Recent advances in elucidating pain mechanisms

  title={Recent advances in elucidating pain mechanisms},
  author={Nalini Vadivelu and Raymond S. Sinatra},
  journal={Current Opinion in Anaesthesiology},
Purpose of review The purpose of this review is to highlight the important recent advances in this fast developing field of pain mechanisms. It is now recognized that acute tissue and neural injuries can result in nociceptor sensitization (primary hyperalgesia) and spinal cord hyperexcitability or central sensitization that results in secondary hyperalgesia and allodynia. Recent findings New findings regarding peripheral and central sensitization are presented in this review. Newer ideas on… 

Somatosympathetic reflex and acupuncture-related analgesia.

The relations between SSR and acupuncture-related analgesia are reviewed so that a targeted pain therapy where in certain areas of the body undergo site-specific somatic stimulation, which in turn, can adjust the impaired regional blood circulation is developed.

Sensitization, glutamate, and the link between migraine and fibromyalgia

These findings have implications for future therapies directed against glutamate receptors (in particular, N-methyl-D-aspartate receptors) and limited clinical experience in this regard does not exclude additional mechanisms contributing to the maintenance of pain.

Back to Basics Calcineurin as a Nociceptor Modulator

It appears that calcineurin functions may encompass actions which promote or dampen nociceptive processes, and C alcineur in may play a significant role in the modulation of nocICEption.

Calcineurin as a nociceptor modulator.

It appears that calcineurin functions may encompass actions which promote or dampen nociceptive processes, which may lead to the development of novel analgesic targets in attempts to optimally alleviate patient discomfort.

Effects of motor cortex modulation and descending inhibitory systems on pain thresholds in healthy subjects.

Role of serum interleukin-6 level on hyperalgesia and spinal mu-opioid receptor expression during the complete Freund's adjuvant-induced chronic inflammation

Results can indicate the importance of a time-dependent relationship between the serum IL-6 level and hyperalgesia during the AA and suggest that the stages of inflammation in AA must be considered for anti-hyperalgesic and antiinflammatory interventions via anti-IL-6 antibody treatment.

Increased serum IL-6 level time-dependently regulates hyperalgesia and spinal mu opioid receptor expression during CFA-induced arthritis

The study confirmed the important time-dependent relationship between serum IL-6 levels and hyperalgesia during AA and suggested that the stages of inflammation in AA must be considered for anti-hyperalgesic and anti-inflammatory interventions via anti-IL-6 antibody treatment.

Cerebral Activation during Von Frey Filament Stimulation in Subjects with Endothelin-1-Induced Mechanical Hyperalgesia: A Functional MRI Study

The findings suggest that injection of ET-1 leads to a state of punctate hyperalgesia, which in turn causes the activation of multiple brain regions, which indicates thatET-1 activates an extended neuronal pathway.


This systematic review highlights the different types of Chronic pain, epidemiology, pathophysiology, and management of chronic pain along with psychological issues associated with it.



Underlying mechanisms of pronociceptive consequences of prolonged morphine exposure

These studies show that opioids elicit systems‐level adaptations resulting in pain due to descending facilitation, upregulation of spinal dynorphin, and enhanced, evoked release of excitatory transmitters from primary afferents, which indicate the need for the evaluation of the clinical consequences of long‐term opioid administration.

Chronic Neuropathic Pain: Mechanisms, Diagnosis, and Treatment

The rapidly evolving symptom- and mechanism-based approach to the treatment of neuropathic pain holds promise for improving the quality of life of patients with neuropathicPain.

[Pathophysiology of radicular pain].

It is found that application of the nucleus pulposus to the nerve roots produces time-dependent reversible hyperalgesia in the affected hindpaw of the rat, and that the hyperalGESia is related to bioactive substances in the arachidonic acid cascade.

Interleukin-1β-mediated induction of Cox-2 in the CNS contributes to inflammatory pain hypersensitivity

Prostaglandin E2 levels in the cerebrospinal fluid are Elevated by finding a widespread induction of Cox-2 expression in spinal cord neurons and in other regions of the CNS, and preventing central prostanoid production by inhibiting the interleukin-1β-mediated induction ofcox-2 in neurons reduces centrally generated inflammatory pain hypersensitivity.

Opioid analgesia in the newborn

Opioids in neuropathic pain: clues from animal studies

Transcriptional and Translational Regulation of Glial Activation by Morphine in a Rodent Model of Neuropathic Pain

It is shown for the first time that there is differential recruitment of transcriptional and translational mechanisms of glial activation by systemic and i.t.c. morphine in an L5 spinal nerve transection rodent model of neuropathic pain and suggested that enhanced neuroimmune activation after i.T. dosing contributes to the hastened development of analgesic tolerance seen in these animals.

Complex regional pain syndrome

  • F. Birklein
  • Medicine, Psychology
    Journal of Neurology
  • 2005
Major mechanism for CRPS symptoms, which might be present subsequently or in parallel during the course of CRPS, are trauma-related cytokine release, exaggerated neurogenic inflammation, sympathetically maintained pain and cortical reorganisation in response to chronic pain (neuroplasticity).

Kappa opioid receptor is expressed in the rat cerebellar cortex

This work has detected, for the first time, expression of the kappa opioid receptor (KOR) gene in the cerebellar cortex of the rat, which may lead to a better understanding of the relationships between nociceptive activity and drug abuse potential.