2007 - Encyclopedia of pain - Schmidt & Willis.pdf - po angielsku - romi9987

Encyclopedia of Pain

With 713 Figures and 211 Tables

123

Professor em. Dr. Robert F. Schmidt

Physiological Institute

University of Würzburg

Röntgenring 9

97070 Würzburg

Germany

rfs@mail.uni-wuerzburg.de

Professor Dr. William D. Willis

Department of Neuroscience and Cell Biology

University of Texas Medical Branch

301 University Boulevard

Galveston

TX 77555-1069

USA

wdwillis@utmb.edu

ISBN-13: 978-3-540-43957-8 Springer Berlin Heidelberg New York

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Print and electronic bundle under ISBN 978-3-540-33447-7

Library of Congress Control Number: 2006925866

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Editor: Thomas Mager, Andrea Pillmann, Heidelberg

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SPIN: 10877912 2109fk - 543210

Preface

As all medical students know, pain is the most common reason for a person to consult a physician. Under ordinary

circumstances, acute pain has a useful, protective function. It discourages the individual from activities that aggravate

the pain, allowing faster recovery from tissue damage. The physician can often tell from the nature of the pain what

its source is. In most cases, treatment of the underlying condition resolves the pain. By contrast, children born with

congenital insensitivity to pain suffer repeated physical damage and die young (see Sweet WH (1981) Pain 10:275).

Pain resulting from difﬁcult to treat or untreatable conditions can become persistent. Chronic pain “never has a

biologic function but is a maleﬁc force that often imposes severe emotional, physical, economic, and social stresses

on the patient and on the family...” (Bonica JJ (1990) The Management of Pain, vol 1, 2 nd edn. Lea & Febiger,

Philadelphia, p 19). Chronic pain can be considered a disease in its own right.

Pain is a complex phenomenon. It has been deﬁned by the Taxonomy Committee of the International Association

for the Study of Pain as “An unpleasant sensory and emotional experience associated with actual or potential tissue

damage, or described in terms of such damage” (Merskey H and Bogduk N (1994) Classiﬁcation of Chronic Pain,

2 nd edn. IASP Press, Seattle). It is often ongoing, but in some cases it may be evoked by stimuli. Hyperalgesia occurs

when there is an increase in pain intensity in response to stimuli that are normally painful. Allodynia is pain that

is evoked by stimuli that are normally non-painful.

Acute pain is generally attributable to the activation of primary afferent neurons called nociceptors (Sherrington

CS (1906) The Integrative Action of the Nervous System. Yale University Press, New Haven; 2 nd edn, 1947). These

sensory nerve ﬁbers have high thresholds and respond to strong stimuli that threaten or cause injury to tissues of the

body. Chronic pain may result from continuous or repeated activation of nociceptors, as in some forms of cancer

or in chronic inﬂammatory states, such as arthritis.

However, chronic pain can also be produced by damage to nervous tissue. If peripheral nerves are injured, peripheral

neuropathic pain may develop. Damage to certain parts of the central nervous system may result in central neuropathic

pain. Examples of conditions that can cause central neuropathic pain include spinal cord injury, cerebrovascular

accidents, and multiple sclerosis.

Research on pain in humans has been an important clinical topic for many years. Basic science studies were relatively

few in number until experimental work on pain accelerated following detailed descriptions of peripheral nocicep-

tors and central nociceptive neurons that were made in the 1960’s and 70’s, by the discovery of the endogenous

opioid compounds and the descending pain control systems in the 1970’s and the application of modern imaging

techniques to visualize areas of the brain that are affected by pain in the 1990’s. Accompanying these advances has

been the development of a number of animal models of human pain states, with the goal of using these to examine

pain mechanisms and also to test analgesic drugs or non-pharmacologic interventions that might prove useful for

the treatment of pain in humans. Basic research on pain now emphasizes multidisciplinary approaches, including

behavioral testing, electrophysiology and the application of many of the techniques of modern cell and molecular

biology, including the use of transgenic animals.

The “Encyclopedia of Pain” is meant to provide a source of information that spans contemporary basic and clinical

research on pain and pain therapy. It should be useful not only to researchers in these ﬁelds but also to practicing

physicians and other health care professionals and to health care educators and administrators. The work is subdivided

into 35 Fields, and the Field Editor of each of these describes the areas covered in the Fields in a brief review chapter.

The topics included in a Field are the subject of a series of short essays, accompanied by key words, deﬁnitions,

2007 - Encyclopedia of pain - Schmidt & Willis.pdf

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