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Chronic Pain Treatment and Theory Infusion of Lidocaine

Joseph Jhon

We incorporate current human and animal studies from the perspective of chronic pain in this review. First, we examine the socioeconomic effect of chronic pain and discuss current definition and clinical treatment issues. Second, we look at pain processes as they relate to nociceptive information transmission cephalic, as well as its influence and interaction with the cortex. Third, we discuss new results on the cortex's active participation in chronic pain, including data that show the human brain constantly reorganizes as it experiences chronic pain. We also provide data demonstrating that different chronic pain situations have different effects on the brain. Fourth, animal research on nociceptive transmission, new evidence for supraspinal remodeling during pain, and the need of descending modulation for neuropathic pain maintenance also discussed is the effect of cortical modifications on neuropathic pain. We go on to explain how chronic pain might be recast in terms of learning and memory, as well as how this concept can be used to the development of new pharmacotherapies. Finally, we combine human and animal data into a coherent working model that outlines the mechanism by which acute pain becomes chronic. It contains information of underlying brain structures and their remodeling, as well as individual changes based on pain persistence and injury type, resulting in mechanistic explanations of numerous distinct chronic pain disorders inside a single model.