The Normal Response to Pain

Abstract

The “normal” response to pain, from nociceptor activation to the ensuing adaptive behavioral response, is a multidimensional, often nonlinear experience that has evolved to improve an individual’s likelihood for survival through an intricate system designed for protection, preservation and restoration, and prevention of future harm. This is made possible by a system of modulation by peripheral, spinal, brainstem, and cortical processes that undergo predictable and functional changes over time to reduce the potential for long-term harm from an injury or illness. The complex central nervous system processing of pain, as well as the presence and extent of ongoing peripheral input, determines an individualized response pattern during recovery and plays a prominent role in the persistence of pain and resulting physical or psychological impairments. Improving outcomes related to persistent pain will require continued investments in better understanding of the individual-, social-, cultural-, and provider-related factors that lead to chronic impairment and suffering due to persistent pain.