Pain Modulation

This volume represents edited material that was presented at a conference on brainstem modulation of spinal nociception held in Beaune, France during July, 1987. Pain Modulation, Volume 77 in the series Progress in Brain Research reviews, analyses and suggests new research strategies on several relevant topics including: the endogenous opioid peptides; sites of action of opiates; the role of biogenic animes and non-opioid peptides in analgesia; dorsal horn circuitry; behavioural factors in the activation of pain modulating networks and clinical studies of nociceptive modulation.

This latest edition provides a thorough overview of the neural mechanisms of pain. Relying on the latest basic and clinical research, a comprehensive approach to patient evaluation and current treatment strategies develop in this text. Subjects covering the sensory transmission system, pain modulation, and analgesic treatment modalities are discussed. Dozens of supplementary tables, figures, and illustrations summarize key information and further reinforce important clinical points.

Local-regional anesthesia and pain therapy represent two areas of common interest for all physicians. A thorough preparation in functional anatomy and general pharmacology, including familiarity with local anesthetics and analgesics, is considered fundamental background for further study or clinical application of such techniques. Knowledge of the mechanisms of action, efficacies and side effects of the relevant drugs is essential, as is appreciation of possible drug interactions to evaluate eventual toxic effects. Local-regional anesthesia and pain management are being increasing used in diverse medical specialties, including those requiring manual dexterity. In contemporary medicine correct evaluation of the medical outcome becomes essential, especially in relation to the cost-benefit balance, not only in terms of the resources consumed, also and more importantly for the quality of life of the patient.

The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.

This volume provides a comprehensive accounting of pain and its relation to neurology. It is dedicated entirely to the mechanisms and clinical aspects of the subject, and provides a wealth of information on the latest neurobiological and clinical data surrounding the topic. From discussions of the physiology and pathology of the pain pathways from signaling, via spinal cord and supraspinal processing to endogenous pain modulation, users will gain an invaluable reference that provides a new understanding of pain related topics, including cytokines, sex differences, and the autonomic nervous system. Practicing clinicians, internists, surgeons, and those in the fields of psychiatry and gerontology will gain a greater understanding of this challenging topic with chapters that deal extensively with peripheral and central pain conditions, including specific disorders such as fibromyalgia, whiplash, psychiatric diseases, dementia, and even cancer. In addition, treatments for neuropathic pain are also thoroughly presented and discussed. * A comprehensive guide to the topic of pain and its relation to neurology* Invaluable information on specific topics of interest, including discussions of pain and its implications for related diseases and conditions such as fibromyalgia, whiplash, and even psychiatric disorders* Treatment protocols for neuropathic pain and patient care

This book deals with physiological, neurophysiological, and psychological aspects of the mechanisms and treatment of pain. It also provides information on the latest research results regarding the influence of age and gender on the perception of pain. Finally, it presents the basic mechanisms of analgesia in terms of pharmacological and nonpharmacological treatments.