Central versus peripheral substrates of persistent pain: Which contributes more?

Abstract

Evidence that central sensitization needs to be maintained in an ongoing manner by nociceptive input from the periphery makes the peripheral drive, rather than the central amplification process, the highest priority target for understanding and control. To stop the peripheral drives to kill two birds with one stone. Moreover, the amplification that central sensitization does provide is selective and not necessarily striking in intensity. A “magic bullet” that neutralized central sensitization would probably be less effective in controlling persistent pain than many investigators would like to believe. [berkley; blumberg et al.; coderre & katz; dickenson; mcmahon; weisenfeld-hallin et al.]