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Pain Mechanisms and Types 

Pain Mechanisms and Types
Chapter:
Pain Mechanisms and Types
Source:
Pain: Dynamics and Complexities
Author(s):

Daniel M. Doleys

DOI:
10.1093/med/9780199331536.003.0003

Different types of pain such as acute, cancer related, chronic, neuropathic, nociceptive, inflammatory, and functional are described. The neurophysiology and neurochemistry of the peripheral system is described as well as the processes of transduction and transmission including the role of purines, peptides, and excitatory amino acids. Different nerve fiber types, their function and the architecture of the spinal cord dorsal horn are summarized. The role of the ascending and descending systems in pain perception is highlighted as well as the neurochemistry of nociception including neurotrophic factor (GDNE) substance P, calcitonin-gene-related peptides (CGRP), nerve-growth factor (NGF, TrkA, brain-derived-neurotrophic factor (BDNF), neruotrphin-3 (NT-3), vanilloid receptor 1 (VR1), and the sensory nerve-specific (SNS) sodium channel. The importance of long-term-potentiation and its association with the Hebbian notion of cell-assemblies is outlined. Various types of pain are discussed with special attention to neuropathic pain including the involvement of spontaneous discharge, ephaptic transmission, sympathetically mediated pain (SMP), central sensitization, disinhibition, and the NMDA receptor.

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