By several measures, no human experience is more important than pain. Chasing Pain discusses the evolution of scientific and clinical evidence that supports contemporary concepts of how pain is created by the nervous system. These concepts influence medical practice, neuroscientific research, and philosophical ideas about pain and other neurological functions. Historically, pain has been conceived as emerging either from an undefined pattern of neural activity or from anatomically localized and physiologically unique structures in the nervous system. Research during the early and middle 20th century showed that pain normally requires both sensory detectors of noxious events (nociceptors) and brain mechanisms that generate emotional experience. Realistic models of pain neurobiology must also consider that the normally tight link between pain and tissue damage is strongly affected by several neurological diseases, emotionally compelling circumstances, complex cognitive processes, and pain itself. As one example of physiological pain modulation, readers may access the author’s videos of surgery performed with acupuncture as the sole analgesic method. Chasing Pain reviews the neuroscientific research and clinical experience that has, over time, greatly enriched our understanding of pain neurobiology, guided medical practice, and influenced contemporary concepts of neurological functions. The limitations of our current conceptual models of pain are exemplified by considering several common, clinically challenging conditions that remain very poorly understood.
Table of Contents
- Introduction: Why Pain?
- 1 A Sample at the Extremes
- 2 Drivers of Pain Research and a Meeting in Issaquah
- 3 Functional Localization, the Spinothalamic Tract, and Neurosurgery for Pain
- 4 Emotions, Affect, and the Limbic System
- 5 Early Evidence of Central Nervous System Control and a Conceptual Model Revisited
- 6 Psychophysics and Nociceptors
- 7 Central Sensitization and Pain Genes
- 8 Central Nervous System Modulation of Pain: Neurophysiological and Clinical Evidence
- 9 Central Nervous System Generation and Modulation of Pain: Early Evidence from Anatomical Brain Imaging and the Development of Functional Brain Imaging
- 10 Functional Imaging Contributions to Chasing Pain
- 11 Unfinished Business: A Sample
- 12 The Chase Today: Summary and Implications