Abstract
Pain is a sensory and emotional experience that is personal and unique to an individual.
Nociception is different from pain and considers the neural process of encoding and
processing noxious stimuli. Anatomically noxious stimuli are transduced by nociceptors
to an electrical signal carried by first-order neurons to the dorsal horn of the spinal
cord. From the spinal cord second-order neurons project in tracts to the thalamus,
where third-order neurons continue to higher cerebral centres. There is no known primary
pain processing centre in the brain, instead multiple different areas activate and
interact in response to noxious stimuli. The brain centres associated with pain perception
overlap with those involved in depression. The brain regulates the nociceptive information
it receives and can exert both anti- and pro-nociceptive influence. Pathology in the
peripheral and central nervous systems can contribute to nociception and pain, as
can changes in the interaction of higher cerebral centres. Appreciating the anatomical
structures involved in pain and nociception affords an understanding of where different
therapies may be applied to alleviate pain.
Keywords
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Further reading
- Pain processing in the human nervous system: a selective review of nociceptive and biobehavioral pathways.Prim Car. 2012; 39: 561-571
- Linking pain sensation to the autonomic nervous system: the role of the anterior cingulate and periaqueductal gray resting-state networks.Front Neurosci. 2020; 14: 147
- Chronic pain: structural and functional changes in brain structures and associated negative affective states.Int J Mol Sci. 2019; 20: 3130
Article Info
Publication History
Published online: May 23, 2022
Royal College of Anaesthetists CPD Skills Framework: PainIdentification
Copyright
© 2022 Published by Elsevier Ltd.
