骨格関節炎における痛みの病原性と痛みの管理

Paul A Dieppe¹, L Stefan Lohmander

¹MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK. p.Dieppe@bristol.ac.uk

Lancet (London, England)

|March 16, 2005

まとめ

骨格関節炎は,軟骨の喪失と骨の変化を含む一般的な,年齢に関連する関節障害です. 疼痛管理には,関節損傷,神経敏感性,および心理社会的要因の調査が必要です.

科学分野:

レウマトロジーの病理学
整形外科整形外科
疼痛管理疼痛管理

背景:

骨格関節炎 (OA) は,一般的な,年齢に関連する退行性関節疾患です.
病理学的には,関節軟骨の喪失,骨菌の形成,サブコンドラ骨の変化,シノビティスによって特徴付けられます.
系統的,遺伝的,および局所的な機械的要因の組み合わせによって引き起こされる.

研究の目的:

骨格関節炎の複雑な病原性を調査するために.
関節損傷と臨床症状,特に痛みとの関係を調査する.
骨格関節炎の管理のための構造的なアプローチを提示する.

主な方法:

骨格関節炎の病因と病原性に関する既存の文献のレビュー.
関節損傷と痛みに寄与する要因の分析.
段階的な管理戦略の開発.

主要な成果:

OAにおける関節損傷は多因性であり,遺伝的および機械的な影響を伴う.
関節疾患の重症度は,臨床的な問題,特に痛みと弱い相関関係にある.
サブコンドラル骨とシノビウムからのノシセプティブ刺激,周辺および中央の感受性,および心理社会的要因は,OAの痛みに大きく貢献します.

結論:

骨格関節炎の管理には,関節病理と痛みのメカニズムの両方に対処する包括的なアプローチが必要です.
OAの痛みの病原性に関するさらなる研究が不可欠です.
効果的なOAケアのために,段階的な管理計画が提案されています.

さらに関連する動画

07:19

Fu's Subcutaneous Needling for Knee Osteoarthritis Pain

Published on: March 24, 2023

04:22

Assessment of Knee Hyperalgesia in Mice using Pressure Application Measurement

Published on: June 13, 2025

関連する概念動画

01:44

Nociception

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. Thus, pain helps the...

01:25

Analgesia and Pain Management

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...

01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...

01:26

Peptic Ulcer Disease IV: Management

Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...

01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...

01:23

Degenerative Disc Disease ll: Pathophysiology

The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...

関連する実験動画