肌肉疼痛：机制和临床意义。
Muscle pain: mechanisms and clinical significance.
机构信息
Institut für Anatomie und Zellbiologie III, Universität Heidelberg.
出版信息
Dtsch Arztebl Int. 2008 Mar;105(12):214-9. doi: 10.3238/artzebl.2008.0214. Epub 2008 Mar 21.
INTRODUCTION
Muscle pain is common, but the understanding of its causes is still patchy. This article addresses the mechanisms of some important types of muscle pain.
METHODS
Selective literature review, predominantly of data derived from neuroanatomical and electrophysiological experiments on anesthetized rats.
RESULTS
Muscle pain is evoked by specialized nerve endings (nociceptors). Important stimuli for muscle pain are adenosintriphosphate (ATP) and a low tissue pH. Excitation of muscle nociceptors leads to hyperexcitability of spinal sensory neurones (central sensitization). Low frequency activity in muscle nociceptors is sufficient to induce central sensitization.
DISCUSSION
Central sensitization leads to increased excitation in the spinal cord and to referral of muscle pain. The motoneurones of a painful muscle are centrally inhibited. Muscular spasm is mostly secondary to a painful lesion in another muscle or joint. The pain of fibromyalgia is assumed to relate to a dysfunction of central nociceptive processing. Psychosocial factors also contribute to pain.
简介
肌肉疼痛很常见，但对其病因的理解仍不全面。本文探讨了一些重要类型肌肉疼痛的发生机制。
方法
主要对麻醉大鼠的神经解剖学和电生理学实验数据进行了选择性文献回顾。
结果
肌肉疼痛是由专门的神经末梢（伤害感受器）引起的。引起肌肉疼痛的重要刺激物是三磷酸腺苷（ATP）和低组织 pH 值。肌肉伤害感受器的兴奋导致脊髓感觉神经元的过度兴奋（中枢敏化）。肌肉伤害感受器的低频活动足以引起中枢敏化。
讨论
中枢敏化导致脊髓兴奋增加，并导致肌肉疼痛的牵涉痛。疼痛肌肉的运动神经元在中枢受到抑制。肌肉痉挛主要继发于另一块肌肉或关节的疼痛性病变。纤维肌痛的疼痛被认为与中枢伤害性处理功能障碍有关。心理社会因素也与疼痛有关。
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