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Central Sensitization and Nociplastic Pain: Shared Mechanisms in Fibromyalgia, Osteoarthritis, and Inflammatory Arthritis - PubMed

4 hours ago
  • #chronic musculoskeletal diseases
  • #nociplastic pain
  • #central sensitization
  • Central sensitization is a key mechanism explaining the discrepancy between structural damage or inflammation and pain intensity in chronic musculoskeletal diseases.
  • It is the defining feature of nociplastic pain in fibromyalgia and contributes to persistent pain in osteoarthritis, rheumatoid arthritis, and psoriatic arthritis, often independent of inflammation or structural changes.
  • Manifestations include hyperalgesia, allodynia, expanded receptive fields, and impaired endogenous pain inhibition.
  • Screening tools like the Widespread Pain Index and Symptom Severity Scale, along with quantitative sensory testing and algometry, help identify nociplastic pain features.
  • Neuroimmune mechanisms such as microglial activation and imbalances in neurotransmission may underlie the mismatch between pain intensity and clinical findings.
  • Recognizing central sensitization enhances assessment and supports mechanism-based management strategies for these conditions.