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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Related Experiment Video

Updated: Apr 26, 2026

Author Spotlight: Advancements and Challenges in Surgical Treatments for Postamputation Pain
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[Neuromodulation for neuropathic pain].

V Tronnier1

  • 1Neurochirurgische Universitätsklinik Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland, volker.tronnier@uksh.de.

Schmerz (Berlin, Germany)
|July 30, 2014
PubMed
Summary

Neurostimulation procedures are now standard in pain therapy, largely replacing lesional methods, particularly for neuropathic pain resulting from somatosensory system damage. This overview details current invasive neurostimulation techniques and their applications.

Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Pain Management

Background:

  • Neurostimulation has largely superseded lesional methods in pain therapy.
  • Neuropathic pain, caused by somatosensory system damage, is a primary indication for neurostimulation.
  • Invasive stimulation procedures are integral to modern pain management.

Purpose of the Study:

  • To provide an overview of current invasive neurostimulation procedures.
  • To outline the indications for these neurostimulation techniques.

Main Methods:

  • Review of currently employed invasive neurostimulation procedures.
  • Analysis of indications based on the site of neurological damage.

Main Results:

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  • Neurostimulation is the predominant approach for pain management.
  • Various stimulation methods are available depending on the specific pain condition and location.
  • Established indications exist for different neurostimulation techniques.

    • Conclusions:

    • Invasive neurostimulation is the current standard of care for many pain conditions, especially neuropathic pain.
    • The choice of neurostimulation procedure is tailored to the patient's specific neurological damage.
    • A comprehensive understanding of indications is crucial for effective pain therapy.