New discoveries in pain research and their clinical relevance for pain medicine Neue Erkenntnisse in der Schmerzforschung und ihre klinische Relevanz für die manuelle Medizin
Meßlinger K (2024)
Publication Type: Journal article
Publication year: 2024
Journal
DOI: 10.1007/s00337-024-01115-4
Abstract
This article informs about important research results from recent years in the field of peripheral nociception. While pain is defined as a subjective phenomenon of perception, nociception comprises all peripheral and central neurophysiological mechanisms that can lead to pain. Nociception is initiated by nocisensors, which consist of afferent Aδ and C fibers with free nerve endings. However, these nerve fibers can also form thermo- or low-threshold mechanosensors. Nocisensors of deep tissues are localized in connective tissues, joint nocisensors particularly in capsules and ligaments. Transduction of painful (noxious) stimuli into propagated electrical information takes place at the membrane receptors of nocisensors. The calcium-conducting transient receptor potential (TRP) channels, which are activated within a specific temperature range through exogenous and endogenous chemical stimuli, hereby play an important role. Sensitization and opening of TRP channels can be increased by inflammatory mediators (bradykinin, prostaglandins) via intracellular metabolic cascades. Neuropeptide release leads to interactions with immune cells and fibroblasts, which release cytokines such as tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β and IL‑6 and increase the nociceptive mechanisms, particularly in chronic pain. In the lumbar area these nociceptive events can originate from degenerated disks or inflamed capsule and ligament structures of vertebra and facet joints. A rather new discovery is the existence of mechanically low-threshold C fibers (CT fibers), the activation of which through mild stroking of the skin or oscillating mild pressure in deep tissues has an antinociceptive and herewith potential pain-inhibitory effect.
How to cite
APA:
Meßlinger, K. (2024). New discoveries in pain research and their clinical relevance for pain medicine Neue Erkenntnisse in der Schmerzforschung und ihre klinische Relevanz für die manuelle Medizin. Manuelle Medizin. https://doi.org/10.1007/s00337-024-01115-4
MLA:
Meßlinger, K.. "New discoveries in pain research and their clinical relevance for pain medicine Neue Erkenntnisse in der Schmerzforschung und ihre klinische Relevanz für die manuelle Medizin." Manuelle Medizin (2024).
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