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See Latest ArticlesPreclinical and Early Clinical Investigations Related to Monoaminergic Pain Modulation
Neurotherapeutics, 10/05/09
Bannister et al. – The links between pain and the comorbidities of sleep problems, anxiety, and depression may be due to the dual roles of noradrenaline and of 5–HT in these functions and also in pain. These controls appear, in the cases of peripheral neuropathy, spinal injury, and cancer–induced bone pain to be driven by altered peripheral and spinal neuronal processes; in opioid–induced hyperalgesia, however, the same changes occur without any pathophysiological peripheral process. Thus, in generalized pain states in which fatigue, mood changes, and diffuse pain occur, such as fibromyalgia and irritable bowel syndrome, one could suggest an abnormal engagement of descending facilitations with or without reduced inhibitions but with central origins. This would be an endogenous central malfunction of top–down processing, with the altered monoamine systems underlying the observed symptoms. A number of analgesic drugs can either interact with or have their actions modulated by these descending systems, reinforcing their importance in the establishment of pain but also in its control.
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Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials
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