When pain gets stuck: the evolution of pain chronification and treatment resistance

Pain
David BorsookChristopher Eccleston

Abstract

It is well-recognized that, despite similar pain characteristics, some people with chronic pain recover, whereas others do not. In this review, we discuss possible contributions and interactions of biological, social, and psychological perturbations that underlie the evolution of treatment-resistant chronic pain. Behavior and brain are intimately implicated in the production and maintenance of perception. Our understandings of potential mechanisms that produce or exacerbate persistent pain remain relatively unclear. We provide an overview of these interactions and how differences in relative contribution of dimensions such as stress, age, genetics, environment, and immune responsivity may produce different risk profiles for disease development, pain severity, and chronicity. We propose the concept of "stickiness" as a soubriquet for capturing the multiple influences on the persistence of pain and pain behavior, and their stubborn resistance to therapeutic intervention. We then focus on the neurobiology of reward and aversion to address how alterations in synaptic complexity, neural networks, and systems (eg, opioidergic and dopaminergic) may contribute to pain stickiness. Finally, we propose an integration of the neurobiologica...Continue Reading

Associated Clinical Trials

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Citations

Sep 24, 2019·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·Amanda C de C Williams
Dec 14, 2019·The Clinical Journal of Pain·Abby TaborMonika I Hasenbring
Sep 22, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Penny L Brennan
Aug 25, 2019·Journal of Clinical Medicine·Michele SterlingScott F Farrell
May 7, 2020·Anaesthesia and Intensive Care·Francois Stapelberg
Mar 13, 2020·The South African Journal of Physiotherapy·Romy Parker, Victoria J Madden
Jan 28, 2020·Pain Reports·Kirstine AmrisAmanda C de C Williams
Mar 14, 2020·Behavioural Pharmacology·Vicente Martínez, Raquel Abalo
Aug 15, 2020·The Cochrane Database of Systematic Reviews·Amanda C de C WilliamsChristopher Eccleston
Oct 5, 2019·Pain Reports·Shahrzad Firouzian, Natalie R Osborne
Oct 29, 2020·Pain Management·Paul GlareKarin Aubrey
Jan 14, 2021·Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Österreichischer Nervenärzte und Psychiater·Hans-Peter Kapfhammer
Jun 15, 2020·Neuroscience and Biobehavioral Reviews·Nick ToddDavid Borsook
Nov 8, 2020·Neuroscience and Biobehavioral Reviews·Keerthana Deepti KarunakaranDavid Borsook
Oct 16, 2020·Pain and Therapy·Ilaria ArdoinoUNKNOWN REPOSI Investigators
Mar 4, 2021·European Journal of Pediatrics·Alessandro AndreucciKate M Dunn
Mar 19, 2021·Neurobiology of Pain·Andrew M YoussefLaura E Simons
Mar 20, 2021·Therapeutic Advances in Musculoskeletal Disease·Filomena PuntilloNicola Brienza
Sep 29, 2020·Physical Medicine and Rehabilitation Clinics of North America·Raouf S Gharbo
Jan 19, 2021·BJA Education·A C de C Williams, J Hughes
Mar 29, 2021·Neuroscience and Biobehavioral Reviews·Christine B SiebergIgor Elman
May 26, 2021·Molecular and Cellular Endocrinology·Melissa C McHannJosée Guindon
Oct 17, 2020·The Lancet Child & Adolescent Health·Christopher EcclestonChantal Wood
Oct 17, 2020·American Journal of Physical Medicine & Rehabilitation·Mohammadreza AmiriDinesh Kumbhare
Aug 12, 2021·British Journal of Pain·Daniel BoardRichard Boulton
Aug 14, 2021·Bioorganic Chemistry·Daniel ButrónRosario González-Muñiz
Oct 8, 2021·Epigenomics·Vidya Chidambaran, Tesfaye B Mersha
Nov 6, 2021·Psychological Medicine·Alicja TimmBettina Studer
Nov 9, 2021·The American Journal of Clinical Hypnosis·Aminata BicegoAudrey Vanhaudenhuyse
Sep 26, 2021·Behavioural Pharmacology·Samira MohammadiFatemeh Abbaszadeh

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