Neurobiology: General considerations - from acute to chronic pain

Abstract

The understanding of the molecular mechanisms behind the transmission and modulation of pain, as well as of the brain cir- cuitry involved in the processing of sensory discriminative, affec- tive, cognitive and motivational components of pain, has incre- ased dramatically during recent years. In the present article we give an outline of the pathways and brain regions involved in pain processing, the most important mediators, receptors and ion channels, as well as peripheral and central mechanisms for incre- ased pain sensitivity and chronification of pain. We also touch on the striking similarities between the way we process physical and emotional pain, and the accumulating evidence that severe phy- sical and social pain may alter brain function and that such changes may contribute to the transition from acute to chronic pain and to the comorbidity between chronic pain, depression and anxiety disorders. We also provide some practical tips to reduce pain, based on the recent neurobiological research, hand in hand with firm clinical experience. Pain