Review: central sensitization and musculoskeletal pain

Abstract

Musculoskeletal pain is a prominent feature of a variety of disorders, resulting in diffuse, difficult-to-localize, aching pain. The quality of pain associated with injury to muscle or joint is uniquely different from that of skin. Furthermore, chronic musculoskeletal pain is common, disabling, and difficult to treat. This review focuses on changes in the central nervous system relating to kaolin and carrageenan joint inflammation, carrageenan muscle inflammation, and noninflammatory repeated intramuscular acid injections. Behavioral, pharmacological, and electrophysiological data are reviewed in the context of central sensitization in these models. Sensitization of dorsal horn neurons and the consequent secondary hyperalgesia involve activation of glutamate receptors, peptidergic receptors, and second messengers in the spinal cord, which contributes to musculoskeletal pain. Understanding the role of central sensitization in musculoskeletal pain is essential for effective treatment of these disorders. Specifically, the knowledge gained from behavioral, pharmacological, and electrophysiological data will assist healthcare practitioners in choosing the most appropriate treatment.