PATHWAYS AND SIGNAL TRANSMISSION: BASES FOR RATIONAL PAIN THERAPY

抄録

There is little question that pain is a sensation with special structural, functional, and perceptual properties. The total pain experience is the result of 1) nociceptive signal transduction at the peripheral receptors, and/or 2) nociceptive signal conduction along the peripheral nerves, and/or 3) modulation of signal transmission at the spinal level, and/or 4) pain perception at the supraspinal sites, and/or 5) emotional reactions and associated sensations at the cortical level. In treating the specific case of pain syndrome, it is essential to understand the phase of pain, the type of pain, and location of the specific pain pathway involved. Each analgesic mode of therapy and each analgesic agent have their own mechanisms and sites of action. The optimum pain relief in each specific case of pain syndrome can be attained, first, by obtaining the correct diagnosis of pain syndrome including (a) the phase of pain, (b) the type of pain, and (c) the site of transmission of the pain signal as discussed above and, second, by administering the proper and rational pain treatment.