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Pain Physiology and the Neurobiology of Nociception

  • Cynthia L. RennEmail author
  • Susan G. Dorsey
  • Mari A. Griffioen
Chapter
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Abstract

Millions of Americans suffer from both acute and chronic pain conditions. While our understanding of the physiological mechanisms underlying pain has increased, pain remains a major healthcare problem in the USA that costs more than $100 million annually for management and due to lost work productivity. The magnitude of the pain problem necessitates that new treatment strategies be discovered, which requires ongoing in-depth research into pain mechanisms, discovery of new therapeutic targets, and the development of new analgesic modalities, both pharmacological and non-pharmacological. This chapter provides a brief overview of pain physiology to help understand where in the pain process new therapeutic targets might be found.

Keywords

Ascending tracts Modulation Nociception Pain physiology 

References

  1. Argoff CE, Albrecht P, Irving G, Rice F. Multimodal analgesia for chronic pain: rationale and future directions. Pain Med. 2009;10:S53–66.  https://doi.org/10.1111/j.1526-4637.2009.00669.x.CrossRefPubMedGoogle Scholar
  2. Beard DJ, Aldington D. Chronic pain after trauma. Trauma. 2011;14:57–66.CrossRefGoogle Scholar
  3. Beecher HK. Relationship of significance of wound to pain experienced. J Am Med Assoc. 1956;161:1609–13.PubMedCrossRefGoogle Scholar
  4. Beissner F, Brandau A, Henke C, Felden L, Baumgärtner U, Treede RD, Oertel BG, Lötsch J. Quick discrimination of Adelta and C fiber mediated pain based on three verbal descriptors. PLoS One. 2010;5:e12944.  https://doi.org/10.1371/journal.pone.0012944.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Boadas-Vaello P, Castany S, Homs J, Álvarez-Pérez B, Deulofeu M, Verdú E. Neuroplasticity of ascending and descending pathways after somatosensory system injury: reviewing knowledge to identify neuropathic pain therapeutic targets. Spinal Cord. 2016;54:330–40.PubMedCrossRefGoogle Scholar
  6. Carpenter D, Engberg I, Lundberg A. Differential Supraspinal control of inhibitory and excitatory actions from, the FRA to ascending spinal pathways. Acta Physiol Scand. 1965;63:103–10.PubMedCrossRefGoogle Scholar
  7. CDC. Prevalence of chronic pain and high-impact chronic pain among adults — United States, 2016. Morb Mortal Wkly Rep. 2018;67:1001–6.Google Scholar
  8. Crofford LJ. Chronic pain: where the body meets the brain. Trans Am Clin Climatol Assoc. 2015;126:167–83.PubMedPubMedCentralGoogle Scholar
  9. Curatolo M, Bogduk N. Pharmacologic pain treatment of musculoskeletal disorders: current perspectives and future prospects. Clin J Pain. 2001;17:25–32.PubMedCrossRefGoogle Scholar
  10. Dahan A, Van Velzen M, Niesters M. Comorbidities and the complexities of chronic pain. Anesthesiology. 2014;121:675–7.PubMedCrossRefGoogle Scholar
  11. Fayaz A, Croft P, Langford RM, Donaldson LJ, Jones GT. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open. 2016;6:1–12.CrossRefGoogle Scholar
  12. Feizerfan A, Sheh G. Transition from acute to chronic pain. Contin Educ Anaesth Crit Care Pain. 2015;15:98–102.CrossRefGoogle Scholar
  13. Hagbarth KE, Kerr DI. Central influences on spinal afferent conduction. J Neurophysiol. 1954;17:295–307.  https://doi.org/10.1152/jn.1954.17.3.295.CrossRefPubMedGoogle Scholar
  14. Harstall C, Ospina M. International Association for the Study of Pain. Pain Clin Update. 2003;11:1–4.CrossRefGoogle Scholar
  15. Head H, Holmes G. Sensory disturbances from cerebral lesions. Brain. 1911;34:102–254.  https://doi.org/10.1093/brain/34.2-3.102.CrossRefGoogle Scholar
  16. Heinricher MM, Tavares I, Leith JL, Lumb BM. Descending control of nociception: specificity, recruitment and plasticity. Brain Res Rev. 2009;60:214–25.PubMedCrossRefGoogle Scholar
  17. Henschke N, Kamper SJ, Maher CG. The epidemiology and economic consequences of pain. Mayo Clin Proc. 2015;90:139–47.PubMedCrossRefGoogle Scholar
  18. IASP Definition of Pain Task Force. IASP’s proposed new definition of pain released for comment. 2019.Google Scholar
  19. Institute of Medicine. Relieving pain in America : a blueprint for transforming prevention. Care Educ Res. 2011;181:397–9.  https://doi.org/10.7205/MILMED-D-16-00012.CrossRefGoogle Scholar
  20. James S. Human pain and genetics: some basics. Br J Pain. 2013;7:171–8.PubMedPubMedCentralCrossRefGoogle Scholar
  21. Julius D, Basbaum AI. Molecular mechanisms of nociception. Nature. 2001;413:203–10.PubMedCrossRefGoogle Scholar
  22. Kapur BM, Lala PK, Shaw JLV. Pharmacogenetics of chronic pain management. Clin Biochem. 2014;47:1169–87.PubMedCrossRefGoogle Scholar
  23. Keay KA, Feil K, Gordon BD, Herbert H, Bandler R. Spinal afferents to functionally distinct periaqueductal gray columns in the rat: an anterograde and retrograde tracing study. J Comp Neurol. 1997;385:207–29.  https://doi.org/10.1002/(SICI)1096-9861(19970825)385:2<207::AID-CNE3>3.0.CO;2-5.CrossRefPubMedGoogle Scholar
  24. Kroenke K. Patients presenting with somatic complaints - epidemiology. Int J Methods Psychiatr Res. 2003;12:34–43.PubMedCrossRefGoogle Scholar
  25. Kroenke K, Krebs E, Wu J, et al. Stepped care to optimize pain care effectiveness (SCOPE) trial study design and sample characteristics. Contemp Clin Trials. 2013;34:270–81.PubMedCrossRefGoogle Scholar
  26. Kwon M, Altin M, Duenas H, Lilly E, Neuroscience EL, Lilly E. The role of descending inhibitory pathways on chronic pain modulation and clinical implications. Pain Pract. 2014;14:656–67.PubMedCrossRefGoogle Scholar
  27. Mäntyselkä P, Kumpusalo E, Ahonen R, Kumpusalo A, Kauhanen J, Viinamäki H, Halonen P, Takala J. Pain as a reason to visit the doctor: a study in Finnish primary health care. Pain. 2001;89:175–80.PubMedCrossRefGoogle Scholar
  28. Mayer DJ, Wolfle TL, Akil H, Carder B, Liebeskind JC. Analgesia from electrical stimulation in the brainstem of the rat. Science. 1971;174:1351–4.PubMedCrossRefGoogle Scholar
  29. McCaffery M, Beebe A. Pain: clinical manual for nursing practice. St. Louis: Mosby; 1989.Google Scholar
  30. Merskey H, Bogduk N. Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the international association for the study of pain, subcommittee on taxonomy. Pain Suppl. 1986;3:S1–226.Google Scholar
  31. Merskey H, Bond MR, Bonica JJ, et al. Classification of chronic pain. Pain. 1986;24:S1–S226.CrossRefGoogle Scholar
  32. Merskey H, Addison RG, Beric A, et al. Classification of chronic pain: Descriptions of chronic pain syndromes and definitions of pain terms. Second. Classif Chronic Pain. 1994.  https://doi.org/10.1002/ana.20394.
  33. Mifflin KA, Kerr BJ. The transition from acute to chronic pain: understanding how different biological systems interact. Can J Anesth. 2014;61:112–22.PubMedCrossRefGoogle Scholar
  34. Millan MJ. The induction of pain: an integrative review. Prog Neurobiol. 1999;57:1–164.PubMedCrossRefGoogle Scholar
  35. Millan MJ. Descending control of pain. Prog Neurobiol. 2002;66:355–474.PubMedCrossRefGoogle Scholar
  36. Nelson R. Decade of pain control and research gets into gear in USA. Lancet. 2003;362:1129.  https://doi.org/10.1016/s0140-6736(03)14505-9.CrossRefPubMedGoogle Scholar
  37. Oliveras JL, Besson J-MM, Guilbaud G, Liebeskind JC. Behavioral and electrophysiological evidence of pain inhibition from midbrain stimulation in the cat. Exp Brain Res. 1974;20:32–44.PubMedCrossRefGoogle Scholar
  38. Ossipov MH, Morimura K, Porreca F. Descending pain modulation and chronification of pain. Curr Opin Support Palliat Care. 2014;8:143–51.PubMedPubMedCentralGoogle Scholar
  39. Perini I, Bergstrand S, Morrison I. Where pain meets action in the human brain. J Neurosci. 2013;33:15930–9.  https://doi.org/10.1523/JNEUROSCI.3135-12.2013.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Ren K, Dubner R. Descending modulation in persistent pain: an update. Pain. 2002;100:1–6.PubMedCrossRefGoogle Scholar
  41. Rexed B. The cytoarchitectonic organization of the spinal cord in the cat. J Comp Neurol. 1952;96:415–95.CrossRefGoogle Scholar
  42. Reynolds DV. Surgery in the rat during electrical analgesia induced by focal brain stimulation. Science. 1969;164:444–5.PubMedCrossRefGoogle Scholar
  43. Scholz J, Woolf CJ. Can we conquer pain? Nat Neurosci. 2002;5(Suppl):1062–7.PubMedCrossRefGoogle Scholar
  44. Sherman SM, Guillery RW. Functional organization of thalamocortical relays. J Neurophysiol. 1996;76:1367–95.  https://doi.org/10.1152/jn.1996.76.3.1367.CrossRefPubMedGoogle Scholar
  45. Sneddon LU. Comparative physiology of nociception and pain. Physiology. 2018;33:63–73.PubMedCrossRefGoogle Scholar
  46. Steeds CE. The anatomy and physiology of pain. Surgery. 2016;34:55–9.Google Scholar
  47. Tracey I, Bushnell MC. How neuroimaging studies have challenged us to rethink: is chronic pain a disease? J Pain. 2009;10:1113–20.  https://doi.org/10.1016/j.jpain.2009.09.001.CrossRefPubMedGoogle Scholar
  48. van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology and its clinical relevance. Br J Anaesth. 2013;111:13–8.PubMedCrossRefGoogle Scholar
  49. Van Hecke O, Austin SK, Khan RA, Smith BH, Torrance N. Neuropathic pain in the general population: a systematic review of epidemiological studies. Pain. 2014;155:654–62.PubMedCrossRefGoogle Scholar
  50. Vanegas H, Schaible HG. Descending control of persistent pain: inhibitory or facilitatory? Brain Res Rev. 2004;46:295–309.PubMedCrossRefGoogle Scholar
  51. von Korff M, Kolodny A, Deyo RA, Chou R. Long-term opioid therapy reconsidered. Ann Intern Med. 2011;155:325.  https://doi.org/10.7326/0003-4819-155-5-201109060-00011.CrossRefGoogle Scholar
  52. Von Korff M, Scher AI, Helmick C, et al. United States national pain strategy for population research: concepts, definitions, and pilot data. J Pain. 2016;17:1068–80.CrossRefGoogle Scholar
  53. Voscopoulos C, Lema M. When does acute pain become chronic? Br J Anaesth. 2010;105:i69–85.PubMedCrossRefGoogle Scholar
  54. Wall PD. The laminar organization of dorsal horn and effects of descending impulses. J Physiol. 1967;188:403–23.PubMedPubMedCentralCrossRefGoogle Scholar
  55. Wiberg M, Westman J, Blomqvist A. Somatosensory projection to the mesencephalon: an anatomical study in the monkey. J Comp Neurol. 1987;264:92–117.  https://doi.org/10.1002/cne.902640108.CrossRefPubMedGoogle Scholar
  56. Williams ACDC, Craig KD. Updating the definition of pain. Pain. 2016;157:2420–3.PubMedCrossRefGoogle Scholar
  57. Woolf CJ, Ma Q. Nociceptors - noxious stimulus detectors. Neuron. 2007;55:353–64.PubMedCrossRefGoogle Scholar
  58. Zhuo M. Descending facilitation: from basic science to the treatment of chronic pain. Mol Pain. 2017;13:1744806917699212.  https://doi.org/10.1177/1744806917699212.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Cynthia L. Renn
    • 1
    Email author
  • Susan G. Dorsey
    • 1
  • Mari A. Griffioen
    • 2
  1. 1.Department of Pain and Translational Symptom ScienceUniversity of Maryland School of NursingBaltimoreUSA
  2. 2.University of Delaware School of NursingNewarkUSA

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