Effect of pain chronification and chronic pain on an endogenous pain modulation circuit in rats

Miranda, Josiane Aparecida de; Lamana, Simone Monaliza Silva; Dias, Elayne Vieira; Athié, Maria Carolina Pedro; Parada, Carlos Amílcar; Tambeli, Cláudia Herrera

doi:10.1016/j.neuroscience.2014.10.049

Cited by 30 publications

(24 citation statements)

References 28 publications

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“…Nonetheless, our findings provide evidence that people with Achilles tendinopathy share similar changes in central pain modulation mechanisms as do chronic pain patients with fibromyalgia,22 37 irritable bowel syndrome,23 38 39 temporomandibular disorders,23 40 whiplash-associated disorders,41 42 tension type headache,25 43 44 osteoarthritis26 45 and low back pain 27. Such changes have been suggested to contribute to the development of central sensitisation9 46–48 and chronicity of pain 49 50. Indeed, most of the aforementioned conditions are expected to exhibit signs of central sensitisation 11 26 51–58.…”

Section: Discussionmentioning

confidence: 57%

Central pain processing is altered in people with Achilles tendinopathy

2015

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We report a reduced conditioned pain modulation effect in people with Achilles tendinopathy compared to people without Achilles tendinopathy. A reduced conditioned pain modulation effect reflects altered central pain processing which is believed to contribute to the persistence of pain in other conditions. Altered central pain processing may also be an important factor in persistent tendon pain that has traditionally been regarded to be dominated by peripheral mechanisms.

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Section: Discussionmentioning

confidence: 57%

Central pain processing is altered in people with Achilles tendinopathy

2015

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“…Thus, increased peripheral input through primary afferents and peripheral sensitization are clearly involved in contributing toward central sensitization and the maintenance of neuropathic pain, and most probably also in the chronification of acute pain as seen in post-surgical pain syndromes 20. The fact that in some cases topically administered analgesic cream leads to pain reduction in central neuropathic pain states might hint on a more neuroplastic relationship between peripheral and central sensitization as envisaged by several authors 21,22.…”

Section: Low-grade Peripheral Neurogenic Inflammationmentioning

confidence: 96%

Skin matters! The role of keratinocytes in nociception: a rational argument for the development of topical analgesics

Hesselink

Kopsky²,

Bhaskar

2016

JPR

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Treatment of neuropathic pain using topical formulations is still in its infancy. Only few topical analgesic formulations have become available for clinical use, and among these, analgesic creams are still rare. This is unfortunate because analgesic creams offer a number of advantages over patches, such as convenience, ease of adapting the frequency of application, and dose, and “rubbing cream where it hurts” involves the patient much more in the therapeutic process compared to patches and other localized treatment modalities. Although the literature supporting the efficacy and safety of analgesic creams (mostly compounded) is growing since the last decade, most pain physicians have not yet noticed and appreciated the therapeutic potential and clinical value of these creams. This is most probably due to a prejudice that topical application should need to act transdermally, more or less as a slow-release formulation, such as in patches delivering opioids. We will discuss this prejudice and show that there are multiple important targets in the skin to be reached by topical analgesic or anti-inflammatory compounds, and that the keratinocyte is one of those targets. By specifically targeting the keratinocyte, analgesia seems possible, effective, and safe, and thus topical analgesic creams may hold promise as a novel treatment modality for neuropathic pain.

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“…One aspect of the descending pain control is associated with diffuse noxious inhibitory control (DNIC), expressed as an inhibition of dorsal horn neurons along the neuroaxis as produced by a noxious stimulus applied to a body region remote from the receptive field of the neurons (Le Bars et al, 1979;Lee et al, 2011c). The endogenous descending pain control network is important for the chronification of pain (Miranda et al, 2015).…”

Section: Descending Pain Modulation (Conditioning Pain Modulation)mentioning

confidence: 99%

Assessment and manifestation of central sensitisation across different chronic pain conditions

Arendt-Nielsen

Morlion

Perrot

et al. 2017

European Journal of Pain

487

494

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Different neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features. The fundamental understanding and quantitative assessment of particularly some of the central sensitisation mechanisms can be translated from preclinical studies into the clinic. The clinical perspectives are implementation of such novel information into diagnostics, mechanistic phenotyping, prevention, personalised treatment, and drug development. The aims of this paper are to introduce and discuss (1) some common fundamental central pain mechanisms, (2) how they may translate into the clinical signs and symptoms across different chronic pain conditions, (3) how to evaluate gain and loss of function using quantitative pain assessment tools, and (4) the implications for optimising prevention and management of pain. The chronic pain conditions selected for the paper are neuropathic pain in general, musculoskeletal pain (chronic low back pain and osteoarthritic pain in particular), and visceral pain (irritable bowel syndrome in particular). The translational mechanisms addressed are local and widespread sensitisation, central summation, and descending pain modulation. Significance Central sensitisation is an important manifestation involved in many different chronic pain conditions. Central sensitisation can be different to assess and evaluate as the manifestations vary from pain condition to pain condition. Understanding central sensitisation may promote better profiling and diagnosis of pain patients and development of new regimes for mechanism based therapy. Some of the mechanisms underlying central sensitisation can be translated from animals to humans providing new options in development of therapies and profiling drugs under development.

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Effect of pain chronification and chronic pain on an endogenous pain modulation circuit in rats

Cited by 30 publications

References 28 publications

Central pain processing is altered in people with Achilles tendinopathy

Central pain processing is altered in people with Achilles tendinopathy

Skin matters! The role of keratinocytes in nociception: a rational argument for the development of topical analgesics

Assessment and manifestation of central sensitisation across different chronic pain conditions

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