On the Concept of Pain Chronicization: Clinical Observations and Neurobiological Inference

Area of Science:

• Neuroscience
• Pain Research
• Clinical Medicine

Background:

• The concept of pain chronicization describes the shift from acute to chronic pain.
• This transition is often attributed to central nervous system mechanisms.

Purpose of the Study:

• To evaluate the clinical relevance of pain chronicization.
• To compare neurobiological models with direct patient observations.

Main Methods:

• A conceptual analysis was performed, integrating experimental data and clinical experience.
• Included analysis of animal models, human neuroimaging studies, and ICD-11 chronic pain classifications.

Main Results:

• Central sensitization is experimentally supported but not clearly observed as a transition in clinical practice.
• Chronic pain is typically heterogeneous, discontinuous, and multifactorial.
• Neuroimaging data is associative, lacking temporal and causal links, and the chronic pain classification doesn't confirm biological conversion.

Conclusions:

• Pain chronicization should be viewed as a theoretical construct.
• Its application to individual patients requires careful consideration due to limited clinical evidence.