The use of passive cable theory to increase the threshold of nociceptors in people with chronic pain

Abstract

Background Chronic pain is one of the disorders that cost any society high expenses. The major mechanisms responsible for the conversion of pain from acute to chronic are still unclear. One major mechanism of these mechanisms is the hypersensitivity of nociceptors to any noxious stimulus. Treatment approaches for chronic pain have not targeted the abnormal function of nociceptors or achieved long-time relief of pain yet. Objectives To outline the effectiveness of passive cable theory to decrease the hypersensitivity of nociceptors in patients with chronic pain and renormalize the abnormal hypersensitivity of nociceptors. Major Findings applying the concept of the passive cable theory in the treatment of chronic pain would decrease the hypersensitivity of nociceptors and produce a decrease in chronic pain levels. This could occur through increasing the passive background leakage of ions in the opposite direction against their major flow direction. During the major flow of ions through the cell membrane occurs with any noxious stimulus, a background passive leakage of the same ions occurs in the opposite direction. This leakage helps in increasing the postsynaptic potentials and prolongs their decay phase. In turn, this decreases the hyperexcitability of the central nervous system, which commonly occurs in chronic pain. Both decreases in the peripheral and central sensitization would decrease the depletion of β-arrestin-2, which leads to a decrease in the descending painful mechanism. Conclusion The use of passive cable theory would be a useful intervention to decrease the hypersensitivity of peripheral nociceptors and hyper-excitability of the central nervous system, which are common mechanisms of persisted chronic pain. This helps to renormalize the abnormal mechanism commonly occur in chronic pain and would cause a prolonged decrease in chronic pain.