Alito Angelo, Verme Federica, Mercati Gian Paolo, Piterà Paolo, Fontana Jacopo Maria, Capodaglio Paolo
Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, 98125 Messina, Italy.
Research Laboratory in Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo, 28824 Verbania, Italy.
Healthcare (Basel). 2024 Feb 25;12(5):546. doi: 10.3390/healthcare12050546.
Central sensitisation is defined as a multifactorial etiopathogenetic condition involving an increase in the reactivity of nociceptive neurons and alterations in pain transmission and perception in the central nervous system. Patients may present with widespread chronic pain, fatigue, sleep disturbance, dizziness, psychological (e.g., depression, anxiety, and anger) and social impairment. Pain can be spontaneous in onset and persistence, characterised by an exaggerated response and spread beyond the site of origin, and sometimes triggered by a non-painful stimulus. Whole-body cryostimulation (WBC) could be an adjuvant therapy in the management of this type of pain because of its global anti-inflammatory effect, changes in cytokines and hormone secretion, reduction in nerve conduction velocity, autonomic modulation, and release of neurotransmitters involved in the pain pathway. In several conditions (e.g., fibromyalgia, rheumatoid arthritis, and chronic musculoskeletal pain), WBC affects physical performance, pain perception, and psychological aspects. Given its multiple targets and effects at different organs and levels, WBC appears to be a versatile adjuvant treatment for a wide range of conditions of rehabilitation interest. Further research is needed to fully understand the mechanisms of analgesic effect and potential actions on pain pathways, as well as to study long-term effects and potential uses in other chronic pain conditions.
中枢敏化被定义为一种多因素的病因病理状态，涉及伤害性神经元反应性增加以及中枢神经系统疼痛传递和感知的改变。患者可能出现广泛的慢性疼痛、疲劳、睡眠障碍、头晕、心理（如抑郁、焦虑和愤怒）及社会功能障碍。疼痛可自发发作并持续存在，其特征为反应过度且扩散至起源部位之外，有时由非疼痛刺激引发。全身冷冻刺激（WBC）因其具有整体抗炎作用、细胞因子和激素分泌变化、神经传导速度降低、自主神经调节以及疼痛通路中神经递质释放等特性，可能成为这类疼痛管理的辅助治疗方法。在多种病症（如纤维肌痛、类风湿性关节炎和慢性肌肉骨骼疼痛）中，WBC会影响身体机能、疼痛感知和心理方面。鉴于其在不同器官和层面具有多种靶点和作用，WBC似乎是一种适用于多种康复相关病症的通用辅助治疗方法。需要进一步研究以充分理解其镇痛作用机制以及对疼痛通路的潜在作用，同时研究其长期影响和在其他慢性疼痛病症中的潜在用途。
