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Pain 

Chapter:
Pain
Author(s):

Per Brodal

DOI:
10.1093/med/9780190228958.003.0015
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date: 06 March 2021

Chapter 15 discusses pain in some depth due to its clinical importance. The pain system has several characteristic properties. Due to pronounced plasticity, ongoing nociceptor activation leads to hyperexcitability and hyperalgesia. Further, pain may be experienced more or less independent of nociceptor activity. The term “pathologic pain” refers to conditions in which pain occurs without any nociceptor activation. Neuropathic pain is pain that is caused by damage to nervous tissue. Signals from nociceptors are transmitted to the cerebral cortex but also the periaqueductal gray, the hypothalamus, and the amygdala. The transmission of nociceptive signals from the cord to higher levels is subject to descending control. Depending on the emotional state and expectations of the subject, descending systems may inhibit or facilitate pain perception. The placebo effect is prominent in relation to pain. The opposite phenomenon is called nocebo.

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