Abstract
The article is devoted to the problem of effective management of chronic pain. A review of the known mechanisms of development and maintenance of chronic pain and possible methods of influence is given. One of the reasons for the lack of chronic pain treatment effectiveness in some patients is the use of treatment regimens with drugs acting exclusively on the targets located in the nerve structures. Today an important role of microglia and mast cells in the development and maintenance of chronic pain conditions is well acknowledged. A new class of drugs from the group of acylethanolamides is described. One of the representatives of this group is palmitoylethanolamide. This drug may modulate the activity of microglia and mast cells, thus increasing the pain threshold and the effectiveness of therapy. The use of palmitoylethanolamide in patients with chronic pain can increase the effectiveness of therapy.
Highlights
The chronic pain is a healthcare problem in many countries all over world; it causes suffering to an individual patient and the patient’s family, environment and society in general [1, 2]
It is worthy of noting that the chronic pain of a predominantly inflammatory/autoimmune genesis may be associated with a neuropathic pain component [9, 10]
The neuroinflammation is characterized by the immune cells infiltrating the damaged tissue, healthy and glial cells being activated and anti-inflammatory mediator being produced at an increased rate; the latter playing a pivotal role in the chronic pain maintenance at the level of peripheral and central nervous system [16,17,18]
Summary
The chronic pain is a healthcare problem in many countries all over world; it causes suffering to an individual patient and the patient’s family, environment and society in general [1, 2]. The neuroinflammation is characterized by the immune cells infiltrating the damaged tissue, healthy and glial cells being activated and anti-inflammatory mediator being produced at an increased rate; the latter playing a pivotal role in the chronic pain maintenance at the level of peripheral and central nervous system [16,17,18]. They are surrounding and interacting with neurons, they play a pivotal role in their modulation and maintenance of inflammatory processes in the nervous tissue; they increase the neuronal excitability, accentuation and prolongation of the pain impulsation transmitted [43, 44].
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