Pain Neuroscience

May 14, 2025

This review is a one pager over the entire pain neuroscience mechanism process down to the nitty gritty. Few things to appreciate:

  • Start on the left side of this page at nociceptive pain and gradually work toward the right side of the page.
  • Notice how the shift from left to right demonstrated by the yellow arrow at the top of the page goes from acute to more persistent pain.
  • Lots and lots of new terms in regard to pain neuroscience that I do not explicit define in this map, cross reference any new/brush up on terminology (I know I definitely had to).
  • Takeaway message:
    • 1. Nociception - danger
    • 2. Adelta and C fibers send this message to DRG to interneuron.
    • 3. Interneuron gate keeps and sorts what is relevant vs not-relevant information to send to 2nd order neuron.
    • 4. 2nd order neuron - relays message to brain.
    • 5. Brain and pain neuromatrix is what tells us to feel pain then sends this down descending pathways to most likely release endogenous opioids, etc. to regulate pain.
    • **At any point along this pathway various changes can happen that lead to persistent pain:
      • Nociceptive - Mechanoreceptors, thermoreceptors, chemoreceptors, immune system implications.
      • Peripheral Neurogenic - Ion channels in areas w/o myeling, DRG area, (myelin can be destroyed w/mechanics ex: ankle sprain), nerve compression, decreased blood flow, etc.
      • Central Sensitization - Interneuron dies losing gating ability, C fiber CNS barrage, 2nd order neuron receptors change to G protein that stay open longer, pain neuromatrix, fear avoidance,etc., etc.

Good luck studying!