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A Manifesto in Defense of Pain Complexity: A Critical Review of Essential Insights in Pain Neuroscience.

作者信息

Párraga Javier Picañol, Castellanos Aida

机构信息

Laboratory of Neurophysiology, Biomedicine Department, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, 08036 Barcelona, Spain.

出版信息

J Clin Med. 2023 Nov 14;12(22):7080. doi: 10.3390/jcm12227080.


DOI:10.3390/jcm12227080
PMID:38002692
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10672144/
Abstract

Chronic pain has increasingly become a significant health challenge, not just as a symptomatic manifestation but also as a pathological condition with profound socioeconomic implications. Despite the expansion of medical interventions, the prevalence of chronic pain remains remarkably persistent, prompting a turn towards non-pharmacological treatments, such as therapeutic education, exercise, and cognitive-behavioral therapy. With the advent of cognitive neuroscience, pain is often presented as a primary output derived from the brain, aligning with Engel's Biopsychosocial Model that views disease not solely from a biological perspective but also considering psychological and social factors. This paradigm shift brings forward potential misconceptions and over-simplifications. The current review delves into the intricacies of nociception and pain perception. It questions long-standing beliefs like the cerebral-centric view of pain, the forgotten role of the peripheral nervous system in pain chronification, misconceptions around central sensitization syndromes, the controversy about the existence of a dedicated pain neuromatrix, the consciousness of the pain experience, and the possible oversight of factors beyond the nervous system. In re-evaluating these aspects, the review emphasizes the critical need for understanding the complexity of pain, urging the scientific and clinical community to move beyond reductionist perspectives and consider the multifaceted nature of this phenomenon.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e896/10672144/66fb3384ea00/jcm-12-07080-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e896/10672144/66fb3384ea00/jcm-12-07080-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e896/10672144/66fb3384ea00/jcm-12-07080-g001.jpg

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本文引用的文献

[1]
Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine.

Lancet Rheumatol. 2021-5

[2]
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Pain. 2024-4-1

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J Clin Med. 2023-6-18

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