预测骨关节炎疼痛的因素：韧性的重要性。
Predictors of Osteoarthritis Pain: the Importance of Resilience.
机构信息
Department of Community Dentistry and Behavioral Science, Pain Research & Intervention Center of Excellence, University of Florida, 1395 Center Drive, Room D2-13, PO Box 100404, Gainesville, FL, 32610, USA.
The University of Tulsa, Department of Psychology, 800 South Tucker Drive, Tulsa, OK, 74104, USA.
出版信息
Curr Rheumatol Rep. 2017 Sep;19(9):57. doi: 10.1007/s11926-017-0683-3.
PURPOSE OF REVIEW
Osteoarthritis (OA) is one of the most common and disabling forms of arthritis worldwide, with joint pain being a primary symptom. Given that clinical symptoms often show poor concordance with tissue damage in OA, processes other than joint remodeling likely play a role in the condition. Using the biopsychosocial model of pain as a guiding framework, the purpose of this review is to highlight the extra-articular mechanisms that contribute to pain and dysfunction in OA, with a specific focus on resilience.
RECENT FINDINGS
Whereas previous research has mostly focused on risk factors for worsening of OA pain, recently emerging evidence places greater emphasis on the identification of protective mechanisms that enhance pain adaptation and palliate the negative effects of joint pain. In view of this new and important research, more emphasis should be placed on endogenous pain modulation and, in particular, pain attenuation. The result of such work could serve as a basis for optimizing treatment in the OA population.
目的综述
骨关节炎（OA）是全球最常见和致残性的关节炎形式之一，关节疼痛是其主要症状。鉴于临床症状与 OA 中的组织损伤常常不一致，除关节重塑外，其他过程可能在该疾病中起作用。本文使用疼痛的身心社会模型作为指导框架，重点介绍 OA 中导致疼痛和功能障碍的关节外机制，特别关注韧性。
最近的发现
虽然之前的研究主要集中在 OA 疼痛恶化的危险因素上，但最近新出现的证据更强调确定增强疼痛适应和减轻关节疼痛负面影响的保护机制。鉴于这项新的重要研究，应该更加重视内源性疼痛调节，特别是疼痛衰减。此类工作的结果可以作为优化 OA 人群治疗的基础。
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