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Chronic Pain: Pathophysiology and Mechanisms

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Essentials of Interventional Techniques in Managing Chronic Pain

Abstract

Understanding the mechanisms of pain is important for any clinician since chronic pain is a global problem that transcends all medical specialties. By understanding pain at a cellular level, clinicians can better apply multimodal pain therapies for their patients that address the four steps of pain signaling and processing: transduction, transmission, modulation, and perception. The purpose of this chapter is to explore each of these avenues along the pain pathway and examine some of the therapies currently being employed to treat pain at these levels. The chapter is divided into four sections, which are the four steps of the pain pathway. Within transduction, nociceptors and the process by which they detect noxious stimuli are discussed. Transmission focuses on the types of nerve fibers involved in pain signaling and the differences among them. The section on modulation investigates peripheral, spinal, and supraspinal mechanisms by which “pain” transmission is modified, including peripheral and central sensitization mechanisms. Finally, perception describes the key centers of the brain responsible for pain processing and examines the influence of context and emotions.

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Author information

Authors and Affiliations

  1. Division of Pain Medicine, Johns Hopkins Hospital, Baltimore, MD, USA

    Sandy Christiansen

  2. Department of Anesthesiology and Critical Care Medicine, Pain Management Division, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Steven P. Cohen

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  1. Sandy Christiansen
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  2. Steven P. Cohen
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Correspondence to Sandy Christiansen .

Editor information

Editors and Affiliations

  1. Pain Management Center of Paducah, Paducah, Kentucky

    Laxmaiah Manchikanti

  2. Department of Anesthesia, LSU Health Science Center, New Orleans, Louisiana, USA

    Alan D. Kaye

  3. Mid Atlantic Spine and Pain Physicians, Newark, Delaware

    Frank J.E. Falco

  4. Service Line Chief of Interventional Radiology, Director of Interventional Neuroradiology, Chief of NeuroInterventional Spine Service, Massachusetts General Hospital, Boston, Massachusetts, USA

    Joshua A. Hirsch

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Christiansen, S., Cohen, S.P. (2018). Chronic Pain: Pathophysiology and Mechanisms. In: Manchikanti, L., Kaye, A., Falco, F., Hirsch, J. (eds) Essentials of Interventional Techniques in Managing Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-60361-2_2

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  • DOI: https://doi.org/10.1007/978-3-319-60361-2_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-60359-9

  • Online ISBN: 978-3-319-60361-2

  • eBook Packages: MedicineMedicine (R0)

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