MEDI7212 Lecture Notes - Lecture 5: Alexithymia, Pain Management, Posterior Grey Column
Document Summary
Sensitization: ongoing receptor activation via ongoing inflammation/ repeated trauma can increase likelihood of developing chronic pain (greater concentration of sensitization products & receptors leads to greater signal transduction) It may be the mechanism of hyperalgesia and central sensitization. It follows high frequency stimulation of a-delta fibres & c-fibres in the superficial dorsal horn & outlasts the initiating stimulus. Secondary hyperalgesia: hyperalgesia in undamaged tissue adjacent to the area of actual tissue damage. It may be due to an increased receptive field and reduced threshold of wide dynamic neurons in the dorsal horn: gate theory. Stimulus -> nociception -> modification of nociception at spinal cord level (eg feedback from cns, peripheral inputs, rational thinking that patient will be okay, irrational thinking that patient won"t be okay) gate either allows or blocks certain inputs from influencing nociception: treatment expectation (bingel et al 2010, this study proves that effective treatment is increased via knowledge that patient is receiving treatment.
