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Mechanisms of Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
Nociceptive pain is caused by damage to body tissues. The noxious stimuli that cause tissue damage activate the nociceptors, which are the pain receptors located on the surface of the body or in the musculoskeletal tissues. A signal is then sent from the neuron via the spinal cord to the medulla of the brain, which determines the location and intensity of the stimulus.
Neuro–Endocrine–Immune Dysfunction in the Chronic Pain Patient
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Up-activation of the immune system may play an important role in maintaining chronic pain states. Multiple mechanisms exist to control the magnitude of inflammation. The endocrine and autonomic nervous systems play a role in controlling inflammation. As we have seen, the magnitude of inflammation has a direct bearing on nociception. The hypothalamic–pituitary–adrenal axis (HPA), the sympatho-adrenal axes, nociceptive neurons, and the sympatho-neural system are all contributing factors. The autonomic nervous system regulates physiological systems by integrating afferent inputs from internal and external environments with the neuronal system, endocrine system, and cell modulated responses.
Peripheral Mechanisms of Pain
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
The nociceptive system is a sensory component of the peripheral and central nervous systems that is devoted to signalling actual or potentially harmful stimuli. It controls involuntary defensive and adaptive responses to harmful or damaging stimuli and mediates the perception of pain. Nociception starts with activation of peripheral nociceptors by potentially harmful thermal, mechanical or chemical stimuli.
Pharmacological approaches to treat intestinal pain
Published in Expert Review of Clinical Pharmacology, 2023
Mikolaj Swierczynski, Adam Makaro, Agata Grochowska, Maciej Salaga
Physiologically, pain originates from specialized sensory neurons (the nociceptors) exposed to mechanical, thermal, or chemical stimuli. However, pain is also classified into many different categories and types depending on its pathophysiology. The most important ones are nociceptive, inflammatory, nociplastic, and neuropathic pain [3]. Nociceptive pain is associated with tissue injury and activation of nociceptors. Autoimmune disorders or infections cause inflammatory pain. Nociplastic pain arises from altered nociception despite the absence of actual or imminent tissue damage. Neuropathic pain is a condition affecting the somatosensory nervous system, both peripheral and central, involving neural damage, irritation, or malfunction. Notably, many types of pain can coexist making suffering even more severe.
Mechanisms of action of vitamin B1 (thiamine), B6 (pyridoxine), and B12 (cobalamin) in pain: a narrative review
Published in Nutritional Neuroscience, 2023
A. M. Paez-Hurtado, C. A. Calderon-Ospina, M. O. Nava-Mesa
Pain is a serious and widespread public health problem affecting around 10%–20% of adults worldwide [1–5]. There are three different types of pain subcategorized according to their pathophysiological mechanisms by the International Association for the Study of Pain. Nociceptive pain is a pain sensation caused by ‘an actual or threatened damage to non-neural tissue and is due to activation of nociceptors’ [6]. Pain initiated or caused by a lesion or a disease of the somatosensory system is referred to as neuropathic pain. Nociplastic pain is defined as ‘pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors or evidence for disease or lesion of the somatosensory system causing the pain’ [6]. Inflammatory pain is a type of nociceptive pain which results from hypersensibility of nociceptors by inflammatory mediators [7].
Effect of biological DMARDs and JAK inhibitors in pain of chronic inflammatory arthritis
Published in Expert Opinion on Biological Therapy, 2022
Alessandra Alciati, Marco Di Carlo, Cesare Siragusano, Antonino Palumbo, Ignazio Francesco Masala, Fabiola Atzeni
Unfortunately, evidence-based classification/diagnostic criteria for the pain subtypes are still absent, and it is unclear to what extent the mechanism-based categories of nociceptive, neuropathic, and nociplastic pain might be distinguished clinically. A recent systematic review [80] analyzed the methods used to discriminate between mechanism-based categories of pain experienced in the musculoskeletal system. The study identified 200 methods in five areas (clinical examination, quantitative sensory testing, imaging, diagnostic and laboratory testing, and pain-type questionnaires). The review revealed substantial convergence between articles. However, no single measure was able to differentiate the three main mechanism-based pain categories, but pairs of them instead (neuropathic vs nociceptive pain; nociplastic vs nociceptive pain). Additionally, several authors highlight the overlap of findings between categories in case of mixed presentations.