La sensibilizzazione del sistema nervo so centrale e periferico può avere un ruolo importante nel dolore cronico alla spalla.
In parole semplici il dolore avvertito alla spalla può derivare da una aumenteta sensibilità del sistema nervoso più che da danni o lesioni ai tessuti.
Braz J Phys Ther. 2015 Aug 7:0. [Epub ahead of print]
The role of sensitization in musculoskeletal shoulder pain.
Borstad J1, Woeste C1.
Author information
1School of Health and Rehabilitation Sciences, Ohio State University, Columbus, Ohio, USA.
Abstract
INTRODUCTION:
Peripheral and central sensitization are neurophysiological processes that can prolong painful conditions. Painful shoulder conditions are often persistent, perhaps due to the presence of sensitization.
METHOD:
This manuscript summarizes six studies that have evaluated those with musculoskeletal shoulder pain for the presence of sensitization.
RESULTS:
All six manuscripts report evidence of peripheral sensitization, while central sensitization was described in five of the studies. The chronicity of symptoms in subjects who were included in the studies is probably influencing this finding. The primary somatosensory test used to assess sensitization in these studies was Pressure Pain Threshold, a test for lowered nociceptive thresholds.
DISCUSSION:
It appears that peripheral sensitization manifests consistently in those with musculoskeletal shoulder pathology, probably due to the inflammatory processes related to tissue injury. Central sensitization, while not universally present, was reported in a majority of the manuscripts. Because central sensitization is thought to be a key step on the pathway to chronic pain, evidence for its presence in those with shoulder pain is significant. Clinicians should expect the presence of sensitization with shoulder pathology and make appropriate choices about interventions so as not to exacerbate pain.