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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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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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Pain01:20

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Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Related Experiment Video

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Chronic Post-Ischemia Pain Model for Complex Regional Pain Syndrome Type-I in Rats
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[Functional pain syndromes - beyond nociception].

Noëmi Zurrón1, Niklaus Egloff2

  • 1CEMIC et Centre d'antalgie, CHUV, 1011 Lausanne.

Revue Medicale Suisse
|June 23, 2021
PubMed
Summary

Functional pain disorders are common in primary care. Neuroscience advances explain these syndromes via dysfunction in perception, autonomic, emotional, and cognitive processes, guiding diagnosis and management.

Area of Science:

  • Neuroscience
  • Primary Care Medicine
  • Psychosomatic Medicine

Background:

  • Functional pain disorders are prevalent, posing a significant challenge in primary care settings.
  • Neuroscience research provides insights into the complex interplay of perceptual, vegetative, affective, and cognitive dysfunctions underlying these conditions.
  • Effective management strategies are crucial for addressing the burden of functional pain.

Purpose of the Study:

  • To highlight the importance of understanding functional pain disorders through a neuroscience lens.
  • To emphasize the utility of simple clinical tools for identifying positive signs of functional pain.
  • To outline key principles for primary care management based on expert recommendations.

Main Methods:

  • Review of scientific advances in neuroscience relevant to functional pain.

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  • Discussion of simple diagnostic tools for clinical examination.
  • Synthesis of expert recommendations for primary care management.

    • Main Results:

    • Neuroscience offers a framework for understanding functional pain disorders as multifaceted syndromes.
    • Specific clinical signs can aid in the diagnosis of functional pain disorders during patient history and examination.
    • Primary care management should prioritize trust-building, salutogenesis, and therapeutic deceleration.

    Conclusions:

    • Functional pain disorders require a comprehensive understanding integrating neuroscience perspectives.
    • Simple clinical assessments are valuable for identifying functional pain.
    • Effective primary care management involves fostering a strong patient-provider relationship and adopting a conservative therapeutic approach, often termed 'choose wisely'.