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Pathophysiology and Conditions

Hypersensitivity as an identifying feature

Chronic pain is a complex phenomenon. It results from a sustained sensory abnormality caused by an ongoing peripheral process such as chronic inflammation; however, it can also occur independently of the trigger that initiated it. A general distinctive feature is hypersensitivity, which can result from two principles: either the response to an injurious stimulus is increased, resulting in exaggerated and prolonged pain, or the thresholds are reduced, leading to pain production in response to normally non-injurious stimuli. In both cases, the responsive pain system is altered, resulting in chronic pain.1 The longer the pain lasts, the lower the chance of an entire normalisation of the nervous system.

Typical chronic pain conditions are: low back pain, neuropathic pain, arthritis pain, osteoporotic pain and cancer pain.

1 Woolf CJ: Somatic Pain – Pathogenesis and Prevention. British Journal of Anaesthesia, 1995; 75:169-76