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Central Sensitization I
T
his JOSPT Pain Science in Practice article dives into one of consequently, to more activity in WDR
the most important discoveries in contemporary pain-related neurons and/or nociceptive-specific neu-
science: central sensitization. It discusses the different categories rons, which in turn also become sensi-
tized. As the inflammation resolves, the
of synaptic plasticity in the dorsal horn of the spinal cord—
nociceptive stimuli are reduced, WDR/
frequently referred to under the umbrella term central sensitization. nociceptive-specific neurons gradually
This editorial examines the role of glia cells and discusses the clinical return to their “resting state,” and pain
implications of central sensitization. Share your thoughts and and/or hyperalgesia diminishes.4
Copyright © 2023 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
1
Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark. ORCID: Hoegh, 0000-0002-9724-767X. No funding was received in
relation to this editorial. Dr Hoegh has received support from nonindustrial, professional, private, and scientific bodies (reimbursement of travel costs and speaker fees) for lectures
on pain, and he receives book royalties from Gyldendal, Munksgaard Denmark, FADL, GAD, and Muusmann publications. Address correspondence to Dr Morten Hoegh, Department
of Health Science and Technology, Faculty of Medicine, Aalborg University, Fredrik Bajers Vej 7D2, 9220 Aalborg, Denmark. E-mail: msh@hst.aau.dk t Copyright ©2023 JOSPT®, Inc
journal of orthopaedic & sports physical therapy | volume 53 | number 1 | january 2023 | 1
[ editorial ]
to think about the pain experienced after
an acute injury to the skin (FIGURE 3). The
area with damaged skin becomes sensitive
to light touch (allodynia), heat (heat hy-
peralgesia), and pinprick (primary hyper-
algesia). This is likely the consequences of
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2 | january 2023 | volume 53 | number 1 | journal of orthopaedic & sports physical therapy
Downloaded from www.jospt.org at Faculdade Motricidade Humana on January 2, 2023. For personal use only. No other uses without permission.
Copyright © 2023 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
Fact Box: Glia Cells or balances the signal-to-noise ratio from is far more complex and still not well
Journal of Orthopaedic & Sports Physical Therapy®
journal of orthopaedic & sports physical therapy | volume 53 | number 1 | january 2023 | 3
[ editorial ]
STUDY DETAILS Sandkühler J, Gruber-Schoffnegger D. does not make things we can measure impor-
AUTHOR CONTRIBUTIONS: Dr Hoegh was Hyperalgesia by synaptic long-term po- tant. Pain. 2022;163:e963-e963. https://doi.
responsible for the concept, drafting, tentiation (LTP): an update. Curr Opin org/10.1097/j.pain.0000000000002662
7. Ji R-R, Kohno T, Moore KA, Woolf CJ. Central
and revisions of the manuscript and is a Pharmacol. 2012;12(1):18-27. https://
sensitization and LTP: do pain and memory
guarantor. doi.org/10.1016/j.coph.2011.10.018 share similar mechanisms? Trends Neurosci.
DATA SHARING: There are no data in this 2003;26:696-705. https://doi.org/10.1016/j.
Downloaded from www.jospt.org at Faculdade Motricidade Humana on January 2, 2023. For personal use only. No other uses without permission.
manuscript. tins.2003.09.017
PATIENT AND PUBLIC INVOLVEMENT: No pa- REFERENCES 8. Kavelaars A, Heijnen CJ. Immune regula-
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ACKNOWLEDGMENTS: I would like to acknowl- doi.org/10.1146/annurev.neuro.051508.135531
clinical criteria and grading system. Pain.
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ADDITIONAL READING Heterosynaptic long-term potentiation at
M, Honsek SD, Teuchmann HL, Sandkühler J.
Gliogenic LTP spreads widely in nociceptive path-
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org/10.1523/JNEUROSCI.3076-11.2011 11. Malcangio M. Microglia and chronic pain. Pain.
Ji R-R. Microglia in pain: detrimen-
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