The biochemical origin of pain – Proposing a new law of pain: The origin of all pain is inflammation and the inflammatory response. Part 1 of 3 – A unifying law of pain

Abstract

We are proposing a unifying theory or law of pain, which states: The origin of all pain is inflammation and the inflammatory response. The biochemical mediators of inflammation include cytokines, neuropeptides, growth factors and neurotransmitters. Irrespective of the type of pain whether it is acute or chronic pain, peripheral or central pain, nociceptive or neuropathic pain, the underlying origin is inflammation and the inflammatory response. Activation of pain receptors, transmission and modulation of pain signals, neuro plasticity and central sensitization are all one continuum of inflammation and the inflammatory response. Irrespective of the characteristic of the pain, whether it is sharp, dull, aching, burning, stabbing, numbing or tingling, all pain arise from inflammation and the inflammatory response. We are proposing a re-classification and treatment of pain syndromes based upon their inflammatory profile. Treatment of pain syndromes should be based on these principles:1. Determination of the inflammatory profile of the pain syndrome 2. Inhibition or suppression of production of the appropriate inflammatory mediators e.g. with inflammatory mediator blockers or surgical intervention where appropriate 3. Inhibition or suppression of neuronal afferent and efferent (motor) transmission e.g. with anti-seizure drugs or local anesthetic blocks Modulation of neuronal transmission e.g. with opioid medicationAt the L.A. Pain Clinic, we have successfully treated a variety of pain syndromes by utilizing these principles. This theory of the biochemical origin of pain is compatible with, inclusive of, and unifies existing theories and knowledge of the mechanism of pain including the gate control theory, and theories of pre-emptive analgesia, windup and central sensitization.

Alternative Cellular Energy as a Unifying Concept in Complementary Alternative Medicine

“…Tumor regressions described by clinicians in response to homeopathy, acupuncture and other CAM modalities are also stated to be essentially painless (personal communications), suggesting a lack of major involvement of the immune system triggered inflammation. This contrasts with chemotherapy in which tumor necrosis occurs and, unlike apoptosis, does evoke painful inflammation and cytokine release [27]. Similarly, recent successes using adoptive immunotherapy of cancers are not-uncommonly accompanied by cytokine storms and other symptoms [28].…”

Altered release of chemokines by phagocytes from fibromyalgia patients: a pilot study

“…According to Janeway and Medzhitov, 22 innate immunity is behind most of the inflammatory responses, all of which are activated in the first instance by monocytes/ macrophages, polymorphonuclear leukocytes and mastocytes by means of its innate immunity receptors. Furthermore, according to Omoigui,12,13 who hypothesized that the origin of all pain is the inflammation and the inflammatory response, it makes sense to think that pain that characterizes FM is provoked, at least in part, by the inflammatory component present in this syndrome, which has already been established by different studies. 5,[15][16][17][18][19]23,24 According to Janeway and Medzhitov, 22 who determined that any inflammatory process has behind it an activation of the innate immunity, in FM a functional activation of the neutrophil phagocytic process is taking place, showing these cells have a higher chemotactic capacity, a higher phagocytic capacity than Candida albicans and a higher microbicide capacity, 18,19,24 along with a higher level of oxidative stress.…”

Seasonal Allergy Induced Back Pain: A Report of Two Cases

“…Substance P not only amplifies nerve pain signals [16] but also induces histamine release from mast cells [14], muscles and joints [17]. In addition it increases the production of TNF-α, which in association with substance P activates immune monocytes and macrophages [12].…”

“…After tissue injury occurs, TNF-α, which is the primary inflammatory mediator in nerve injury, is also released by macrophages and nerve cells. This TNF-α release increases inflammation and prostaglandin formation which in turn increases the release of the neurotransmitter glutamate, enhancing nerve communication and pain [12].…”