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Year : 2020  |  Volume : 13  |  Issue : 1  |  Page : 1-19

Pain: Physiologic background and therapeutic Consequences

Consultant for Anesthesiology and Intensive Care and Pain Medicine at the Vienna Private Clinic, Professor and Member of the Selection Committee for Professors at the Medical Faculty of the Sigmund Freud University, Vienna, Austria

Correspondence Address:
Wilfried Ilias
Vienna Private Clinic, Pelikangasse 9-15 A-1090, Vienna
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/HMJ.HMJ_1_20

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The perception of harmful or near harmful threats is expressed and recognized by a feeling of extreme discomfort that is pain. Starting with simple reflex circuits such as contraction or flight to avoid further harm in primitive organisms, evolution provided higher organisms with a complex structure of receptors, transmitters, hormones and nervous systems in order to not only detect harmful or near harmful threat, but also to discriminate quality and intensity of a threatful event as well as to learn how to avoid further exposure and how to behave in order to allow healing and recovery after getting injured. The variety of receptors and transmitters as well as the transmitting inter-neuronal networks are extremely complex and are still not completely elucidated. What is already known of this“nociceptive networks” on the other hand, allows better understanding of the progress and treatment of pathological pain states. By analyzing structure - action relation a variety of new drugs such as receptor agonists and antagonists as well as ion-channel blockers primarily not designed for pain treatment have been proven to be useful in the control of complex pain syndromes. A better understanding of the mechanisms involved in perception and transmission of nociceptive inputs as well as peripheral and central downregulating feedback may help to create individualize analgesic treatment regimens for complicated pain syndromes.

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