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Muscle pain: mechanisms and clinical significance

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Tags: chronic pain, muscle pain, fibromyalgia, pain problems, muscle

Two articles on PainSci cite Mense 2008: (1) The Complete Guide to Trigger Points & Myofascial Pain(2) Sensitization in Chronic Pain

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

INTRODUCTION: Muscle pain is common, but the understanding of its causes is still patchy. This article addresses the mechanisms of some important types of muscle pain.

METHODS: Selective literature review, predominantly of data derived from neuroanatomical and electrophysiological experiments on anesthetized rats.

RESULTS: Muscle pain is evoked by specialized nerve endings (nociceptors). Important stimuli for muscle pain are adenosintriphosphate (ATP) and a low tissue pH. Excitation of muscle nociceptors leads to hyperexcitability of spinal sensory neurones (central sensitization). Low frequency activity in muscle nociceptors is sufficient to induce central sensitization.

DISCUSSION: Central sensitization leads to increased excitation in the spinal cord and to referral of muscle pain. The motoneurones of a painful muscle are centrally inhibited. Muscular spasm is mostly secondary to a painful lesion in another muscle or joint. The pain of fibromyalgia is assumed to relate to a dysfunction of central nociceptive processing. Psychosocial factors also contribute to pain.

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