In addition to loss of descending analgesic activity, central sensitization may also alter pain processing among OA patients.
3 4 It is recognised that chronic pain may alter central pain processing, for example, central sensitisation, as the continuous damage of the pancreatic nerves may in time lead to central sensitisation of the pain system.
Data collected with such wide time intervals may be subject to bias with regards to differences in social and cultural attitudes to pain that may alter both pain perception and behavior.
A few studies have also noted alterations in central pain processing in osteoarthritis, and some data, including the observation of widespread pain sensitivity, suggest that central pain-processing defects may alter the pain response in rheumatoid arthritis patients.
These central mechanisms may involve spinal or supraspinal modulation of normal peripheral input, or efferent mechanisms that alter pain sensitivity at the periphery.
Early encounters with pain may alter the threshold at which pain is felt later on, making a child hypersensitive to pain — or, alternatively, dangerously indifferent to it.
These autonomic responses are clinically important as they may contribute to altered pain processing [ 4, 18], decreased tolerance to physical loads [ 19], and poor cardiovascular prognosis [ 20, 21].
Hence, the presence of pain may alter muscle recruitment.
Also, in patients with FM, continuous perception of pain may alter the brain resting state.
The disease usually has a devastating effect on a patient's life: pain may alter the eating and sleeping patterns; may induce significant movement impairment depending on lesions' location; and treatment usually implies numerous hospital appointments.
