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Peripheral and Central Mechanisms of Pain Generation

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Book cover Analgesia

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 177))

Abstract

Pain research has uncovered important neuronal mechanisms that underlie clinically relevant pain states such as inflammatory and neuropathic pain. Importantly, both the peripheral and the central nociceptive system contribute significantly to the generation of pain upon inflammation and nerve injury. Peripheral nociceptors are sensitized during inflammation, and peripheral nerve fibres develop ectopic discharges upon nerve injury or disease. As a consequence a complex neuronal response is evoked in the spinal cord where neurons become hyperexcitable, and a new balance is set between excitation and inhibition. The spinal processes are significantly influenced by brain stem circuits that inhibit or facilitate spinal nociceptive processing. Numerous mechanisms are involved in peripheral and central nociceptive processes including rapid functional changes of signalling and long-term regulatory changes such as up-regulation of mediator/receptor systems. Conscious pain is generated by thalamocortical networks that produce both sensory discriminative and affective components of the pain response.

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  1. Institut für Physiologie/Neurophysiologie, Teichgraben 8, 07740, Jena, Germany

    H. -G. Schaible

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  1. Department of Anesthesiology and Critical Care Medicine Charité — Campus Benjamin Franklin, Free University Berlin, Hindenburgdamm 30, 12200, Berlin, Germany

    Christoph Stein

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Schaible, H.G. (2006). Peripheral and Central Mechanisms of Pain Generation. In: Stein, C. (eds) Analgesia. Handbook of Experimental Pharmacology, vol 177. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33823-9_1

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