El papel de la sensibilización central en el dolor de hombro / The role of central sensitization in shoulder pain: A systematic literature review.

#dolor #hombro #pain #shoulder #central sensitization #sensibilización central

Fuente
Este artículo es originalmente publicado en:
http://www.ncbi.nlm.nih.gov/pubmed/25523242
http://www.semarthritisrheumatism.com/article/S0049-0172(14)00276-5/abstract
http://www.anatomia-fisioterapia.es/22-systems/musculoskeletal/upper-extremity/shoulder/1193-el-papel-de-la-sensibilizacion-central-en-el-dolor-de-hombro
De:
N Sanchis M1, Lluch E2, Nijs J3, Struyf F4, Kangasperko M1.
Semin Arthritis Rheum. 2015 Jun;44(6):710-716. doi: 10.1016/j.semarthrit.2014.11.002. Epub 2014 Nov 13.
Todos los derechos reservados para:
Copyright © 2015 Elsevier Inc. All rights reserved.


Abstract

INTRODUCTION:

Hyperexcitability of the central nervous system has been suggested to play an important role in pain experienced by patients with unilateral shoulder pain. A systematic literature review following the PRISMA guidelines was performed to evaluate the existing evidence related to the presence of central sensitization in patients with unilateral shoulder pain of different etiologies including those with chronic subacromial impingement syndrome. Studies addressing neuropathic pain (e.g., post-stroke shoulder pain) were not considered.
 
METHODS:
Electronic databases PubMed, EBSCO, and Web of Science were searched to identify relevant articles using predefined keywords regarding central sensitization and shoulder pain. Articles were included till September 2013. Full-text clinical reports addressing studies of central sensitization in human adults with unilateral shoulder complaints including those diagnosed with subacromial impingement syndrome were included and screened for methodological quality by two independent reviewers.
 

RESULTS:
A total of 10 articles were retrieved for quality assessment and data extraction. All studies were cross-sectional (case-control) or longitudinal in nature. Different subjective and objective parameters, considered manifestations of central sensitization, were established in subjects with unilateral shoulder pain of different etiologies, including those receiving a diagnosis of subacromial impingement syndrome. Overall results suggest that, although peripheral mechanisms are involved, hypersensitivity of the central nervous system plays a role in a subgroup within the shoulder pain population.
 

CONCLUSIONS:
Although the majority of the literature reviewed provides emerging evidence for the presence of central sensitization in unilateral shoulder pain (including those diagnosed with subacromial impingement syndrome), our understanding of the role central sensitization plays in the shoulder pain population is still in its infancy. Future studies with high methodical quality are therefore required to investigate this further.

Copyright © 2015 Elsevier Inc. All rights reserved.

KEYWORDS:

Central nervous system sensitization; Shoulder pain; Subacromial impingement syndrome; Systematic review
PMID: 25523242 [PubMed – as supplied by publisher]


El papel de la sensibilización central en el dolor de hombro

La presencia de una sensibilización central (SC) se ha establecido como un factor contribuyente en varias afecciones osteomusculares como el latigazo cervical, dolor lumbar crónico y osteoartritis. Recientemente, la posible presencia de SC se ha vuelto a tener en cuenta con mayor frecuencia en pacientes que presentan dolor de hombro unilateral.

Después de una amplia selección y de un proceso de evaluación exhaustivo hecho a partir de la literatura más reciente conocida al respecto, se hizo un estudio en el que se incluyeron 10 artículos que pretendían determinar el papel de la SC en el dolor de hombro unilateral.

De hecho, la mayoría de dichos estudios (8/10) señala alguna forma de sensibilización central. Sin embargo, no existe ninguna regla de oro para el diagnóstico de la SC, se utilizan diversos métodos de evaluación para establecer la presencia, en función de los diferentes cambios que pueden darse como resultado de una SC (dolor referido, hiperalgesia e hipersensibilidad a la presión generalizada). Se necesitan más estudios que determinen la influencia de los factores psicológicos y sociales en el proceso sensorial en el dolor de hombro.
> De: Sanchis et al., Semin Arthr Rheum (2015) . Todos los derechos reservados: Elsevier, Inc. Pincha aquí para acceder al resumen de Pubmed.. Traducido por Carmen Velasco.

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