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Related Concept Videos

Nociception01:44

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Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
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Pain mechanisms for the practicing rheumatologist.

Deeba Minhas1

  • 1Department of Internal Medicine, Division of Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA.

Best Practice & Research. Clinical Rheumatology
|March 23, 2024
PubMed
Summary

Chronic pain in rheumatic diseases involves complex biological, psychological, and social factors, moving beyond simple nociception. Effective management requires integrated medical, psychological, and social interventions for a holistic approach.

Keywords:
Central sensitizationNociplasticPain mechanismsRheumatic pain

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Area of Science:

  • Rheumatology
  • Pain Medicine
  • Neuroscience

Background:

  • Rheumatic disease pain extends beyond nociception.
  • Chronic pain involves peripheral and central sensitization.
  • Nociplastic pain arises from altered central nervous system processing.

Purpose of the Study:

  • To explore the multifaceted nature of pain in rheumatic diseases.
  • To highlight the role of biological, psychological, and social factors.
  • To emphasize comprehensive treatment strategies.

Main Methods:

  • Review of current understanding of pain mechanisms in rheumatic diseases.
  • Analysis of the interplay between biological and psychosocial factors.
  • Synthesis of research on central nervous system processing in pain.

Main Results:

  • Pain in rheumatic diseases is influenced by nociceptive, neuropathic, and nociplastic mechanisms.
  • Psychosocial factors like mood disorders and catastrophizing significantly impact pain perception.
  • The brain plays a central role in the experience of chronic pain.

Conclusions:

  • A modern understanding of rheumatic disease pain integrates neurobiological and psychosocial elements.
  • Comprehensive management requires a combination of medical, psychological, and social interventions.
  • Addressing the intricate interplay of factors is crucial for effective pain management.