrossRef Bertolini GRF, Rosa CT, Silva LI, Meireles A, Rocha BP. Use of resistance exercise as a factor antagonized by naloxone of analgesia in acute knee synovitis in Wistar rats. Rev Bras Med Esporte. 2012;18:126–9.CrossRef
Zurück zum Zitat Bruehl S, Chung OY. Interactions between the cardiovascular and pain regulatory systems: an updated review of mechanisms and possible alterations in chronic pain. Neurosci Biobehav Rev. 2004;28:395–414.PubMedCrossRef Bruehl S, Chung OY. Interactions between the cardiovascular and pain regulatory systems: an updated review of mechanisms and possible alterations in chronic pain. Neurosci Biobehav Rev. 2004;28:395–414.PubMedCrossRef
Zurück zum Zitat Bruehl S, Chung OY, Diedrich L, Diedrich A, Robertson D. The relationship between resting blood pressure and acute pain sensitivity: effects of chronic pain and alpha-2 adrenergic blockade. J Behav Med. 2008;31:71–80.PubMedCrossRef Bruehl S, Chung OY, Diedrich L, Diedrich A, Robertson D. The relationship between resting blood pressure and acute pain sensitivity: effects of chronic pain and alpha-2 adrenergic blockade. J Behav Med. 2008;31:71–80.PubMedCrossRef
Zurück zum Zitat Bruehl S, Burns JW, Chung OY, Magid E, Chont M, Gilliam W, Matsuura J, Somar K, Goodlad JK, Stone K, Cairl H. Hypoalgesia associated with elevated resting blood pressure: evidence for endogenous opioid involvement. J Behav Med. 2010;33:168–76.PubMedCrossRef Bruehl S, Burns JW, Chung OY, Magid E, Chont M, Gilliam W, Matsuura J, Somar K, Goodlad JK, Stone K, Cairl H. Hypoalgesia associated with elevated resting blood pressure: evidence for endogenous opioid involvement. J Behav Med. 2010;33:168–76.PubMedCrossRef
Zurück zum Zitat Cadden SW, Villanueva L, Chitour D, Le Bars D. Depression of activities of dorsal horn convergent neurones by propriospinal mechanisms triggered by noxious inputs; comparison with diffuse noxious inhibitory controls (DNIC). Brain Res. 1983;275(1):1–11.PubMedCrossRef Cadden SW, Villanueva L, Chitour D, Le Bars D. Depression of activities of dorsal horn convergent neurones by propriospinal mechanisms triggered by noxious inputs; comparison with diffuse noxious inhibitory controls (DNIC). Brain Res. 1983;275(1):1–11.PubMedCrossRef
Zurück zum Zitat Campbell TS, Ditto B. Exaggeration of blood pressure-related hypoalgesia and reduction of blood pressure with low frequency transcutaneous electrical nerve stimulation. Psychophysiology. 2002;39:473–81. [PubMed: 12212639].PubMedCrossRef Campbell TS, Ditto B. Exaggeration of blood pressure-related hypoalgesia and reduction of blood pressure with low frequency transcutaneous electrical nerve stimulation. Psychophysiology. 2002;39:473–81. [PubMed: 12212639].PubMedCrossRef
Zurück zum Zitat Chapleau MW, Li Z, Meyrelles SS, Ma X, Abboud FM. Mechanisms determining sensitivity of baroreceptor afferents in health and disease. Ann N Y Acad Sci. 2001;940:1–19. Chapleau MW, Li Z, Meyrelles SS, Ma X, Abboud FM. Mechanisms determining sensitivity of baroreceptor afferents in health and disease. Ann N Y Acad Sci. 2001;940:1–19.
Zurück zum Zitat Clauw DJ. What is the meaning of „small fiber neuropathy“ in fibromyalgia? Pain. 2015;156(11):2115–6. [PubMed: 26307862].PubMedCrossRef Clauw DJ. What is the meaning of „small fiber neuropathy“ in fibromyalgia? Pain. 2015;156(11):2115–6. [PubMed: 26307862].PubMedCrossRef
Zurück zum Zitat Cook DB, O’Connor PJ, Eubanks SA, Smith JC, Lee M. Naturally occurring muscle pain during exercise: assessment and experimental evidence. Med Sci Sports Exerc. 1997;29:999–1012. [PubMed: 9268956].PubMedCrossRef Cook DB, O’Connor PJ, Eubanks SA, Smith JC, Lee M. Naturally occurring muscle pain during exercise: assessment and experimental evidence. Med Sci Sports Exerc. 1997;29:999–1012. [PubMed: 9268956].PubMedCrossRef
Zurück zum Zitat Crombie KM, Brellenthin AG, Hillard CJ, Koltyn KF. Endocannabinoid and opioid system interactions in exercise-induced hypoalgesia. Pain Med. 2018;19(1):118–23.PubMedCrossRef Crombie KM, Brellenthin AG, Hillard CJ, Koltyn KF. Endocannabinoid and opioid system interactions in exercise-induced hypoalgesia. Pain Med. 2018;19(1):118–23.PubMedCrossRef
Zurück zum Zitat Derbyshire SW, Osborn J. Enhancement of offset analgesia during sequential testing. Eur J Pain. 2008;12:980–9.PubMedCrossRef Derbyshire SW, Osborn J. Enhancement of offset analgesia during sequential testing. Eur J Pain. 2008;12:980–9.PubMedCrossRef
Zurück zum Zitat Derbyshire SW, Osborn J. Offset analgesia is mediated by activation in the region of the periaqueductal grey and rostral ventromedial medulla. NeuroImage. 2009;47:1002–6. [PubMed:19375510].PubMedCrossRef Derbyshire SW, Osborn J. Offset analgesia is mediated by activation in the region of the periaqueductal grey and rostral ventromedial medulla. NeuroImage. 2009;47:1002–6. [PubMed:19375510].PubMedCrossRef
Zurück zum Zitat Duschek S, Mück I, Reyes Del Paso GA. Relationship between baroreceptor cardiac reflex sensitivity and pain experience in normotensive individuals. Int J Psychophysiol. 2007;65(3):193–200.PubMedCrossRef Duschek S, Mück I, Reyes Del Paso GA. Relationship between baroreceptor cardiac reflex sensitivity and pain experience in normotensive individuals. Int J Psychophysiol. 2007;65(3):193–200.PubMedCrossRef
Zurück zum Zitat 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.PubMedCrossRef 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.PubMedCrossRef
Zurück zum Zitat Dworkin BR, Elbert T, Rau H, Birbaumer N, Pauli P, Droste C, Brunia CH. Central effects of baroreceptor activation in humans: attenuation of skeletal reflexes and pain perception. Proc Natl Acad Sci U S A. 1994;91:6329–33.PubMedPubMedCentralCrossRef Dworkin BR, Elbert T, Rau H, Birbaumer N, Pauli P, Droste C, Brunia CH. Central effects of baroreceptor activation in humans: attenuation of skeletal reflexes and pain perception. Proc Natl Acad Sci U S A. 1994;91:6329–33.PubMedPubMedCentralCrossRef
Zurück zum Zitat Edwards RR, Fillingim RB, Ness TJ. Age-related differences in endogenous pain modulation: a comparison of diffuse noxious inhibitory controls in healthy older and younger adults. Pain. 2003;101:155–65.PubMedCrossRef Edwards RR, Fillingim RB, Ness TJ. Age-related differences in endogenous pain modulation: a comparison of diffuse noxious inhibitory controls in healthy older and younger adults. Pain. 2003;101:155–65.PubMedCrossRef
Zurück zum Zitat Fingleton C, Smart K, Doody C, Dip T. Exercise-induced hypoalgesia in people with knee osteoarthritis with normal and abnormal conditioned pain modulation. Clin J Pain. 2017;33:395–404.PubMedCrossRef Fingleton C, Smart K, Doody C, Dip T. Exercise-induced hypoalgesia in people with knee osteoarthritis with normal and abnormal conditioned pain modulation. Clin J Pain. 2017;33:395–404.PubMedCrossRef
Zurück zum Zitat Foerster BR, Petrou M, Edden RA, Sundgren PC, Schmidt-Wilcke T, Lowe SE, Harte SE, Clauw DJ, Harris RE. Reduced insular gamma-aminobutyric acid in fibromyalgia. Arthritis Rheum. 2012;64(2):579–83. [PubMed: 21913179].PubMedPubMedCentralCrossRef Foerster BR, Petrou M, Edden RA, Sundgren PC, Schmidt-Wilcke T, Lowe SE, Harte SE, Clauw DJ, Harris RE. Reduced insular gamma-aminobutyric acid in fibromyalgia. Arthritis Rheum. 2012;64(2):579–83. [PubMed: 21913179].PubMedPubMedCentralCrossRef
Zurück zum Zitat France CR. Decreased pain perception and risk for hypertension: considering a common physiological mechanism. Psychophysiology. 1999;36:683–92. [PubMed: 10554582].PubMedCrossRef France CR. Decreased pain perception and risk for hypertension: considering a common physiological mechanism. Psychophysiology. 1999;36:683–92. [PubMed: 10554582].PubMedCrossRef
Zurück zum Zitat France CR, al’Absi M, Ring C, France J, Brose J, Spaeth D, Harju A, Nordehn G, Wittmers LE. Assessment of opiate modulation of pain and nociceptive responding in young adults with a parental history of hypertension. Biol Psychol. 2005;70:168–74. [PubMed: 15936866].PubMedCrossRef France CR, al’Absi M, Ring C, France J, Brose J, Spaeth D, Harju A, Nordehn G, Wittmers LE. Assessment of opiate modulation of pain and nociceptive responding in young adults with a parental history of hypertension. Biol Psychol. 2005;70:168–74. [PubMed: 15936866].PubMedCrossRef
Zurück zum Zitat Fuss J, Steinle J, Bindila L, Auer MK, Kirchherr H, Lutz B, Gass P. A runner’s high depends on cannabinoid receptors in mice. Proc Natl Acad Sci U S A. 2015;112(42):13105–8.PubMedPubMedCentralCrossRef Fuss J, Steinle J, Bindila L, Auer MK, Kirchherr H, Lutz B, Gass P. A runner’s high depends on cannabinoid receptors in mice. Proc Natl Acad Sci U S A. 2015;112(42):13105–8.PubMedPubMedCentralCrossRef
Zurück zum Zitat Gajsar H, Nahrwold K, Titze C, Hasenbring MI, Vaegter HB. Exercise does not produce hypoalgesia when performed immediately after a painful stimulus. Scand J Pain. 2018;18(2):311–20.PubMedCrossRef Gajsar H, Nahrwold K, Titze C, Hasenbring MI, Vaegter HB. Exercise does not produce hypoalgesia when performed immediately after a painful stimulus. Scand J Pain. 2018;18(2):311–20.PubMedCrossRef
Zurück zum Zitat Gallez A, Albanese MC, Rainville P, Duncan GH. Attenuation of sensory and affective responses to heat pain: evidence for contralateral mechanisms. J Neurophysiol. 2005;94(5):3509–15.PubMedCrossRef Gallez A, Albanese MC, Rainville P, Duncan GH. Attenuation of sensory and affective responses to heat pain: evidence for contralateral mechanisms. J Neurophysiol. 2005;94(5):3509–15.PubMedCrossRef
Zurück zum Zitat Ghione S. Hypertension-associated hypalgesia. Evidence in experimental animals and humans, pathophysiological mechanisms, and potential clinical consequences. Hypertension. 1996;28(3):494–504.PubMedCrossRef Ghione S. Hypertension-associated hypalgesia. Evidence in experimental animals and humans, pathophysiological mechanisms, and potential clinical consequences. Hypertension. 1996;28(3):494–504.PubMedCrossRef
Zurück zum Zitat Granot M, Weissman-Fogel I, Crispel Y, Pud D, Granovsky Y, Sprecher E, Yarnitsky D. Determinants of endogenous analgesia magnitude in a diffuse noxious inhibitory control (DNIC) paradigm: do conditioning stimulus painfulness, gender and personality variables matter? Pain. 2008;136(1–2):142–9.PubMedCrossRef Granot M, Weissman-Fogel I, Crispel Y, Pud D, Granovsky Y, Sprecher E, Yarnitsky D. Determinants of endogenous analgesia magnitude in a diffuse noxious inhibitory control (DNIC) paradigm: do conditioning stimulus painfulness, gender and personality variables matter? Pain. 2008;136(1–2):142–9.PubMedCrossRef
Zurück zum Zitat Grill JD, Coghill RC. Transient analgesia evoked by noxious stimulus offset. J Neurophysiol. 2002;87:2205–8.PubMedCrossRef Grill JD, Coghill RC. Transient analgesia evoked by noxious stimulus offset. J Neurophysiol. 2002;87:2205–8.PubMedCrossRef
Zurück zum Zitat 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.PubMedCrossRef 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.PubMedCrossRef
Zurück zum Zitat Harper DE, Schrepf A, Clauw DJ. Pain mechanisms and centralized pain in temporomandibular disorders. J Dent Res. 2016;95(10):1102–8. [PubMed: 27422858].PubMedPubMedCentralCrossRef Harper DE, Schrepf A, Clauw DJ. Pain mechanisms and centralized pain in temporomandibular disorders. J Dent Res. 2016;95(10):1102–8. [PubMed: 27422858].PubMedPubMedCentralCrossRef
Zurück zum Zitat Hassett AL, Clauw DJ, Williams DA. Premature Aging in Fibromyalgia. Curr Aging Sci. 2015; 8(2):178–85. Hassett AL, Clauw DJ, Williams DA. Premature Aging in Fibromyalgia. Curr Aging Sci. 2015; 8(2):178–85.
Zurück zum Zitat Harte SE, Ichesco E, Hampson JP, Peltier SJ, Schmidt-Wilcke T, Clauw DJ, Harris RE. Pharmacologic attenuation of cross-modal sensory augmentation within the chronic pain insula. Pain. 2016;157(9):1933–45. [PubMed: 27101425].PubMedPubMedCentralCrossRef Harte SE, Ichesco E, Hampson JP, Peltier SJ, Schmidt-Wilcke T, Clauw DJ, Harris RE. Pharmacologic attenuation of cross-modal sensory augmentation within the chronic pain insula. Pain. 2016;157(9):1933–45. [PubMed: 27101425].PubMedPubMedCentralCrossRef
Zurück zum Zitat Hermans L, Van Oosterwijck J, Goubert D, Goudman L, Crombez G, Calders P, Meeus M. Inventory of personal factors influencing conditioned pain modulation in healthy people: a systematic literature review. Pain Pract. 2016a;16:758–69.PubMedCrossRef Hermans L, Van Oosterwijck J, Goubert D, Goudman L, Crombez G, Calders P, Meeus M. Inventory of personal factors influencing conditioned pain modulation in healthy people: a systematic literature review. Pain Pract. 2016a;16:758–69.PubMedCrossRef
Zurück zum Zitat Hermans L, Calders P, Van Oosterwijck J, Verschelde E, Bertel E, Meeus M. An overview of offset analgesia and the comparison with conditioned pain modulation: s systematic literature review. Pain Physician. 2016b;19(6):307–26.PubMed Hermans L, Calders P, Van Oosterwijck J, Verschelde E, Bertel E, Meeus M. An overview of offset analgesia and the comparison with conditioned pain modulation: s systematic literature review. Pain Physician. 2016b;19(6):307–26.PubMed
Zurück zum Zitat Herrero JF, Laird JM, Lopez-Garcia JA. Wind-up of spinal cord neurones and pain sensation: much ado about something? Prog Neurobiol. 2000;61:169–203. [PubMed: 10704997].PubMedCrossRef Herrero JF, Laird JM, Lopez-Garcia JA. Wind-up of spinal cord neurones and pain sensation: much ado about something? Prog Neurobiol. 2000;61:169–203. [PubMed: 10704997].PubMedCrossRef
Zurück zum Zitat Heyman E, Gamelin F-X, Goekint M, Piscitelli F, Roelands B, Leclair E, Di Marzo V, Meeusen R. Intense exercise increases circulating endocannabinoid and BDNF levels in humans – possible implications for reward and depression. Psychoneuroendocrinology. 2012;37:844–51. [PubMed: 22029953].PubMedCrossRef Heyman E, Gamelin F-X, Goekint M, Piscitelli F, Roelands B, Leclair E, Di Marzo V, Meeusen R. Intense exercise increases circulating endocannabinoid and BDNF levels in humans – possible implications for reward and depression. Psychoneuroendocrinology. 2012;37:844–51. [PubMed: 22029953].PubMedCrossRef
Zurück zum Zitat Hoeger Bement MK, Dicapo J, Rasiarmos R, Hunter SK. Dose response of isometric contractions on pain perception in healthy adults. Med Sci Sports Exerc. 2008;40(11):1880–9. [PubMed:18845975].PubMedCrossRef Hoeger Bement MK, Dicapo J, Rasiarmos R, Hunter SK. Dose response of isometric contractions on pain perception in healthy adults. Med Sci Sports Exerc. 2008;40(11):1880–9. [PubMed:18845975].PubMedCrossRef
Zurück zum Zitat Hollins M, Harper D, Gallagher S, Owings EW, Lim PF, Miller V, Siddiqi MQ, Maixner W. Perceived intensity and unpleasantness of cutaneous and auditory stimuli: an evaluation of the generalized hypervigilance hypothesis. Pain. 2009;141(3):215–21. [PubMed: 19121558].PubMedPubMedCentralCrossRef Hollins M, Harper D, Gallagher S, Owings EW, Lim PF, Miller V, Siddiqi MQ, Maixner W. Perceived intensity and unpleasantness of cutaneous and auditory stimuli: an evaluation of the generalized hypervigilance hypothesis. Pain. 2009;141(3):215–21. [PubMed: 19121558].PubMedPubMedCentralCrossRef
Zurück zum Zitat Hughes L, Patterson SD. Low intensity blood flow restriction exercise: rationale for a hypoalgesia effect. Med Hypotheses. 2019;132:109370.PubMedCrossRef Hughes L, Patterson SD. Low intensity blood flow restriction exercise: rationale for a hypoalgesia effect. Med Hypotheses. 2019;132:109370.PubMedCrossRef
Zurück zum Zitat Janal MN, Colt EW, Clark WC, Glusman M. Pain sensitivity, mood and plasma endocrine levels in man following long-distance running: effects of naloxone. Pain. 1984;19:13–25.PubMedCrossRef Janal MN, Colt EW, Clark WC, Glusman M. Pain sensitivity, mood and plasma endocrine levels in man following long-distance running: effects of naloxone. Pain. 1984;19:13–25.PubMedCrossRef
Zurück zum Zitat Kairys AE, Schmidt-Wilcke T, Puiu T, Ichesco E, Labus JS, Martucci K, Farmer MA, Ness TJ, Deutsch G, Mayer EA, Mackey S, Apkarian AV, Maravilla K, Clauw DJ, Harris RE. Increased brain gray matter in the primary somatosensory cortex is associated with increased pain and mood disturbance in patients with interstitial cystitis/painful bladder syndrome. J Urol. 2015;193(1):131–7. [PubMed: 25132239].PubMedCrossRef Kairys AE, Schmidt-Wilcke T, Puiu T, Ichesco E, Labus JS, Martucci K, Farmer MA, Ness TJ, Deutsch G, Mayer EA, Mackey S, Apkarian AV, Maravilla K, Clauw DJ, Harris RE. Increased brain gray matter in the primary somatosensory cortex is associated with increased pain and mood disturbance in patients with interstitial cystitis/painful bladder syndrome. J Urol. 2015;193(1):131–7. [PubMed: 25132239].PubMedCrossRef
Zurück zum Zitat Kami K, Tajima F, Senba E. Exercise-induced hypoalgesia: potential mechanisms in animal models of neuropathic pain. Anat Sci Int. 2017;92(1):79–90. Epub 2016 Aug 2.PubMedCrossRef Kami K, Tajima F, Senba E. Exercise-induced hypoalgesia: potential mechanisms in animal models of neuropathic pain. Anat Sci Int. 2017;92(1):79–90. Epub 2016 Aug 2.PubMedCrossRef
Zurück zum Zitat Kami K, Tajima F, Senba E. Activation of msolimbic reward system via laterodorsal tegmental nucleus and hypothalamus in exercise-induced hypoalgesia. Sci Rep. 2018;8(1):11540.PubMedPubMedCentralCrossRef Kami K, Tajima F, Senba E. Activation of msolimbic reward system via laterodorsal tegmental nucleus and hypothalamus in exercise-induced hypoalgesia. Sci Rep. 2018;8(1):11540.PubMedPubMedCentralCrossRef
Zurück zum Zitat Kemppainen P, Paalasmaa P, Pertovaara A, Alila A, Johansson G. Dexamethasone attenuates exercise-induced dental analgesia in man. Brain Res. 1990;519(1–2):329–32.PubMedCrossRef Kemppainen P, Paalasmaa P, Pertovaara A, Alila A, Johansson G. Dexamethasone attenuates exercise-induced dental analgesia in man. Brain Res. 1990;519(1–2):329–32.PubMedCrossRef
Zurück zum Zitat Koltyn KF, Umeda M. Exercise, hypoalgesia and blood pressure. Sports Med. 2006;36(3):207–14.PubMedCrossRef Koltyn KF, Umeda M. Exercise, hypoalgesia and blood pressure. Sports Med. 2006;36(3):207–14.PubMedCrossRef
Zurück zum Zitat Koltyn KF, Garvin AW, Gardiner RL, Nelson TF. Perception of pain following aerobic exercise. Med Sci Sports Exerc. 1996;28(11):1418–21.PubMedCrossRef Koltyn KF, Garvin AW, Gardiner RL, Nelson TF. Perception of pain following aerobic exercise. Med Sci Sports Exerc. 1996;28(11):1418–21.PubMedCrossRef
Zurück zum Zitat Koltyn KF, Trine MR, Stegner AJ, Tobar DA. Effect of isometric exercise on pain perception and blood pressure in men and women. Med Sci Sports Exerc. 2001;33:282–90.PubMedCrossRef Koltyn KF, Trine MR, Stegner AJ, Tobar DA. Effect of isometric exercise on pain perception and blood pressure in men and women. Med Sci Sports Exerc. 2001;33:282–90.PubMedCrossRef
Zurück zum Zitat Koltyn KF, Knauf MT, Brellenthin AG. Temporal summation of heat pain modulated by isometric exercise. Eur J Pain. 2013;17:1005–11. [PubMed: 23239238].PubMedCrossRef Koltyn KF, Knauf MT, Brellenthin AG. Temporal summation of heat pain modulated by isometric exercise. Eur J Pain. 2013;17:1005–11. [PubMed: 23239238].PubMedCrossRef
Zurück zum Zitat Kosek E, Martinsen S, Gerdle B, Mannerkorpi K, Löfgren M, Bileviciute-Ljungar I, Fransson P, Schalling M, Ingvar M, Ernberg M, Jensen KB. The translocator protein gene is associated with symptom severity and cerebral pain processing in fibromyalgia. Brain Behav Immun. 2016;58:218–27.PubMedCrossRef Kosek E, Martinsen S, Gerdle B, Mannerkorpi K, Löfgren M, Bileviciute-Ljungar I, Fransson P, Schalling M, Ingvar M, Ernberg M, Jensen KB. The translocator protein gene is associated with symptom severity and cerebral pain processing in fibromyalgia. Brain Behav Immun. 2016;58:218–27.PubMedCrossRef
Zurück zum Zitat Kutch JJ, Ichesco E, Hampson JP, Labus JS, Farmer MA, Martucci KT, Ness TJ, Deutsch G, Apkarian AV, Mackey SC, Klumpp DJ, Schaeffer AJ, Rodriguez LV, Kreder KJ, Buchwald D, Andriole GL, Lai HH, Mullins C, Kusek JW, Landis JR, Mayer EA, Clemens JQ, Clauw DJ, Harris RE, Network MR. Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study. Pain. 2017;158(10):1979–91. [PubMed: 28692006].PubMedPubMedCentralCrossRef Kutch JJ, Ichesco E, Hampson JP, Labus JS, Farmer MA, Martucci KT, Ness TJ, Deutsch G, Apkarian AV, Mackey SC, Klumpp DJ, Schaeffer AJ, Rodriguez LV, Kreder KJ, Buchwald D, Andriole GL, Lai HH, Mullins C, Kusek JW, Landis JR, Mayer EA, Clemens JQ, Clauw DJ, Harris RE, Network MR. Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study. Pain. 2017;158(10):1979–91. [PubMed: 28692006].PubMedPubMedCentralCrossRef
Zurück zum Zitat Lariviere M, Goffaux P, Marchand S, Julien N. Changes in pain perception and descending inhibitory controls start at middle age in healthy adults. Clin J Pain. 2007;23:506–10.PubMedCrossRef Lariviere M, Goffaux P, Marchand S, Julien N. Changes in pain perception and descending inhibitory controls start at middle age in healthy adults. Clin J Pain. 2007;23:506–10.PubMedCrossRef
Zurück zum Zitat Laube W. Zur Rückführung des vegetativ-chronotropen Tonus, der Erholung im neuromuskulären System und den Wechselbeziehungen zwischen beiden Funktionssystemen nach Auslösung einer identischen anaeroben Stoffwechselsituation durch verschiedene Belastungsarten. Dissertation B (Dr. med. sc.). Humboldt-Universität zu Berlin, Bereich Medizin Charité, Physiologisches Institut; 1990. Laube W. Zur Rückführung des vegetativ-chronotropen Tonus, der Erholung im neuromuskulären System und den Wechselbeziehungen zwischen beiden Funktionssystemen nach Auslösung einer identischen anaeroben Stoffwechselsituation durch verschiedene Belastungsarten. Dissertation B (Dr. med. sc.). Humboldt-Universität zu Berlin, Bereich Medizin Charité, Physiologisches Institut; 1990.
Zurück zum Zitat Laube W. Physiologie des Zyklus Belastung – Beanspruchung – Ermüdung – Erholung – Adapatation. In: Laube W, Herausgeber. Sensomotorisches System. Stuttgart/New York: Thieme; 2009. S. 499–555. Laube W. Physiologie des Zyklus Belastung – Beanspruchung – Ermüdung – Erholung – Adapatation. In: Laube W, Herausgeber. Sensomotorisches System. Stuttgart/New York: Thieme; 2009. S. 499–555.
Zurück zum Zitat Laube W. Sensomotorik und Schmerz. Heidelberg: Springer;2020. Laube W. Sensomotorik und Schmerz. Heidelberg: Springer;2020.
Zurück zum Zitat Lawler JE, Sanders BJ, Cox RH, O’Connor EF. Baroreflex function in chronically stressed borderline hypertensive rats. Physiol Behav. 1991;49:539–42.PubMedCrossRef Lawler JE, Sanders BJ, Cox RH, O’Connor EF. Baroreflex function in chronically stressed borderline hypertensive rats. Physiol Behav. 1991;49:539–42.PubMedCrossRef
Zurück zum Zitat Le Bars D, Dickenson AH, Besson JM. Diffuse noxious inhibitory controls (DNIC). I. effects on dorsal horn convergent neurones in the rat. Pain. 1979a;6:283–304.PubMedCrossRef Le Bars D, Dickenson AH, Besson JM. Diffuse noxious inhibitory controls (DNIC). I. effects on dorsal horn convergent neurones in the rat. Pain. 1979a;6:283–304.PubMedCrossRef
Zurück zum Zitat Le Bars D, Dickenson AH, Besson JM. Diffuse noxious inhibitory controls (DNIC). II. Lack of effect on non-convergent neurones, supraspinal involvement and theoretical implications. Pain. 1979b;6:305–27.PubMedCrossRef Le Bars D, Dickenson AH, Besson JM. Diffuse noxious inhibitory controls (DNIC). II. Lack of effect on non-convergent neurones, supraspinal involvement and theoretical implications. Pain. 1979b;6:305–27.PubMedCrossRef
Zurück zum Zitat Le Bars D, Chitour D, Kraus E, Dickenson AH, Besson JM. Effect of naloxone upon diffuse noxious inhibitory controls (DNIC) in the rat. Brain Res. 1981;204:387–402.PubMedCrossRef Le Bars D, Chitour D, Kraus E, Dickenson AH, Besson JM. Effect of naloxone upon diffuse noxious inhibitory controls (DNIC) in the rat. Brain Res. 1981;204:387–402.PubMedCrossRef
Zurück zum Zitat Le Bars D, Villanueva L, Bouhassira D, Willer JC. Diffuse noxious inhibitory controls (DNIC) in animals and in man. Patol Fiziol Eksp Ter. 1992;4:55–65. Le Bars D, Villanueva L, Bouhassira D, Willer JC. Diffuse noxious inhibitory controls (DNIC) in animals and in man. Patol Fiziol Eksp Ter. 1992;4:55–65.
Zurück zum Zitat Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti K. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14(2):145–61.PubMedCrossRef Lee M, Silverman SM, Hansen H, Patel VB, Manchikanti K. A comprehensive review of opioid-induced hyperalgesia. Pain Physician. 2011;14(2):145–61.PubMedCrossRef
Zurück zum Zitat Lemley KJ, Drewek B, Hunter SK, Hoeger Bement MK. Pain relief after isometric exercise is not task-dependent in older men and women. Med Sci Sports Exerc. 2014;46(1):185–91.PubMedCrossRef Lemley KJ, Drewek B, Hunter SK, Hoeger Bement MK. Pain relief after isometric exercise is not task-dependent in older men and women. Med Sci Sports Exerc. 2014;46(1):185–91.PubMedCrossRef
Zurück zum Zitat Lemley KJ, Hunter SK, Bement MK. Conditioned pain modulation predicts exercise-induced hypoalgesia in healthy adults. Med Sci Sports Exerc. 2015;47(1):176–84. [PubMed: 24870571].PubMedCrossRef Lemley KJ, Hunter SK, Bement MK. Conditioned pain modulation predicts exercise-induced hypoalgesia in healthy adults. Med Sci Sports Exerc. 2015;47(1):176–84. [PubMed: 24870571].PubMedCrossRef
Zurück zum Zitat Lewis GN, Rice DA, McNair PJ. Conditioned pain modulation in populations with chronic pain: a systematic review and metaanalysis. J Pain. 2012;13:936–44.PubMedCrossRef Lewis GN, Rice DA, McNair PJ. Conditioned pain modulation in populations with chronic pain: a systematic review and metaanalysis. J Pain. 2012;13:936–44.PubMedCrossRef
Zurück zum Zitat Ligato D, Petersen KK, Mørch CD, Arendt-Nielsen L. Offset analgesia: the role of peripheral and central mechanisms. Eur J Pain. 2018;22(1):142–9.PubMedCrossRef Ligato D, Petersen KK, Mørch CD, Arendt-Nielsen L. Offset analgesia: the role of peripheral and central mechanisms. Eur J Pain. 2018;22(1):142–9.PubMedCrossRef
Zurück zum Zitat Lima LV, DeSantana JM, Rasmussen LA, Sluka KA. Short-duration physical activity prevents the development of activity-induced hyperalgesia through opioid and serotoninergic mechanisms. Pain. 2017b;158(9):1697–710.PubMedPubMedCentralCrossRef Lima LV, DeSantana JM, Rasmussen LA, Sluka KA. Short-duration physical activity prevents the development of activity-induced hyperalgesia through opioid and serotoninergic mechanisms. Pain. 2017b;158(9):1697–710.PubMedPubMedCentralCrossRef
Zurück zum Zitat Liu XG, Morton CR, Azkue JJ, Zimmermann M, Sandkühler J. Long-term depression of C-fibreevoked spinal field potentials by stimulation of primary afferent Ad-fibres in the adult rat. Eur J Neurosci. 1998;10:3069–75. [PubMed: 9786201].PubMedCrossRef Liu XG, Morton CR, Azkue JJ, Zimmermann M, Sandkühler J. Long-term depression of C-fibreevoked spinal field potentials by stimulation of primary afferent Ad-fibres in the adult rat. Eur J Neurosci. 1998;10:3069–75. [PubMed: 9786201].PubMedCrossRef
Zurück zum Zitat Lopez-Sola M, Pujol J, Wager TD, Garcia-Fontanals A, Blanco-Hinojo L, Garcia-Blanco S, Poca-Dias V, Harrison BJ, Contreras-Rodriguez O, Monfort J, Garcia-Fructuoso F, Deus J. Altered functional magnetic resonance imaging responses to nonpainful sensory stimulation in fibromyalgia patients. Arthritis Rheum. 2014;66(11):3200–9. [PubMed: 25220783].CrossRef Lopez-Sola M, Pujol J, Wager TD, Garcia-Fontanals A, Blanco-Hinojo L, Garcia-Blanco S, Poca-Dias V, Harrison BJ, Contreras-Rodriguez O, Monfort J, Garcia-Fructuoso F, Deus J. Altered functional magnetic resonance imaging responses to nonpainful sensory stimulation in fibromyalgia patients. Arthritis Rheum. 2014;66(11):3200–9. [PubMed: 25220783].CrossRef
Zurück zum Zitat Marinelli S, Vaughan CW, Schnell SA, Wessendorf MW, Christie MJ. Rostral ventromedial medulla neurons that project to the spinal cord express multiple opioid receptor phenotypes. J Neurosci. 2002;22(24):10847–55.PubMedPubMedCentralCrossRef Marinelli S, Vaughan CW, Schnell SA, Wessendorf MW, Christie MJ. Rostral ventromedial medulla neurons that project to the spinal cord express multiple opioid receptor phenotypes. J Neurosci. 2002;22(24):10847–55.PubMedPubMedCentralCrossRef
Zurück zum Zitat Martin WJ, Gupta NK, Loo CM, Rohde DS, Basbaum AI. Differential effects of neurotoxic destruction of descending noradrenergic pathways on acute and persistent nociceptive processing. Pain. 1999;80(1–2):57–65.PubMedCrossRef Martin WJ, Gupta NK, Loo CM, Rohde DS, Basbaum AI. Differential effects of neurotoxic destruction of descending noradrenergic pathways on acute and persistent nociceptive processing. Pain. 1999;80(1–2):57–65.PubMedCrossRef
Zurück zum Zitat Martucci KT, Eisenach JC, Tong C, Coghill RC. Opioid-independent mechanisms supporting offset analgesia and temporal sharpening of nociceptive information. Pain. 2012;153:1232–43. [PubMed: 22503222].PubMedPubMedCentralCrossRef Martucci KT, Eisenach JC, Tong C, Coghill RC. Opioid-independent mechanisms supporting offset analgesia and temporal sharpening of nociceptive information. Pain. 2012;153:1232–43. [PubMed: 22503222].PubMedPubMedCentralCrossRef
Zurück zum Zitat Mauderli AP, Vierck CJ, Cannon RL, Rodrigues A, Shen C. Relationships between skin temperature and temporal summation of heat and cold pain. J Neurophysiol. 2003;90:100–9. [PubMed: 12843304].PubMedCrossRef Mauderli AP, Vierck CJ, Cannon RL, Rodrigues A, Shen C. Relationships between skin temperature and temporal summation of heat and cold pain. J Neurophysiol. 2003;90:100–9. [PubMed: 12843304].PubMedCrossRef
Zurück zum Zitat Moont R, Crispel Y, Lev R, Pud D, Yarnitsky D. Temporal changes in cortical activation during conditioned pain modulation (CPM), a LORETA study. Pain. 2011;152(7):1469–77. Epub 2011 Feb 19.PubMedCrossRef Moont R, Crispel Y, Lev R, Pud D, Yarnitsky D. Temporal changes in cortical activation during conditioned pain modulation (CPM), a LORETA study. Pain. 2011;152(7):1469–77. Epub 2011 Feb 19.PubMedCrossRef
Zurück zum Zitat Morato M, Pinho D, Sousa T, Tavares I, Albino-Teixeira A. Inhibition of nociceptive responses of spinal cord neurones during hypertension involves the spinal GABAergic system and a pain modulatory center located at the caudal ventrolateral medulla. J Neurosci Res. 2006;83(4):647–55.PubMedCrossRef Morato M, Pinho D, Sousa T, Tavares I, Albino-Teixeira A. Inhibition of nociceptive responses of spinal cord neurones during hypertension involves the spinal GABAergic system and a pain modulatory center located at the caudal ventrolateral medulla. J Neurosci Res. 2006;83(4):647–55.PubMedCrossRef
Zurück zum Zitat Morgan MM, Sohn JH, Lohof AM, Ben-Eliyahu S, Liebeskind JC. Characterization of stimulation-produced analgesia from the nucleus tractus solitarius in the rat. Brain Res. 1989;486(1):175–80.PubMedCrossRef Morgan MM, Sohn JH, Lohof AM, Ben-Eliyahu S, Liebeskind JC. Characterization of stimulation-produced analgesia from the nucleus tractus solitarius in the rat. Brain Res. 1989;486(1):175–80.PubMedCrossRef
Zurück zum Zitat Nahman-Averbuch H, Granovsky Y, Coghill RC, Yarnitsky D, Sprecher E, Weissman-Fogel I. Waning of ‚conditioned pain modulation‘: a novel expression of subtle pronociception in migraine. Headache 2e J Head Face Pain. 2013;53(7):1104–15.CrossRef Nahman-Averbuch H, Granovsky Y, Coghill RC, Yarnitsky D, Sprecher E, Weissman-Fogel I. Waning of ‚conditioned pain modulation‘: a novel expression of subtle pronociception in migraine. Headache 2e J Head Face Pain. 2013;53(7):1104–15.CrossRef
Zurück zum Zitat Napadow V, Kim J, Clauw DJ, Harris RE. Decreased intrinsic brain connectivity is associated with reduced clinical pain in fibromyalgia. Arthritis Rheum. 2012;64(7):2398–403. [PubMed:22294427].PubMedPubMedCentralCrossRef Napadow V, Kim J, Clauw DJ, Harris RE. Decreased intrinsic brain connectivity is associated with reduced clinical pain in fibromyalgia. Arthritis Rheum. 2012;64(7):2398–403. [PubMed:22294427].PubMedPubMedCentralCrossRef
Zurück zum Zitat Naugle KM, Naugle KE, Fillingim RB, Samuels B, Riley JL 3rd. Intensity thresholds for aerobic exercise-induced hypoalgesia. Med Sci Sports Exerc. 2014;46(4):817–25.PubMedPubMedCentralCrossRef Naugle KM, Naugle KE, Fillingim RB, Samuels B, Riley JL 3rd. Intensity thresholds for aerobic exercise-induced hypoalgesia. Med Sci Sports Exerc. 2014;46(4):817–25.PubMedPubMedCentralCrossRef
Zurück zum Zitat Nielsen J, Arendt-Nielsen L. The importance of stimulus configuration for temporal summation of first and second pain to repeated heat stimuli. Eur J Pain. 1998;2:329–41. [PubMed: 10700328].PubMedCrossRef Nielsen J, Arendt-Nielsen L. The importance of stimulus configuration for temporal summation of first and second pain to repeated heat stimuli. Eur J Pain. 1998;2:329–41. [PubMed: 10700328].PubMedCrossRef
Zurück zum Zitat Niesters M, Dahan A, Swartjes M, Noppers I, Fillingim RB, Aarts L, Sarton EY. Effect of ketamine on endogenous pain modulation in healthy volunteers. Pain. 2011;152:656–63. [PubMed: 21237568].PubMedCrossRef Niesters M, Dahan A, Swartjes M, Noppers I, Fillingim RB, Aarts L, Sarton EY. Effect of ketamine on endogenous pain modulation in healthy volunteers. Pain. 2011;152:656–63. [PubMed: 21237568].PubMedCrossRef
Zurück zum Zitat Niesters M, Proto PL, Aarts L, Sarton EY, Drewes AM, Dahan A. Tapentadol potentiates descending pain inhibition in chronic pain patients with diabetic polyneuropathy. Br J Anaesth. 2014;113:148–56.PubMedCrossRef Niesters M, Proto PL, Aarts L, Sarton EY, Drewes AM, Dahan A. Tapentadol potentiates descending pain inhibition in chronic pain patients with diabetic polyneuropathy. Br J Anaesth. 2014;113:148–56.PubMedCrossRef
Zurück zum Zitat O’Brien EM, Atchison JW, Gremillion HA, Waxenberg LB, Robinson ME. Somatic focus/awareness: relationship to negative affect and pain in chronic pain patients. Eur J Pain. 2008;12(1):104–15. [PubMed: 17524684].PubMedCrossRef O’Brien EM, Atchison JW, Gremillion HA, Waxenberg LB, Robinson ME. Somatic focus/awareness: relationship to negative affect and pain in chronic pain patients. Eur J Pain. 2008;12(1):104–15. [PubMed: 17524684].PubMedCrossRef
Zurück zum Zitat Oosterwijck JV, Marusic U, De Wandele I, Paul L, Meeus M, Moorkens G, Lambrecht L, Danneels L, Nijs J. The role of autonomic function in exercise-induced endogenous analgesia: a case-control study in myalgic encephalomyelitis/chronic fatigue syndrome and healthy people. Pain Physician. 2017;20(3):E389–99.PubMed Oosterwijck JV, Marusic U, De Wandele I, Paul L, Meeus M, Moorkens G, Lambrecht L, Danneels L, Nijs J. The role of autonomic function in exercise-induced endogenous analgesia: a case-control study in myalgic encephalomyelitis/chronic fatigue syndrome and healthy people. Pain Physician. 2017;20(3):E389–99.PubMed
Zurück zum Zitat Pacheco D, Klein A, Perez A, et al. The m-opioid receptor agonist morphine, but not agonists at gabba- or delta-opioid receptors, induces peripheral antinociception mediated by cannabinoid receptors. Br J Pharmacol. 2008;154(5):1143–9.CrossRef Pacheco D, Klein A, Perez A, et al. The m-opioid receptor agonist morphine, but not agonists at gabba- or delta-opioid receptors, induces peripheral antinociception mediated by cannabinoid receptors. Br J Pharmacol. 2008;154(5):1143–9.CrossRef
Zurück zum Zitat Pacheco D, Klein A, Perez AC, et al. Central antinociception induced by mu-opioid receptor agonist morphine, but not delta- or kappa-, is mediated by cannabinoid CB1 receptor. Br J Pharmacol. 2009;158(1):225–31.PubMedCrossRef Pacheco D, Klein A, Perez AC, et al. Central antinociception induced by mu-opioid receptor agonist morphine, but not delta- or kappa-, is mediated by cannabinoid CB1 receptor. Br J Pharmacol. 2009;158(1):225–31.PubMedCrossRef
Zurück zum Zitat Pareja-Blanco F, Rodríguez-Rosell D, González-Badillo JJ. Time course of recovery from resistance exercise before and after a training program. J Sports Med Phys Fitness. 2019;59(9):1458–65.PubMedCrossRef Pareja-Blanco F, Rodríguez-Rosell D, González-Badillo JJ. Time course of recovery from resistance exercise before and after a training program. J Sports Med Phys Fitness. 2019;59(9):1458–65.PubMedCrossRef
Zurück zum Zitat Piché M, Arsenault M, Rainville P. Cerebral and cerebrospinal processes underlying counterirritation analgesia. J Neurosci. 2009;29:14236–46. [PubMed: 19906971].PubMedPubMedCentralCrossRef Piché M, Arsenault M, Rainville P. Cerebral and cerebrospinal processes underlying counterirritation analgesia. J Neurosci. 2009;29:14236–46. [PubMed: 19906971].PubMedPubMedCentralCrossRef
Zurück zum Zitat Powell J, DiLeo T, Roberge R, Coca A, Kim JH. Salivary and serum cortisol levels during recovery from intense exercise and prolonged, moderate exercise. Biol Sport. 2015;32(2):91–5.PubMedPubMedCentralCrossRef Powell J, DiLeo T, Roberge R, Coca A, Kim JH. Salivary and serum cortisol levels during recovery from intense exercise and prolonged, moderate exercise. Biol Sport. 2015;32(2):91–5.PubMedPubMedCentralCrossRef
Zurück zum Zitat Price DD, Hu JW, Dubner R, Gracely RH. Peripheral suppression of first pain and central summation of second pain evoked by noxious heat pulses. Pain. 1977;3:57–68. [PubMed: 876667].PubMedCrossRef Price DD, Hu JW, Dubner R, Gracely RH. Peripheral suppression of first pain and central summation of second pain evoked by noxious heat pulses. Pain. 1977;3:57–68. [PubMed: 876667].PubMedCrossRef
Zurück zum Zitat Raichlen DA, Foster AD, Gerdeman GL, Seillier A, Giuffrida A. Wired to run: exercise-induced endocannabinoid signaling in humans and cursorial mammals with implications for the „runner’s high“. J Exp Biol. 2012;215:1331–6. [PubMed: 22442371].PubMedCrossRef Raichlen DA, Foster AD, Gerdeman GL, Seillier A, Giuffrida A. Wired to run: exercise-induced endocannabinoid signaling in humans and cursorial mammals with implications for the „runner’s high“. J Exp Biol. 2012;215:1331–6. [PubMed: 22442371].PubMedCrossRef
Zurück zum Zitat Raichlen DA, Foster AD, Seillier A, Giuffrida A, Gerdeman GL. Exercise-induced endocannabinoid signaling is modulated by intensity. Eur J Appl Physiol. 2013;13:869–75. [PubMed: 22990628].CrossRef Raichlen DA, Foster AD, Seillier A, Giuffrida A, Gerdeman GL. Exercise-induced endocannabinoid signaling is modulated by intensity. Eur J Appl Physiol. 2013;13:869–75. [PubMed: 22990628].CrossRef
Zurück zum Zitat Ram KC, Eisenberg E, Haddad M, Pud D. Oral opioid use alters DNIC but not cold pain perception in patients with chronic pain: new perspective of opioidinduced hyperalgesia. Pain. 2008;139:431–8.PubMedCrossRef Ram KC, Eisenberg E, Haddad M, Pud D. Oral opioid use alters DNIC but not cold pain perception in patients with chronic pain: new perspective of opioidinduced hyperalgesia. Pain. 2008;139:431–8.PubMedCrossRef
Zurück zum Zitat Randich A, Maixner W. Interactions between cardiovascular and pain regulatory systems. Neurosci Biobehav Rev. 1984;8:343–67.PubMedCrossRef Randich A, Maixner W. Interactions between cardiovascular and pain regulatory systems. Neurosci Biobehav Rev. 1984;8:343–67.PubMedCrossRef
Zurück zum Zitat Reyes del Paso GA, Garrido S, Pulgar A, Duschek S. Autonomic cardiovascular control and responses to experimental pain stimulation in fibromyalgia syndrome. J Psychosom Res. 2011;70:125–34.PubMedCrossRef Reyes del Paso GA, Garrido S, Pulgar A, Duschek S. Autonomic cardiovascular control and responses to experimental pain stimulation in fibromyalgia syndrome. J Psychosom Res. 2011;70:125–34.PubMedCrossRef
Zurück zum Zitat Riley JL, Cruz-Almeida Y, Glover TL, King CD, Goodin BR, Sibille KT, Bartley EJ, Herbert MS, Sotolongo A, Fessler BJ, Redden DT, Staud R, Bradley LA, Fillingim RB. Age and race effects on pain sensitivity and modulation among middle-aged and older adults. J Pain. 2014;15:272–82.PubMedCrossRef Riley JL, Cruz-Almeida Y, Glover TL, King CD, Goodin BR, Sibille KT, Bartley EJ, Herbert MS, Sotolongo A, Fessler BJ, Redden DT, Staud R, Bradley LA, Fillingim RB. Age and race effects on pain sensitivity and modulation among middle-aged and older adults. J Pain. 2014;15:272–82.PubMedCrossRef
Zurück zum Zitat Ring C, Edwards L, Kavussanu M. Effects of isometric exercise on pain are mediated by blood pressure. Biol Psychol. 2008;78:123–8.PubMedCrossRef Ring C, Edwards L, Kavussanu M. Effects of isometric exercise on pain are mediated by blood pressure. Biol Psychol. 2008;78:123–8.PubMedCrossRef
Zurück zum Zitat Ruscheweyh R, Weinges F, Schiffer M, Bäumler M, Feller M, Krafft S, Straube A, Sommer J, Marziniak M. Control over spinal nociception as quantified by the nociceptive flexor reflex (RIII reflex) can be achieved under feedback of the RIII reflex. Eur J Pain. 2015a;19(4):480–9.PubMedCrossRef Ruscheweyh R, Weinges F, Schiffer M, Bäumler M, Feller M, Krafft S, Straube A, Sommer J, Marziniak M. Control over spinal nociception as quantified by the nociceptive flexor reflex (RIII reflex) can be achieved under feedback of the RIII reflex. Eur J Pain. 2015a;19(4):480–9.PubMedCrossRef
Zurück zum Zitat 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 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
Zurück zum Zitat Schmitt A, Wallat D, Stangier C, Martin JA, Schlesinger-Irsch U, Boecker H. Effects of fitness level and exercise intensity on pain and mood responses. Eur J Pain. 2020;24(3):568–79.PubMedCrossRef Schmitt A, Wallat D, Stangier C, Martin JA, Schlesinger-Irsch U, Boecker H. Effects of fitness level and exercise intensity on pain and mood responses. Eur J Pain. 2020;24(3):568–79.PubMedCrossRef
Zurück zum Zitat Schobel HP, Hanwerker HO, Schmieder RE, Heusser K, Dominiak P, Luft FC. Effects of naloxone on hemodynamic and sympathetic nerve responses to pain in normotensives vs. borderline hypertensive men. J Auton Nerv Syst. 1998;69:49–55. [PubMed: 9672123].PubMedCrossRef Schobel HP, Hanwerker HO, Schmieder RE, Heusser K, Dominiak P, Luft FC. Effects of naloxone on hemodynamic and sympathetic nerve responses to pain in normotensives vs. borderline hypertensive men. J Auton Nerv Syst. 1998;69:49–55. [PubMed: 9672123].PubMedCrossRef
Zurück zum Zitat Schrepf A, Harper DE, Harte SE, Wang H, Ichesco E, Hampson JP, Zubieta JK, Clauw DJ, Harris RE. Endogenous opioidergic dysregulation of pain in fibromyalgia: a PET and fMRI study. Pain. 2016;157(10):2217–25. [PubMed: 27420606].PubMedPubMedCentralCrossRef Schrepf A, Harper DE, Harte SE, Wang H, Ichesco E, Hampson JP, Zubieta JK, Clauw DJ, Harris RE. Endogenous opioidergic dysregulation of pain in fibromyalgia: a PET and fMRI study. Pain. 2016;157(10):2217–25. [PubMed: 27420606].PubMedPubMedCentralCrossRef
Zurück zum Zitat Seminowicz DA, Labus JS, Bueller JA, Tillisch K, Naliboff BD, Bushnell MC, Mayer EA. Regional gray matter density changes in brains of patients with irritable bowel syndrome. Gastroenterology. 2010;139(1):48–57.e2. [PubMed: 20347816].PubMedCrossRef Seminowicz DA, Labus JS, Bueller JA, Tillisch K, Naliboff BD, Bushnell MC, Mayer EA. Regional gray matter density changes in brains of patients with irritable bowel syndrome. Gastroenterology. 2010;139(1):48–57.e2. [PubMed: 20347816].PubMedCrossRef
Zurück zum Zitat Silverman SM. Opioid induced hyperalgesia: clinical implications for the pain practitioner. Pain Physician. 2009;12(3):679–84.PubMedCrossRef Silverman SM. Opioid induced hyperalgesia: clinical implications for the pain practitioner. Pain Physician. 2009;12(3):679–84.PubMedCrossRef
Zurück zum Zitat Smith A, López-Solà M, McMahon K, Pedler A, Sterling M. Multivariate pattern analysis utilizing structural or functional MRI-in individuals with musculoskeletal pain and healthy controls: a systematic review. Semin Arthritis Rheum. 2017;47(3):418–31.PubMedCrossRef Smith A, López-Solà M, McMahon K, Pedler A, Sterling M. Multivariate pattern analysis utilizing structural or functional MRI-in individuals with musculoskeletal pain and healthy controls: a systematic review. Semin Arthritis Rheum. 2017;47(3):418–31.PubMedCrossRef
Zurück zum Zitat Sparling PB, Giuffrida A, Piomelli D, Rosskopf L, Dietrich A. Exercise activates the endocannabinoid system. Neuroreport. 2003;14:2209–11. [PubMed: 14625449].PubMedCrossRef Sparling PB, Giuffrida A, Piomelli D, Rosskopf L, Dietrich A. Exercise activates the endocannabinoid system. Neuroreport. 2003;14:2209–11. [PubMed: 14625449].PubMedCrossRef
Zurück zum Zitat Sprenger C, Bingel U, Büchel C. Treating pain with pain: supraspinal mechanisms of endogenous analgesia elicited by heterotopic noxious conditioning stimulation. Pain. 2011;152:428–39. [PubMed: 21196078].PubMedCrossRef Sprenger C, Bingel U, Büchel C. Treating pain with pain: supraspinal mechanisms of endogenous analgesia elicited by heterotopic noxious conditioning stimulation. Pain. 2011;152:428–39. [PubMed: 21196078].PubMedCrossRef
Zurück zum Zitat Staud R, Vierck CJ, Cannon RL, Mauderli AP, Price DD. Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain. 2001;91(1–2):165–75.PubMedCrossRef Staud R, Vierck CJ, Cannon RL, Mauderli AP, Price DD. Abnormal sensitization and temporal summation of second pain (wind-up) in patients with fibromyalgia syndrome. Pain. 2001;91(1–2):165–75.PubMedCrossRef
Zurück zum Zitat Staud R, Cannon RC, Mauderli AP, Robinson ME, Price DD, Vierck CJ Jr. Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome. Pain. 2003;102(1–2):87–95.PubMedCrossRef Staud R, Cannon RC, Mauderli AP, Robinson ME, Price DD, Vierck CJ Jr. Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome. Pain. 2003;102(1–2):87–95.PubMedCrossRef
Zurück zum Zitat Suzan E, Midbari A, Treister R, Haddad M, Pud D, Eisenberg E. Oxycodone alters temporal summation but not conditioned pain modulation: preclinical findings and possible relations to mechanisms of opioid analgesia. Pain. 2013;154:1413–8.PubMedCrossRef Suzan E, Midbari A, Treister R, Haddad M, Pud D, Eisenberg E. Oxycodone alters temporal summation but not conditioned pain modulation: preclinical findings and possible relations to mechanisms of opioid analgesia. Pain. 2013;154:1413–8.PubMedCrossRef
Zurück zum Zitat Suzan E, Treister R, Pud D, Haddad M, Eisenberg E. The effect of hydromorphone therapy on psychophysical measurements of the descending inhibitory pain systems in patients with chronic radicular pain. Pain Med. 2015;16:168–75.PubMedCrossRef Suzan E, Treister R, Pud D, Haddad M, Eisenberg E. The effect of hydromorphone therapy on psychophysical measurements of the descending inhibitory pain systems in patients with chronic radicular pain. Pain Med. 2015;16:168–75.PubMedCrossRef
Zurück zum Zitat Taylor BK, Roderick RE, Basbaum AI. Brainstem noradrenergic control of nociception is abnormal in the spontaneously hypertensive rat. Neurosci Lett. 2000;291(3):139–42.PubMedCrossRef Taylor BK, Roderick RE, Basbaum AI. Brainstem noradrenergic control of nociception is abnormal in the spontaneously hypertensive rat. Neurosci Lett. 2000;291(3):139–42.PubMedCrossRef
Zurück zum Zitat Taylor BK, Roderick RE, St Lezin E, Basbaum AI. Hypoalgesia and hyperalgesia with inherited hypertension in the rat. Am J Physiol Regul Integr Comp Physiol. 2001;280(2):R345–54.PubMedCrossRef Taylor BK, Roderick RE, St Lezin E, Basbaum AI. Hypoalgesia and hyperalgesia with inherited hypertension in the rat. Am J Physiol Regul Integr Comp Physiol. 2001;280(2):R345–54.PubMedCrossRef
Zurück zum Zitat Thoren P, Floras JS, Hoffmann P, Seals DR. Endorphins and exercise: physiological mechanisms and clinical implications. Med Sci Sports Exerc. 1990;22(4):417–28.PubMed Thoren P, Floras JS, Hoffmann P, Seals DR. Endorphins and exercise: physiological mechanisms and clinical implications. Med Sci Sports Exerc. 1990;22(4):417–28.PubMed
Zurück zum Zitat 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.PubMedPubMedCentralCrossRef 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.PubMedPubMedCentralCrossRef
Zurück zum Zitat Umeda M, Newcomb LW, Ellingson LD, Koltyn KF. Examination of the dose-response relationship between pain perception and blood pressure elevations induced by isometric exercise in men and women. Biol Psychol. 2010;85:90–6.PubMedCrossRef Umeda M, Newcomb LW, Ellingson LD, Koltyn KF. Examination of the dose-response relationship between pain perception and blood pressure elevations induced by isometric exercise in men and women. Biol Psychol. 2010;85:90–6.PubMedCrossRef
Zurück zum Zitat Vaegter HB, Handberg G, Graven-Nielsen T. Similarities between exercise-induced hypoalgesia and conditioned pain modulation in humans. Pain. 2014;155(1):158–67.PubMedCrossRef Vaegter HB, Handberg G, Graven-Nielsen T. Similarities between exercise-induced hypoalgesia and conditioned pain modulation in humans. Pain. 2014;155(1):158–67.PubMedCrossRef
Zurück zum Zitat Vaegter HB, Handberg G, Graven-Nielsen T. Hypoalgesia after exercise and the cold pressor test is reduced in chronic musculoskeletal pain patients with high pain sensitivity. Clin J Pain. 2016;32(1):58–69.PubMedCrossRef Vaegter HB, Handberg G, Graven-Nielsen T. Hypoalgesia after exercise and the cold pressor test is reduced in chronic musculoskeletal pain patients with high pain sensitivity. Clin J Pain. 2016;32(1):58–69.PubMedCrossRef
Zurück zum Zitat Vierck CJ, Cannon RL, Fry G, Maixner W, Whitsel BL. Characteristics of temporal summation of second pain sensations elicited by brief contact of glabrous skin by a preheated thermode. J Neurophysiol. 1997;78:992–1002. [PubMed: 9307129].PubMedCrossRef Vierck CJ, Cannon RL, Fry G, Maixner W, Whitsel BL. Characteristics of temporal summation of second pain sensations elicited by brief contact of glabrous skin by a preheated thermode. J Neurophysiol. 1997;78:992–1002. [PubMed: 9307129].PubMedCrossRef
Zurück zum Zitat Vierck CJ, Mauderli AP, Riley JL III. Relationships between the intensity and duration of Peltier heat stimulation and pain magnitude. Exp Brain Res. 2013a;225:339–48. [PubMed: 23423165].PubMedCrossRef Vierck CJ, Mauderli AP, Riley JL III. Relationships between the intensity and duration of Peltier heat stimulation and pain magnitude. Exp Brain Res. 2013a;225:339–48. [PubMed: 23423165].PubMedCrossRef
Zurück zum Zitat Vierck CJ, Whitsel BL, Favorov OV, Brown AW, Tommerdahl M. Role of primary somatosensory cortex in the coding of pain. PAIN®. 2013b;154:334–44. [PubMed: 23245864].CrossRef Vierck CJ, Whitsel BL, Favorov OV, Brown AW, Tommerdahl M. Role of primary somatosensory cortex in the coding of pain. PAIN®. 2013b;154:334–44. [PubMed: 23245864].CrossRef
Zurück zum Zitat Vierck CJ Jr, Staud R, Price DD, et al. The effect of maximal exercise on temporal summation of second pain (windup) in patients with fibromyalgia syndrome. J Pain. 2001;2:334–44.PubMedCrossRef Vierck CJ Jr, Staud R, Price DD, et al. The effect of maximal exercise on temporal summation of second pain (windup) in patients with fibromyalgia syndrome. J Pain. 2001;2:334–44.PubMedCrossRef
Zurück zum Zitat Villanueva L, Chitour D, Le Bars D. Involvement of the dorsolateral funiculus in the descending spinal projections responsible for diffuse noxious inhibitory controls in the rat. J Neurophysiol. 1986a;56(4):1185–95.PubMedCrossRef Villanueva L, Chitour D, Le Bars D. Involvement of the dorsolateral funiculus in the descending spinal projections responsible for diffuse noxious inhibitory controls in the rat. J Neurophysiol. 1986a;56(4):1185–95.PubMedCrossRef
Zurück zum Zitat Villanueva L, Peschanski M, Calvino B, Le Bars D. Ascending pathways in the spinal cord involved in triggering of diffuse noxious inhibitory controls in the rat. J Neurophysiol. 1986b;55(1):34–55.PubMedCrossRef Villanueva L, Peschanski M, Calvino B, Le Bars D. Ascending pathways in the spinal cord involved in triggering of diffuse noxious inhibitory controls in the rat. J Neurophysiol. 1986b;55(1):34–55.PubMedCrossRef
Zurück zum Zitat Vogler P. Periostbehandlung. Stuttgart: Thieme;1953. Vogler P. Periostbehandlung. Stuttgart: Thieme;1953.
Zurück zum Zitat Vogler P, Krauß H. Periostbehandlung – Kolonbehandung. Zwei reflextherapeutische Methoden. Stuttgart: Thieme;1980. Vogler P, Krauß H. Periostbehandlung – Kolonbehandung. Zwei reflextherapeutische Methoden. Stuttgart: Thieme;1980.
Zurück zum Zitat Wakaizumi K, Kondo T, Hamada Y, Narita M, Kawabe R, Narita H, Watanabe M, Kato S, Senba E, Kobayashi K, Kuzumaki N, Yamanaka A, Morisaki H, Narita M. Involvement of mesolimbic dopaminergic network in neuropathic pain relief by treadmill exercise: a study for specific neural control with Gi-DREADD in mice. Mol Pain. 2016;12:1–11. Wakaizumi K, Kondo T, Hamada Y, Narita M, Kawabe R, Narita H, Watanabe M, Kato S, Senba E, Kobayashi K, Kuzumaki N, Yamanaka A, Morisaki H, Narita M. Involvement of mesolimbic dopaminergic network in neuropathic pain relief by treadmill exercise: a study for specific neural control with Gi-DREADD in mice. Mol Pain. 2016;12:1–11.
Zurück zum Zitat Walker JM, Hohmann AG. Cannabinoid mechanisms of pain suppression. Handb Exp Pharmacol. 2005;168:509–54. [PubMed: 16596786].CrossRef Walker JM, Hohmann AG. Cannabinoid mechanisms of pain suppression. Handb Exp Pharmacol. 2005;168:509–54. [PubMed: 16596786].CrossRef
Zurück zum Zitat Warren JW, Langenberg P, Clauw DJ. The number of existing functional somatic syndromes (FSSs) is an important risk factor for new, different FSSs. J Psychosom Res. 2013;74(1):12–7. [PubMed:23272983].PubMedCrossRef Warren JW, Langenberg P, Clauw DJ. The number of existing functional somatic syndromes (FSSs) is an important risk factor for new, different FSSs. J Psychosom Res. 2013;74(1):12–7. [PubMed:23272983].PubMedCrossRef
Zurück zum Zitat Washington LL, Gibson SJ, Helme RD. Age-related differences in the endogenous analgesic response to repeated cold water immersion in human volunteers. Pain. 2000;89:89–96.PubMedCrossRef Washington LL, Gibson SJ, Helme RD. Age-related differences in the endogenous analgesic response to repeated cold water immersion in human volunteers. Pain. 2000;89:89–96.PubMedCrossRef
Zurück zum Zitat Willer JC, Boureau F, Albe-Fessard D. Supraspinal influences on nociceptive flexion reflex and pain sensation in man. Brain Res. 1979;179(1):61–8.PubMedCrossRef Willer JC, Boureau F, Albe-Fessard D. Supraspinal influences on nociceptive flexion reflex and pain sensation in man. Brain Res. 1979;179(1):61–8.PubMedCrossRef
Zurück zum Zitat Willer JC, Le Bars D, De Broucker T. Diffuse noxious inhibitory controls in man: involvement of an opioidergic link. Eur J Pharmacol. 1990;182:347–55.PubMedCrossRef Willer JC, Le Bars D, De Broucker T. Diffuse noxious inhibitory controls in man: involvement of an opioidergic link. Eur J Pharmacol. 1990;182:347–55.PubMedCrossRef
Zurück zum Zitat Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science. 2000;288:1765–9.PubMedCrossRef Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science. 2000;288:1765–9.PubMedCrossRef
Zurück zum Zitat Xu J, Casserly E, Yin Y, Cheng J. A systematic review of growth hormone in pain medicine: from rodents to humans. Pain Med. 2020;21(1):21–31.PubMedCrossRef Xu J, Casserly E, Yin Y, Cheng J. A systematic review of growth hormone in pain medicine: from rodents to humans. Pain Med. 2020;21(1):21–31.PubMedCrossRef
Zurück zum Zitat Yarnitsky D, Crispel Y, Eisenberg E, Granovsky Y, Ben-Nun A, Sprecher E, Best LA, Granot M. Prediction of chronic post-operative pain: preoperative DNIC testing identifies patients at risk. Pain. 2008;138(1):22–8.PubMedCrossRef Yarnitsky D, Crispel Y, Eisenberg E, Granovsky Y, Ben-Nun A, Sprecher E, Best LA, Granot M. Prediction of chronic post-operative pain: preoperative DNIC testing identifies patients at risk. Pain. 2008;138(1):22–8.PubMedCrossRef
Zurück zum Zitat Yelle MD, Rogers JM, Coghill RC. Offset analgesia: a temporal contrast mechanism for nociceptive information. Pain. 2008;134:174–86. [PubMed: 17533118]. Yelle MD, Rogers JM, Coghill RC. Offset analgesia: a temporal contrast mechanism for nociceptive information. Pain. 2008;134:174–86. [PubMed: 17533118].
Zurück zum Zitat Yelle MD, Oshiro Y, Kraft RA, Coghill RC. Temporal filtering of nociceptive information by dynamic activation of endogenous pain modulatory systems. J Neurosci. 2009;29:10264–71. [PubMed: 19692600].PubMedPubMedCentralCrossRef Yelle MD, Oshiro Y, Kraft RA, Coghill RC. Temporal filtering of nociceptive information by dynamic activation of endogenous pain modulatory systems. J Neurosci. 2009;29:10264–71. [PubMed: 19692600].PubMedPubMedCentralCrossRef
Zurück zum Zitat Yeomans DC, Proudfit HK. Nociceptive responses to high and low rates of noxious cutaneous heating are mediated by different nociceptors in the rat: electrophysiological evidence. Pain. 1996;68:141–50. [PubMed: 9252009].PubMedCrossRef Yeomans DC, Proudfit HK. Nociceptive responses to high and low rates of noxious cutaneous heating are mediated by different nociceptors in the rat: electrophysiological evidence. Pain. 1996;68:141–50. [PubMed: 9252009].PubMedCrossRef
Zurück zum Zitat Zachariou V, Goldstein BD, Yeomans DC. Low but not high rate noxious radiant skin heating evokes a capsaicin-sensitive increase in spinal cord dorsal horn release of substance P. Brain Res. 1997;752:143–50. [PubMed: 9106450].PubMedCrossRef Zachariou V, Goldstein BD, Yeomans DC. Low but not high rate noxious radiant skin heating evokes a capsaicin-sensitive increase in spinal cord dorsal horn release of substance P. Brain Res. 1997;752:143–50. [PubMed: 9106450].PubMedCrossRef
Zurück zum Zitat Zamir N, Maixner W. The relationship between cardiovascular and pain regulatory systems. Ann N Y Acad Sci. 1986;467:371–84.PubMedCrossRef Zamir N, Maixner W. The relationship between cardiovascular and pain regulatory systems. Ann N Y Acad Sci. 1986;467:371–84.PubMedCrossRef
Zurück zum Zitat Zamir N, Shuber E. Altered pain perception in hypertensive humans. Brain Res. 1980;201:471–4.PubMedCrossRef Zamir N, Shuber E. Altered pain perception in hypertensive humans. Brain Res. 1980;201:471–4.PubMedCrossRef
Metadaten
Titel
Mechanismen der endogenen Schmerzhemmung
verfasst von
Wolfgang Laube
Copyright-Jahr
2022
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-63846-0_6

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