Article

Chronic pain can develop from numerous conditions and is one of the most
widespread and disabling health problems today. Unfortunately, the
pathophysiology of chronic pain in most of these conditions, along with
consistently effective treatments, remain elusive. However, recent advances in
neuroimaging and neurophysiology are rapidly expanding our understanding of these
pain syndromes. It is now clear that substantial functional and structural
changes, or plasticity, in the central nervous system (CNS) are associated with
many chronic pain syndromes. A group of cortical and subcortical brain regions,
often referred to as the "pain matrix," often show abnormalities on functional
imaging studies in persons with chronic pain, even with different pain locations
and etiologies. Changes in the motor and sensory homunculus also are seen. Some
of these CNS changes return to a normal state with resolution of the pain. It is
hoped that this knowledge will lead to more effective treatments or even new
preventative measures. The purpose of this article is to review recent advances
in the understanding of the CNS changes associated with chronic pain in a number
of clinical entities encountered in the field of physical medicine and
rehabilitation. These clinical entities include nonspecific low back pain,
fibromyalgia, complex regional pain syndrome, postamputation phantom pain, and
chronic pain after spinal cord injury.
CI - Copyright (c) 2011 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS