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Central Pain Processing in Patients with Shoulder Pain: A Review of the Literature
Author(s) -
Noten Suzie,
Struyf Filip,
Lluch Enrique,
D'Hoore Marika,
Van Looveren Eveline,
Meeus Mira
Publication year - 2017
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12502
Subject(s) - medicine , hyperalgesia , allodynia , physical therapy , referred pain , central sensitization , somatosensory system , sensory system , pain catastrophizing , quantitative sensory testing , physical medicine and rehabilitation , anesthesia , chronic pain , nociception , neuroscience , psychology , psychiatry , receptor
Background Shoulder pain is a common health problem in which changes in shoulder structure cannot always explain the patient's perceived pain. Central sensitization ( CS ) might play a role in a subgroup of these patients. Methods The literature was systematically reviewed to address the role of CS in patients with shoulder pain. Electronic databases PubMed and Web of Knowledge were searched for relevant studies. Results Eighteen full‐text articles were included, methodological quality was scored, and information was extracted. Studies were clustered on those studying patients with musculoskeletal ( MSK ) shoulder pain and those studying patients with hemiplegic shoulder pain ( HSP ). In particular, quantitative sensory testing revealed hyperalgesia for pressure pain in the MSK group, whereas these results were inconsistent in patients with HSP . Conditioned pain modulation was reduced in patients with MSK shoulder pain, but functioned normally in the HSP group. Conclusion This review has shown that great progress has been made toward a better understanding of neurophysiologic pain mechanisms in patients with shoulder pain. The presence of generalized mechanical hyperalgesia, allodynia, and impaired conditioned pain modulation in patients with MSK shoulder pain indicates the involvement of the central nervous system. Widespread somatosensory abnormalities observed in patients with HSP could suggest a central origin for their shoulder pain and predispose patients with HSP to develop CS , although results are inconsistent. Additional research is required adopting different assessment methods (especially dynamic methods) to establish the role of CS in patients with shoulder pain.