Redefining chronic pain models: What should we model?

Chronic pain is generally defined as pain that persists or recurs for more than 3 months. However, its pathogenesis cannot be fully explained solely by ongoing tissue injury or inflammation. Conventional inflammatory and neuropathic pain models have greatly advanced our understanding of pain hypersensitivity and its underlying mechanisms. Clinically, many patients experience persistent pain despite minimal peripheral pathology. These observations underscore the need for experimental models that better reflect the mechanisms of pain chronification and recurrence. Recent advances in research on central sensitization, hyperalgesic priming, and latent sensitization support the view that chronic pain involves persistent neuroplastic changes. In some chronic pain conditions, these changes may persist even after the initial injury or inflammation has resolved, suggesting that chronic pain may involve a form of "pain memory" encoded within the nervous system. This review outlines the limitations of conventional pain models and focuses on persistent sensitization models, particularly hyperalgesic priming and latent sensitization. Considering chronic pain as a manifestation of persistent neuroplastic changes, we summarize the experimental features and pathophysiological significance and discuss their relevance to chronic pain conditions that are difficult to explain solely by ongoing inflammation or nerve injury, including nociplastic pain-related conditions. Finally, we argue that future chronic pain models should aim to reproduce persistent neural states that drive pain chronification, maintenance, and recurrence rather than pain hypersensitivity alone. This approach may help bridge the translational gap between preclinical and clinical pain research and facilitate the development of more effective therapies.