Struyf Filip, Lluch Enrique, Falla Deborah, Meeus Mira, Noten Suzie, Nijs Jo
Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium,
Eur J Appl Physiol. 2015 Feb;115(2):225-34. doi: 10.1007/s00421-014-3059-7. Epub 2014 Nov 28.
Shoulder pain is often a challenging clinical phenomenon because of the potential mismatch between pathology and the perception of pain. Current evidence clearly emphasizes an incomplete understanding of the nature of shoulder pain. Indeed, the effective diagnosis and treatment of shoulder pain should not only rely upon a detailed knowledge of the peripheral pathologies that may be present in the shoulder, but also on current knowledge of pain neurophysiology. To assess and treat shoulder pain, a comprehensive understanding of the way in which pain is processed is essential. This review reflects modern pain neurophysiology to the shoulder and aims to answer the following questions: why does my shoulder hurt? What is the impact of shoulder pain on muscle function? What are the implications for the clinical examination of the shoulder? And finally, what are the clinical implications for therapy? Despite the increasing amount of research in this area, an in-depth understanding of the bidirectional nociception-motor interaction is still far from being achieved. Many questions remain, especially related to the treatment of nociception-motor interactions.
由于病理状况与疼痛感知之间可能存在不匹配,肩部疼痛常常是一个具有挑战性的临床现象。目前的证据清楚地表明,人们对肩部疼痛的本质理解并不完整。事实上,肩部疼痛的有效诊断和治疗不仅应依赖于对肩部可能存在的外周病理状况的详细了解,还应依赖于当前疼痛神经生理学的知识。为了评估和治疗肩部疼痛,全面理解疼痛的处理方式至关重要。本综述将现代疼痛神经生理学应用于肩部,旨在回答以下问题:我的肩膀为什么疼?肩部疼痛对肌肉功能有什么影响?对肩部临床检查有什么启示?最后,对治疗有什么临床意义?尽管该领域的研究数量不断增加,但对双向伤害感受 - 运动相互作用的深入理解仍远未实现。许多问题依然存在,尤其是与伤害感受 - 运动相互作用的治疗相关的问题。