Puntillo Filomena, Giglio Mariateresa, Paladini Antonella, Perchiazzi Gaetano, Viswanath Omar, Urits Ivan, Sabbà Carlo, Varrassi Giustino, Brienza Nicola
Department of Interdisciplinary Medicine, 'Aldo Moro' University of Bari, Piazza G. Cesare 11, Bari 70124, Italy.
Anesthesia, Intensive Care and Pain Unit, Policlinico Hospital, Bari, Italy.
Ther Adv Musculoskelet Dis. 2021 Feb 26;13:1759720X21995067. doi: 10.1177/1759720X21995067. eCollection 2021.
Musculoskeletal pain (excluding bone cancer pain) affects more than 30% of the global population and imposes an enormous burden on patients, families, and caregivers related to functional limitation, emotional distress, effects on mood, loss of independence, and reduced quality of life. The pathogenic mechanisms of musculoskeletal pain relate to the differential sensory innervation of bones, joints, and muscles as opposed to skin and involve a number of peripheral and central nervous system cells and mediators. The interplay of neurons and non-neural cells (e.g. glial, mesenchymal, and immune cells) amplifies and sensitizes pain signals in a manner that leads to cortical remodeling. Moreover, sex, age, mood, and social factors, together with beliefs, thoughts, and pain behaviors influence the way in which musculoskeletal pain manifests and is understood and assessed. The aim of this narrative review is to summarize the different pathogenic mechanisms underlying musculoskeletal pain and how these mechanisms interact to promote the transition from acute to chronic pain.
肌肉骨骼疼痛（不包括骨癌疼痛）影响着全球超过30%的人口，并给患者、家庭和护理人员带来了巨大负担，涉及功能受限、情绪困扰、对情绪的影响、失去独立性以及生活质量下降等问题。肌肉骨骼疼痛的发病机制与骨骼、关节和肌肉（与皮肤相对）的不同感觉神经支配有关，涉及许多外周和中枢神经系统细胞及介质。神经元与非神经细胞（如神经胶质细胞、间充质细胞和免疫细胞）之间的相互作用以导致皮质重塑的方式放大并使疼痛信号敏感化。此外，性别、年龄、情绪和社会因素，以及信念、思想和疼痛行为会影响肌肉骨骼疼痛的表现方式以及人们对其的理解和评估。本叙述性综述的目的是总结肌肉骨骼疼痛背后的不同发病机制，以及这些机制如何相互作用以促进从急性疼痛向慢性疼痛的转变。
