What Do We Know About the Pathophysiology of Chronic Pain? Implications for Treatment Considerations

Med Clin North Am. 2016 Jan;100(1):31-42. doi: 10.1016/j.mcna.2015.08.004. Epub 2015 Oct 27.

Abstract

We discuss the complex features of the pathophysiology of chronic pain and the implications for treatment and provide an overview of nociceptive processes, neuropathic pain, cold hyperalgesia, peripheral nerve injury, wind-up pain, central sensitization, and common clinical presentation and diagnostic criteria. Advanced medicine has proven that chronic pain need not involve any structural pathology as pain is a complex biopsychosocial experience. Treatment of the specific mechanisms responsible for pain should be aimed at preventing and or reducing dysfunctional neuro-plasticity resulting from poorly controlled chronic pain. Further study is needed to reduce the probability and of persistent changes that cause chronic pain.

Keywords: Central sensitization; Cold hyperalgesia; Neuropathic pain; Nociceptive processes; Pain pathophysiology; Peripheral nerve injury; Wind-up pain.

Publication types

  • Review

MeSH terms

  • Analgesia / methods*
  • Analgesics / therapeutic use
  • Chronic Pain / physiopathology*
  • Chronic Pain / therapy*
  • Humans
  • Neuralgia / physiopathology
  • Neuralgia / therapy
  • Pain Management / methods
  • Pain Threshold
  • Peripheral Nervous System Diseases / physiopathology
  • Peripheral Nervous System Diseases / therapy

Substances

  • Analgesics