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Chronic Pain

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Geriatric Medicine

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Abstract

Pain receptors are free nerve endings. The skin pain fibers are mechanoreceptors, while the deeper pain receptors are polymodal and respond equally well to intense mechanical, thermal, and chemical stimuli. They basically may function as chemoreceptors and respond to agents that are released from damaged tissue, such as bradykinin, histamine, serotonin, and prostaglandin E1 (PGE1). These free nerve endings, or nocioceptors, are the dendrites of neurons whose cell bodies are in the dorsal root ganglia. They are the slow-conducting, unmyelinated C fibers in the peripheral nerve. Their axons enter the gray matter of the dorsal horns and synapse. These first-order pain neurons use “substance P” as a neurotransmitter. Then, there is a series of interneurons whose axons eventually leave the gray matter and project into the contralateral spinothalamic and spinoreticular pathways (see Figure 18-1). These two pathways serve different functions and form the basis of the two different kinds of pain.

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Authors
  1. Patricia A. Newton M.D.
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Editors and Affiliations

  1. Department of Geriatrics, Mt. Sinai Medical Center, 1 Gustave Levy Place, New York, New York, 10029, USA

    Christine K. Cassel M.D.

  2. Section of Geriatric Medicine, Veterans Administration Medical Center, Portland, Oregon, 97201, USA

    John Richard Walsh M.D.

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© 1984 Springer-Verlag New York, Inc.

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Newton, P.A. (1984). Chronic Pain. In: Cassel, C.K., Walsh, J.R. (eds) Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-5232-0_18

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  • DOI: https://doi.org/10.1007/978-1-4612-5232-0_18

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