Abstract
Chronic joint pain (CJP) is among the major musculoskeletal comorbidities in patients with sickle cell disease (SCD), however, the poor correlation between structural joint injury and the intensity CJP reported by patients makes healthcare professionals have difficulties in understanding and evaluating it. In addition, most musculoskeletal evaluation procedures do not take into consideration central nervous system (CNS) plasticity associated with CJP, which are frequently maladaptive. Among the maladaptive CNS plasticity mechanisms, some seem to be important in CJP, including the impairment of pain endogenous control systems, central sensitization, motor cortex reorganization, motor control modification, and atherogenic muscle inhibition. Understanding the link between maladaptive CNS plasticity and CJP mechanisms, and its assessment through accurate instruments and methods may help healthcare professionals to increase the quality of treatment offered to SCD patients. This review study highlights the mechanisms of CNS maladaptive plasticity that might be related to CJP in SCD and proposes reliable instruments and methods for musculoskeletal assessment adapted to those patients.
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