Woolf CJ What is this things called pain? J Clin Invest 2010;120(11):3742-3744
- Pain is actually three quite different things.
- nociceptive pain, and early-warning physiological protective system
- inflammatory pain, adaptive and protective
- pathological pain, not protective, but maladaptive, in which there exists substantial pain but no noxious stimulus and no , or minimal peripheral inflammatory pathology
- Nociceptive pain is, therefore, a pain essential for maintaining bodily integrity
- Pain involves active regulation by excitatory and inhibitory circuits in the central nervous system, controlled primarily by nuclei in the brainstem that can either diminish or exaggerate pain depending on mood, cognitive function, and memories.
- This work (Schweinhardt and Bushnell) has revealed a wide range of different brain areas that constitute what has been called pain’s matrix; these areas are activated during the encoding of nociceptive pain’s location, intensity, duration, quality, and emotional associations and show how pain can be influenced by attention, distraction, and manipulation of mood.
- A big difference between inflammatory and pathological pain is that the former represents hypersensitivity in reaction to a defined peripheral pathology, whereas the latter is the result of altered neural processing.
