Recent advances in the neurophysiology of chronic pain

Abstract

Drug manipulation causes complex action and reaction in chronic pain. Emergency physicians must also optimize cognitive and behavioural aspects of treatment to successfully manage this systemic disease.

Chronic Female Pelvic Pain—Part 1: Clinical Pathoanatomy and Examination of the Pelvic Region

“…Chronic pain paradigms point to a dysfunction of peripheral and/or central sensory signaling, as well as central processing mechanisms 88,89 . As a consequence, the patient’s attention and focus paid to the painful symptoms appear to enhance the development of chronic pain 89,90 .…”

“…10,87 Chronic pain paradigms point to a dysfunction of peripheral and/or central sensory signaling, as well as central processing mechanisms. 88,89 As a consequence, the patient's attention and focus paid to the painful symptoms appear to enhance the development of chronic pain. 89,90 Thus, management of these painful conditions requires a biopsychosocial approach that includes thorough assessment and treatment of the structural pathology, as well as interventions to assist the emotional, psychological, motivational, and cognitive factors contributing to the ongoing pain.…”

“…88,89 As a consequence, the patient's attention and focus paid to the painful symptoms appear to enhance the development of chronic pain. 89,90 Thus, management of these painful conditions requires a biopsychosocial approach that includes thorough assessment and treatment of the structural pathology, as well as interventions to assist the emotional, psychological, motivational, and cognitive factors contributing to the ongoing pain. [91][92][93] In order to appropriately direct the management, one should begin to understand the historical features associated with each subsystem.…”

Antinociceptive effect of topiramate in models of acute pain and diabetic neuropathy in rodents

“…Tissue injury and inflammation generate bradykinin, which not only activates nociceptors but increases their sensitivity by triggering prostaglandin production (Baker 2005). The process of pain transduction, gating and modulation involves neurotransmitters (L-glutamate, N-methyl-D-aspartic acid, γ-amino butyric acid), ionic channels (calcium and sodium) and neuropeptides (calcitonin gene-related peptide, substance P) (Okuse 2006).…”

Can Heterogeneity of Chronic Sickle-Cell Disease Pain Be Explained by Genomics? A Literature Review

“…Previous authors have proposed guidance and strategies for chronic pain management designed to maintain consistent and competent care for patients with chronic pain (Baker, 2005;Jacob, 2001;Rosenblatt & Mekhail, 2005;Todd, 2005;Todd et al, 2006). Generally, healthcare providers should be adequately versed in pain management principles, which will enable them to deliver compassionate, skilled care void of biases that may compromise professional objectivity.…”