Table 3.

Education Session: the Neurophysiology of Pain.

How Acute Pain Originates in the Body
Peripheral nerves, ascending pain pathways
The role of the thalamus, descending pain pathways
The somatosensory region
Pain processing (physical, emotional) and pain memory
The limbic system: (i) the fight or flight response; (ii) threat surveillance
How threat modifies sensation
The hypothalamic-pituitary-adrenal (HPA) axis
Chronic activation of the limbic system
Pain and sensory amplification/sensitization
Brain imaging of modified pain processing in fibromyalgia (FM)
Brain imaging of modified pain networks in FM
Reduced endorphin receptors in fibromyalgia
Brain imaging comparing normal injury pain to FM
Hyperalgesia and allodynia
Recruitment
Neurochemical changes in central sensitization (CS)
Changes in the HPA axis in CS
Peripheral sensitization
Narcotic effects on pain in FM/CS
CS autonomic effects
CS motor effects
Chronic fatigue brain changes
Frontal brain and limbic system control
Neuroplasticity and recovery

CS, central sensitization; FM, fibromyalgia; HPA, hypothalamic-pituitary-adrenal.

RMMJ Rambam Maimonides Medical Journal Rambam Health Care Campus 2015 April; 6(2): e0020. ISSN: 2076-9172
Published online 2015 April 29. doi: 10.5041/RMMJ.10204.