Pathogenesis Of Chronic Pain Syndromes Research Articles

Медико-социальные особенности хронических болевых синдромов у детей и подростков

ABSTRACT INTRODUCTION. A review of the social, psychological and medical issues of chronic pain syndromes in children and adolescents. The impact of chronic pain on daily activity, academic performance and morbidity in adulthood in this category of patients is analyzed. MATERIAL AND METHODS. A systematic search was conducted on the RSCI and PubMed database for the period from 2000 to 2023 on the topic of chronic pain syndromes in children and adolescents, which yielded 761 matches on key features, of which we analyzed 24 sources. DISCUSSION. The review presents information according to which, in the pathogenesis of chronic pain syndromes in children and adolescents, a significant role is given to both the characteristics of the antinociceptive system and socio-psychological aspects. The main factors involved in the formation of chronic pain syndromes are presented. CONCLUSION. Chronic pain in children and adolescents has its own medical, psychological and social characteristics, which affect not only the current state of health, but also has a significant impact on later life. KEYWORDS: children, adolescents, chronic pain, medicalization of pain, depression

ANALYSIS OF THE PATHOGENETIC MECHANISMS OF CHRONIC JOINT PAIN IN PATIENTS WITH RHEUMATOID ARTHRITIS AND KNEE OSTEOARTHRITIS

Objective: to reveal neurogenic mechanisms in the pathogenesis of chronic pain syndrome in rheumatoid arthritis (RA) and knee osteoarthritis (OA) in order to develop individualized pharmacotherapy. Subjects and methods . One hundred and eighty-three patients with RA and 80 with knee OA were examined. By using the neuropathic pain diagnostic questionnaire (DN4), all the patients were divided into 2 groups with and without a neuropathic pain component (NPC). Results. NPC was found in 43% of the patients with RA and it was connected with involvement of the peripheral somatosensory system. In RA, NPC was common in older patients with longer disease duration, higher X-ray stage, and severe functional insufficiency. 30% of patients with knee OA also had NPC, however the signs of nervous system involvement were absent. In OA, NPC was associated with hyperalgesia, higher pain intensity, more marked joint dysfunction on the WOMAC, and anxiety. Discussion. This investigation revealed a mixed pattern of chronic pain syndrome in patients with RA and knee OA; some patients were found to have a NPC in the presence of predominantly a nociceptive component

OP0060 Underinvestigated Mechanisms of Chronic Pain in Knee Osteoarthritis

BackgroundIn recent studies was shown that chronic pain in knee osteoarthritis (OA) has multicomponent mechanism. Besides degenerative changes of the knee, neuroplastic changes of CNS play a leading role in...

Fibromyalgia as a sympathetically maintained pain syndrome.

Abnormal activity of the sympathetic nervous system may be involved in the pathogenesis of chronic pain syndromes. This article reviews the animal studies of sympathetically induced pain behavior, the controversy of sympathetically maintained pain in clinical practice, and the dysautonomic nature of fibromyalgia (FM). FM has neuropathic pain features (stimuli-independent pain state accompanied by allodynia and paresthesias). The proposal of FM as a sympathetically maintained pain syndrome is based on the controlled studies showing that patients with FM display signs of relentless sympathetic hyperactivity and that the pain is submissive to sympathetic blockade and is rekindled by norepinephrine injections. Dysautonomia also may explain the multisystem features of FM.

A possible role for saliva as a diagnostic fluid in patients with chronic pain

Objectives: The focus of this review was on proteins and peptides found in saliva. Of greatest interest were those neuropeptides relevant to nociception and to the pathogenesis of chronic pain syndromes. An additional goal was to develop a standardized protocol to collect saliva for laboratory assessment. Methods: Data were obtained through discussion with experts at the medical schools in San Antonio and Heidelberg and a Medline literature search involving all relevant studies from 1966 to 1997. The literature search was based on the following key terms: saliva, serotonin, neuropeptide, substance P (SP), calcitonin gene-related peptide (CGRP), and nerve growth factor (NGF). Results: The mean concentration of SP in the saliva of healthy normal controls ranged from 9.6 to 220 pg/mL. Generally, the concentration of SP was approximately three times higher in saliva than in plasma. In a number of painful conditions, particularly tension headache, substantial elevations of salivary SP were found. Mean values for salivary CGRP in healthy controls were approximately 22 pmol/L and were significantly elevated in patients with migraine attacks or cluster headache. There were no data to indicate prior quantitative determination of NGF in human saliva. Conclusions: After sampling and processing techniques have been standardized,measurement of neuropeptides in human saliva could provide a valuable tool for the study of patients with chronic painful disorders such as rheumatoid arthritis, osteoarthritis, and even fibromyalgia syndrome.

The pathogenesis of chronic pain syndromes

In chronic pain syndromes in which no organic pathology or pathophysiological mechanism can be found to account for the pain, i.e. the idiopathic pain syndromes, there is a high frequency of sadness, inner tension and inhibition-retardation. The clinical similarities between the idiopathic pain syndromes and the depressive syndromes have led to the hypothesis that the two syndromes have a common pathogenetic mechanism, that the idiopathic pain syndrome is a masked depression, a special syndrome in a spectrum of depressive diseases or simply a variant of the depressive disorders. In a series of studies, patients with idiopathic pain syndromes have been found to have a high frequency of subjects with affective disorders among their first degree relatives, many have had earlier depressive episodes before the start of the pain syndrome and in about 1/4 of the patients there is a clearcut major affective episode concurrently with the idiopathic pain syndrome. Furthermore, the REM latency in sleep EEG is shorte...