rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2014-438-444rsp-1967Research ArticleОБЗОРREVIEWСовременные представления о патогенетических механизмах боли при остеоартрозеCURRENT IDEAS ABOUT THE PATHOGENETIC MECHANISMS OF PAIN IN OSTEOARTHROSISТуровскаяЕ. Ф.TurovskayaE. F.katetur@yandex.ruАлексееваЛ. И.AlekseevaL. I.ФилатоваЕ. Г.FilatovaE. G.ФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, МоскваРоссияV.A. Nasonova Research Institute of Rheumatology, Moscow I.M. Sechenov First Moscow State Medical University, MoscowRussian FederationФГБНУ Научно-исследовательский институт ревматологии им. В.А. Насоновой, Москва ГБОУ ВПО «Первый Московский медицинский университет им. И.М. Сеченова», МоскваРоссияV.A. Nasonova Research Institute of Rheumatology, MoscowRussian FederationГБОУ ВПО «Первый Московский медицинский университет им. И.М. Сеченова», МоскваРоссияI.M. Sechenov First Moscow State Medical University, MoscowRussian Federation201402092014524438444Copyright © Туровская Е.Ф., Алексеева Л.И., Филатова Е.Г., 20142014Туровская Е.Ф., Алексеева Л.И., Филатова Е.Г.Turovskaya E.F., Alekseeva L.I., Filatova E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1967

В обзоре литературы отражены современные представления о механизмах хронической боли. Детально рассмотрены экспериментальные и клинические исследования, посвященные механизмам хронической боли при остеоартрозе (ОА), в которых показано, что наряду с ноцицептивными механизмами, обусловленными хроническим воспалением и дегенеративными изменениями в области сустава, важную роль в хронизации болевого синдрома может играть и дисфункция самих болевых систем (так называемая дисфункциональная боль). Выделение дисфункциональных механизмов хронической боли при ОА позволяет понять имеющиеся диссоциации между интенсивностью боли и степенью структурных изменений в суставе. Также в статье осуществляются попытки выявить коморбидные заболевания, которые могут дополнительно участвовать в развитии боли. Намечаются эффективные пути лечения ОА.

The literature review presents the current idea about the mechanisms of chronic pain. Experimental and clinical studies of the mechanism of chronic pain in osteoarthrosis (OA), which show that dysfunction of pain systems themselves (the so-called dysfunctional pain) along with the nociceptive mechanisms caused by chronic inflammation and degenerative changes in the joint area plays an important role in the chronization of pain syndrome, are considered in detail. Identification of the dysfunctional mechanisms of chronic pain in OA allows an understanding of the dissociations existing between the intensity of pain and the degree of structural changes in the joint. The paper also attempts to detect comorbidities that may be additionally involved in the development of pain. Effective ways to treat OA are outlined.

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The authors declare that there are no conflicts of interest present.