Continuum (Minneap Minn). 2024 Oct 1;30(5):1427-1446. doi: 10.1212/CON.0000000000001470.
This article reviews the potential etiologies of chronic widespread pain syndromes and outlines a practical approach to the management of patients with these disorders.
Recent updates to diagnostic criteria for primary chronic widespread pain syndromes have allowed for more effective diagnosis. Fibromyalgia is the most common presentation of chronic widespread pain, and the concept of nociplastic pain has been used to describe pain that is related to altered processing of pain sensory pathways. Research studies have provided a better understanding of the pathophysiology of the central augmentation that occurs in patients with nociplastic pain and fibromyalgia.
Primary chronic widespread pain and fibromyalgia have established diagnostic criteria in which chronic pain involves multiple defined regions and occurs for longer than 3 months. Evaluation of chronic widespread pain should be directed by the clinical presentation. Neurologic disease can present with chronic widespread pain but is accompanied by associated signs and symptoms. Patients with chronic widespread pain benefit from effective communication that validates concerns, provides an understandable explanation of the presenting symptoms, and sets realistic expectations in outcomes using a comprehensive multimodal care plan.
本文回顾了慢性广泛性疼痛综合征的潜在病因，并概述了管理此类疾病患者的实用方法。
原发性慢性广泛性疼痛综合征的诊断标准最近有所更新，从而提高了诊断的准确性。纤维肌痛是慢性广泛性疼痛的最常见表现，痛觉过敏疼痛的概念被用来描述与疼痛感觉通路的改变处理有关的疼痛。研究为理解痛觉过敏疼痛和纤维肌痛患者中枢放大的病理生理学提供了更好的认识。
原发性慢性广泛性疼痛和纤维肌痛有既定的诊断标准，其中慢性疼痛涉及多个定义明确的区域，且持续时间超过 3 个月。慢性广泛性疼痛的评估应根据临床表现进行。神经病可表现为慢性广泛性疼痛，但伴有相关的体征和症状。慢性广泛性疼痛患者受益于有效的沟通，这种沟通可以验证患者的担忧，对现有症状提供可理解的解释，并使用综合的多模式护理计划为患者设定现实的预后期望。
