Pathophysiology of pain modulation

  • C. J. Glynn
Part of the Topics in Anaesthesia and Critical Care book series (TIACC)


The pathophysiology of pain modulation by definition relates to pain in humans, as pain in animals is defined as nociception. This presentation will only provide information and data about pain in humans and will not confuse the issue with nociception (see below for the official definitions). Modulation of pain suggests that the pain is changed for the better, that is to relieve the pain, but it also infers that it is symptomatic management (treatment) of the pain, not treatment of the cause of the pain. The presentation will concentrate on what is often called clinical pain. In humans our understanding of the pathophysiology of pain is based on the modulation of that pain. As a result the pathophysiological mechanisms underlying the pain are inferred from the treatment [1, 2]. This is a circular argument; as a result of successful treatment of a particular pain we infer that the underlying pathophysiological mechanisms of that pain are directly related to this successful treatment. This assumption may not be true for all situations and this observation is fundamental in defining the limits of our understanding of the pathophysiological mechanisms of pain modulation. The evidence for effective treatment (modulation) of pain will be presented and the pathophysiology will be inferred from this modulation.


Neuropathic Pain NMDA Antagonist Transcutaneous Electrical Nerve Stimulation Pain Modulation Emotional Component 
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© Springer Verlag Italia, Milano 1999

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  • C. J. Glynn

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