Abstract

SUMMARYObjective: The purpose of this review is to show how central mechanisms of pain transmission relate to pharmacological systems that are responsible for the generation of central sensitization states.Findings: Pain transmission is a complex process involving the interplay between excitatory and inhibitory systems acting at different levels of the central nervous system. A balance between excitatory and inhibitory receptor mediated events determines the level of excitability within spinal circuits capable of contributing to the transmission of noxious messages. All of these systems are subject to plasticity and other alterations in pharmacological functions that characterize pathological conditions.Conclusions: A better understanding of the neuropharmacology of pain transmission within the spinal cord has the potential to improve the clinical management of pathologically severe and persistent pain.

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