Neurophysiological underpinnings of electronic analgesic neuromodulation for dummies

Abstract

Electronic neuromodulation can be a safe and effective treatment for intractable pain. Unfortunately, many physicians and other healthcare providers know nothing of neuromodulatory techniques. There is little opportunity to learn about them in medical school or during general medical training. Nearly all of the literature about neuromodulation is aimed at specialists who already have a detailed knowledge of the field. This article reviews the pathophysiology of chronic pain from the point of view of a primary care practitioner, with the aim of providing a rationale for the appropriate use of electronic neurostimulators in patients with chronic pain. In order to understand advanced pain management, it is important to first understand that pain management is not about treating pain, but about "reducing hypersensitivity". Specifically, advanced pain management techniques are aimed at the pathophysiological processes of hyperalgesia, allodynia, neurogenic inflammation, and neural remodeling. Some approaches to electronic analgesic neuromodulation are summarized. © 2006 American Academy of Pain Medicine.