When does acute pain become chronic?

Voscopoulos, C; Lema, M

doi:10.1093/bja/aeq323

Cited by 473Pain Mechanisms and TreatmentsPain Management and TreatmentMusculoskeletal pain and rehabilitation

When does acute pain become chronic?

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Voscopoulos, C, Lema, M·2010·British Journal of Anaesthesia

DOI 10.1093/bja/aeq323

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Abstract

The transition from acute to chronic pain appears to occur in discrete pathophysiological and histopathological steps. Stimuli initiating a nociceptive response vary, but receptors and endogenous defence mechanisms in the periphery interact in a similar manner regardless of the insult. Chemical, mechanical, and thermal receptors, along with leucocytes and macrophages, determine the intensity, location, and duration of noxious events. Noxious stimuli are transduced to the dorsal horn of the spinal cord, where amino acid and peptide transmitters activate second-order neurones. Spinal neurones then transmit signals to the brain. The resultant actions by the individual involve sensory-discriminative, motivational-affective, and modulatory processes in an attempt to limit or stop the painful process. Under normal conditions, noxious stimuli diminish as healing progresses and pain sensation lessens until minimal or no pain is detected. Persistent, intense pain, however, activates secondary mechanisms both at the periphery and within the central nervous system that cause allodynia, hyperalgesia, and hyperpathia that can diminish normal functioning. These changes begin in the periphery with upregulation of cyclo-oxygenase-2 and interleukin-1β-sensitizing first-order neurones, which eventually sensitize second-order spinal neurones by activating N-methyl-d-aspartic acid channels and signalling microglia to alter neuronal cytoarchitecture. Throughout these processes, prostaglandins, endocannabinoids, ion-specific channels, and scavenger cells all play a key role in the transformation of acute to chronic pain. A better understanding of the interplay among these substances will assist in the development of agents designed to ameliorate or reverse chronic pain.

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Depression, anxiety and other psychological co-morbidities are risk factors for pain chronification.
“Since numerous studies have demonstrated that depression, anxiety and other psychological co-morbidities (e.g. catastrophization, poor coping skills) are risk factors for pain chronification [7, 12, 18]”
From Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study (2022) · cites this paper as [12]

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Authors' reply
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The lumbar spinal cord glial cells actively modulate subcutaneous formalin induced hyperalgesia in the rat
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Preventing Chronic Postsurgical Pain
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Non-Serratus-Sparing Antero-Axillary Thoracotomy With Disconnection of Anterior Rib Cartilage
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Long-Term Pain Vulnerability After Surgery in Rats: Prevention by Nefopam, an Analgesic with Antihyperalgesic Properties
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Spinal Microglial Expression and Mechanical Hypersensitivity in a Postoperative Pain Model: Comparison with a Neuropathic Pain Model
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The coding of noxious mechanical and thermal stimuli of deep dorsal horn neurones is attenuated in NK1 knockout mice
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Effects of neurotoxic destruction of descending noradrenergic pathways on cannabinoid antinociception in models of acute and tonic nociception
Gutierrez, T., Nackley, A. G., Neely, M. H., Freeman, K. G., Edwards, G. L., & Hohmann, A. G. (2003) · Brain Research · doi:10.1016/s0006-8993(03)03324-9 · Cited by 48 · see citing works
Telling the brain about pain
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A combination of gabapentin and local anaesthetics attenuates acute and late pain after abdominal hysterectomy
Fassoulaki, A., Melemeni, A., Stamatakis, E., Petropoulos, G., & Sarantopoulos, C. D. (2007) · European Journal of Anaesthesiology · doi:10.1017/s0265021506002134 · Cited by 45 · see citing works
Stressed-out endogenous cannabinoids relieve pain
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Sympathetic Influence on Capsaicin-Evoked Enhancement of Dorsal Root Reflexes in Rats
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Early and late morbidity after vasectomy: a comparison of chronic scrotal pain at 1 and 10 years
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Inflammation increases the excitability of masseter muscle afferents
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Inflammation alters sodium currents and excitability of temporomandibular joint afferents
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Spinal changes associated with mechanical hypersensitivity in a model of Guillain–Barré syndrome
Luongo, L., Sajic, M., Grist, J., Clark, A. K., Maione, S., & Malcangio, M. (2008) · Neuroscience Letters · doi:10.1016/j.neulet.2008.04.019 · Cited by 39 · see citing works
Psychological vulnerability as a predictor for short-term outcome in lumbar spine surgery
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Absorption and distribution of etoricoxib in plasma, CSF, and wound tissue in patients following hip surgery—a pilot study
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Cerebrospinal Fluid and Plasma Pharmacokinetics of the Cyclooxygenase 2 Inhibitor Rofecoxib in Humans: Single and Multiple Oral Drug Administration
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Intrathecal Infusion of Pyrrolidine Dithiocarbamate for the Prevention and Reversal of Neuropathic Pain in Rats Using a Sciatic Chronic Constriction Injury Model
Pan, Y., Guo, Q., Wang, E., Ye, Z., He, Z.-H., Zou, W., Cheng, Z., & Wang, Y. (2010) · Regional Anesthesia & Pain Medicine · doi:10.1097/aap.0b013e3181df245b · Cited by 28 · see citing works
Preclinical Research on Persistent Postsurgical Pain
Scholz, J., & Yaksh, T. L. (2010) · Anesthesiology · doi:10.1097/aln.0b013e3181cf4266 · Cited by 27 · see citing works
Experimental autoimmune neuritis induces differential microglia activation in the rat spinal cord
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Evidence for heritability of pain in patients with traumatic neuropathy
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Nociceptor structural specialization in canine and rodent testicular “free” nerve endings
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Long-term impact of neonatal intensive care and surgery on somatosensory perception in extremely preterm children
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Anesthetic blockade of the dorsolateral funiculus enhances evoked activity of spinal cord dorsal horn neurons
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Contributions of dorsal root reflex and axonal reflex to formalin-induced inflammation
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Reversing tissue injury—induced plastic changes in the spinal cord: The search for the magic bullet
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Assessment and manifestation of central sensitisation across different chronic pain conditions
Arendt‐Nielsen, L., Morlion, B., Perrot, S., Dahan, A., Dickenson, A., Kress, H. G., Wells, C., Bouhassira, D., & Drewes, A. M. (2018) · European Journal of Pain · doi:10.1002/ejp.1140 · Cited by 695 · see citing works
Music for pain relief
Cepeda, M. S., Carr, D. B., Lau, J., & Álvarez, H. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004843.pub2 · Cited by 432 · see citing works
Retracted
The transition of acute postoperative pain to chronic pain: an integrative overview of research on mechanisms
Chapman, C. R., & Vierck, C. J. (2017) · The Journal of Pain · doi:10.1016/j.jpain.2016.11.004 · Cited by 423 · see citing works
Morphine paradoxically prolongs neuropathic pain in rats by amplifying spinal NLRP3 inflammasome activation
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Acute pain: a multifaceted challenge – the role of nimesulide
Kress, H. G., Baltov, A., Basiński, A., Berghea, F., Castellsagué, J., Codreanu, C., Copaciu, E., Giamberardino, M. A., Hakl, M., Hrazdíra, L., et al. (2015) · Current Medical Research and Opinion · doi:10.1185/03007995.2015.1100986 · Cited by 321 · see citing works
Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury
Malanga, G. A., Yan, N., & Stark, J. (2014) · Postgraduate Medicine · doi:10.1080/00325481.2015.992719 · Cited by 313 · see citing works
The downward spiral of chronic pain, prescription opioid misuse, and addiction: Cognitive, affective, and neuropsychopharmacologic pathways
Garland, E. L., Froeliger, B., Zeidan, F., Partin, K., & Howard, M. O. (2013) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2013.08.006 · Cited by 277 · see citing works
Analgesic mechanisms of gabapentinoids and effects in experimental pain models: a narrative review
Chincholkar, M. (2018) · British Journal of Anaesthesia · doi:10.1016/j.bja.2018.02.066 · Cited by 220 · see citing works
Domains of Chronic Low Back Pain and Assessing Treatment Effectiveness: A Clinical Perspective
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The Role of the Dorsal Root Ganglion in the Development of Neuropathic Pain
Krames, E. S. (2014) · Pain Medicine · doi:10.1111/pme.12413 · Cited by 209 · see citing works
The neurobiology of skeletal pain
Mantyh, P. W. (2014) · European Journal of Neuroscience · doi:10.1111/ejn.12462 · Cited by 190 · see citing works
Surgically Induced Neuropathic Pain
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Brain-derived neurotrophic factor from microglia: a molecular substrate for neuropathic pain
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Chronification of Pain: Mechanisms, Current Understanding, and Clinical Implications
Pak, D., Yong, R. J., Kaye, A. D., & Urman, R. D. (2018) · Current Pain and Headache Reports · doi:10.1007/s11916-018-0666-8 · Cited by 172 · see citing works
ATP receptors gate microglia signaling in neuropathic pain
Trang, T., Beggs, S., & Salter, M. W. (2011) · Experimental Neurology · doi:10.1016/j.expneurol.2011.11.012 · Cited by 161 · see citing works
Identification of pain-related psychological risk factors for the development and maintenance of pediatric chronic postsurgical pain
Pagé, G., Stinson, Campbell, Isaac, & Katz, J. (2013) · Journal of Pain Research · doi:10.2147/jpr.s40846 · Cited by 159 · see citing works
Local and regional anaesthesia in dogs and cats: Overview of concepts and drugs (Part 1)
Grubb, T., & Lobprise, H. B. (2020) · Veterinary Medicine and Science · doi:10.1002/vms3.219 · Cited by 158 · see citing works
Influence of Centrally Mediated Symptoms on Postoperative Pain in Osteoarthritis Patients Undergoing Total Knee Arthroplasty: A Prospective Observational Evaluation
Kim, S. H., Yoon, K. B., Yoon, D. M., Yoo, J. H., & Ahn, K. R. (2015) · Pain Practice · doi:10.1111/papr.12311 · Cited by 153 · see citing works
Transition from Acute to Chronic Pain: Evaluating Risk for Chronic Postsurgical Pain
Wang, J. (2019) · Pain Physician · doi:10.36076/ppj/2019.22.479 · Cited by 151 · see citing works
Remifentanil during cardiac surgery is associated with chronic thoracic pain 1 yr after sternotomy
van Gulik, L., Ahlers, S. J. G. M., van de Garde, E. M. W., Bruins, P., van Boven, W. J., Tibboel, D., van Dongen, E. P. A., & Knibbe, C. A. J. (2012) · British Journal of Anaesthesia · doi:10.1093/bja/aes247 · Cited by 140 · see citing works
The in vitro mechanisms and in vivo efficacy of intravenous lidocaine on the neuroinflammatory response in acute and chronic pain
van der Wal, S. E. I., van den Heuvel, S. A. S., Radema, S. A., BERKUM, B. V., Vaneker, M., Steegers, M. A. H., Scheffer, G. J., & Vissers, K. C. P. (2015) · European Journal of Pain · doi:10.1002/ejp.794 · Cited by 132 · see citing works
Psychosocial predictors in the transition from acute to chronic pain: a systematic review
Hruschak, V., & Cochran, G. (2018) · Psychology Health & Medicine · doi:10.1080/13548506.2018.1446097 · Cited by 130 · see citing works
Associations of Socioeconomic Position and Pain Prevalence in the United States: Findings from the National Health and Nutrition Examination Survey
Riskowski, J. L. (2014) · Pain Medicine · doi:10.1111/pme.12528 · Cited by 123 · see citing works
Preventive analgesia
Dahl, J. B., & Kehlet, H. (2011) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0b013e328345afd9 · Cited by 116 · see citing works
Transition from acute to chronic pain
Feizerfan, A., & Sheh, G. (2014) · Continuing Education in Anaesthesia Critical Care & Pain · doi:10.1093/bjaceaccp/mku044 · Cited by 112 · see citing works
Treatment of Neuropathic Pain with Venlafaxine: A Systematic Review
Aiyer, R., Barkin, R. L., & Bhatia, A. (2016) · Pain Medicine · doi:10.1093/pm/pnw261 · Cited by 114 · see citing works
Acute Pain Medicine in the United States: A Status Report
Tighe, P. J., Buckenmaier, C. C., Boezaart, A. P., Carr, D. B., Clark, L., Herring, A. A., Kent, M. L., Mackey, S., Mariano, E. R., Polomano, R. C., et al. (2015) · Pain Medicine · doi:10.1111/pme.12760 · Cited by 110 · see citing works
Neonatal pain: What′s age got to do with it?
Hatfield, L. (2014) · Surgical Neurology International · doi:10.4103/2152-7806.144630 · Cited by 102 · see citing works
Managing Neuropathic Pain in Dogs
Moore, S. A. (2016) · Frontiers in Veterinary Science · doi:10.3389/fvets.2016.00012 · Cited by 96 · see citing works
Revisiting Tramadol: A Multi-Modal Agent for Pain Management
Barakat, A. (2019) · CNS Drugs · doi:10.1007/s40263-019-00623-5 · Cited by 95 · see citing works
Molecular targeting of NOX4 for neuropathic pain after traumatic injury of the spinal cord
Im, Y. B., Jee, M. K., Choi, J.-Y., Cho, H. T., Kwon, O. H., & Kang, S. (2012) · Cell Death and Disease · doi:10.1038/cddis.2012.168 · Cited by 83 · see citing works
The Acute to Chronic Pain Transition
Pozek, J.-P. J., Beausang, D. H., Baratta, J. L., & Viscusi, E. R. (2015) · Medical Clinics of North America · doi:10.1016/j.mcna.2015.08.005 · Cited by 78 · see citing works
Effects of intra‐operative maintenance of general anaesthesia with propofol on postoperative pain outcomes – a systematic review and meta‐analysis
Qiu, Q., Choi, S. W., Wong, S. S. C., Irwin, M. G., & Cheung, C. W. (2016) · Anaesthesia · doi:10.1111/anae.13578 · Cited by 77 · see citing works
Activation of PPAR-γ induces macrophage polarization and reduces neutrophil migration mediated by heme oxygenase 1
Abdalla, H. B., Napimoga, M. H., Lopes, A. H., Maganin, A. G. M., Cunha, T. M., Dyke, T. E. V., & Clemente‐Napimoga, J. T. (2020) · International Immunopharmacology · doi:10.1016/j.intimp.2020.106565 · Cited by 76 · see citing works
A Role for Superficial Heat Therapy in the Management of Non-Specific, Mild-to-Moderate Low Back Pain in Current Clinical Practice: A Narrative Review
Freiwald, J., Magni, A., Fanlo-Mazas, P., Paulino, E., de Medeiros, L. S., Moretti, B., Schleip, R., & Solarino, G. (2021) · Life · doi:10.3390/life11080780 · Cited by 85 · see citing works
Postoperative pain impairs subsequent performance on a spatial memory task via effects on N-methyl-d-aspartate receptor in aged rats
Chi, H., Kawano, T., Tamura, T., Iwata, H., Takahashi, Y., Eguchi, S., Yamazaki, F., Kumagai, N., & Yokoyama, M. (2013) · Life Sciences · doi:10.1016/j.lfs.2013.10.028 · Cited by 74 · see citing works
Intravenous Ibuprofen for Treatment of Post-Operative Pain: A Multicenter, Double Blind, Placebo-Controlled, Randomized Clinical Trial
Gago, A., Rodríguez, B. A. E., Roca, A. P., & Ruiz, A. M. (2016) · PLoS ONE · doi:10.1371/journal.pone.0154004 · Cited by 71 · see citing works
<p>A Conceptual Model of Biopsychosocial Mechanisms of Transition from Acute to Chronic Postsurgical Pain in Children and Adolescents</p>
Rabbitts, J. A., Palermo, T. M., & Lang, E. A. (2020) · Journal of Pain Research · doi:10.2147/jpr.s239320 · Cited by 70 · see citing works
mTOR Kinase: A Possible Pharmacological Target in the Management of Chronic Pain
Lisi, L., Aceto, P., Navarra, P., & Russo, C. D. (2015) · BioMed Research International · doi:10.1155/2015/394257 · Cited by 69 · see citing works
Uses of fluoxetine in nociceptive pain management: A literature overview
Barakat, A., Hamdy, M. M., & Elbadr, M. M. (2018) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2018.03.042 · Cited by 65 · see citing works
Sleep Well and Recover Faster with Less Pain—A Narrative Review on Sleep in the Perioperative Period
Sipilä, R. M., & Kalso, E. A. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10092000 · Cited by 67 · see citing works
Effective analgesia with low-dose ketamine and reduced dose hydromorphone in ED patients with severe pain
Ahern, T. L., Herring, A. A., Stone, M. B., & Frazee, B. W. (2013) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2013.02.008 · Cited by 65 · see citing works
Pain-related psychological correlates of pediatric acute post-surgical pain
Pagé, M. G., Stinson, J., Campbell, Isaac, & Katz, J. D. (2012) · Journal of Pain Research · doi:10.2147/jpr.s36614 · Cited by 64 · see citing works
Magnesium sulphate attenuates acute postoperative pain and increased pain intensity after surgical injury in staged bilateral total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial
Shin, H., Kim, E.-Y., Na, H.-S., Kim, T. K., Kim, M. H., & Do, S.-H. (2016) · British Journal of Anaesthesia · doi:10.1093/bja/aew227 · Cited by 64 · see citing works
The first 500: initial experience with widespread use of low-dose ketamine for acute pain management in the ED
Ahern, T. L., Herring, A. A., Anderson, E. S., Madia, V. A., Fahimi, J., & Frazee, B. W. (2014) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2014.11.010 · Cited by 63 · see citing works
Comparison of anterior cingulate vs. insular cortex as targets for real-time fMRI regulation during pain stimulation
Emmert, K., Breimhorst, M., Bauermann, T., Birklein, F., Ville, D. V. D., & Haller, S. (2014) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2014.00350 · Cited by 60 · see citing works
Chronic Poststernotomy Pain
Kleiman, A. M., Sanders, D. T., Nemergut, E. C., & Huffmyer, J. L. (2017) · Regional Anesthesia & Pain Medicine · doi:10.1097/aap.0000000000000663 · Cited by 61 · see citing works
Glutamatergic systems in neuropathic pain and emerging non-opioid therapies
Temmermand, R., Barrett, J. E., & Fontana, A. C. K. (2022) · Pharmacological Research · doi:10.1016/j.phrs.2022.106492 · Cited by 59 · see citing works
Oral non-steroidal anti-inflammatory drugs (single dose) for perineal pain in the early postpartum period
Wuytack, F., Smith, V. A., & Cleary, B. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011352.pub2 · Cited by 59 · see citing works
Measurement of chronic pain in companion animals: Discussions from the Pain in Animals Workshop (PAW) 2017
Lascelles, B. D. X., Brown, D. C., Conzemius, M. G., Gill, M., Oshinsky, M. L., & Sharkey, M. (2019) · The Veterinary Journal · doi:10.1016/j.tvjl.2019.07.001 · Cited by 59 · see citing works
The Emerging Role of Spinal Dynorphin in Chronic Pain: A Therapeutic Perspective
Podvin, S., Yaksh, T. L., & HOOK, V. Y. H. (2016) · The Annual Review of Pharmacology and Toxicology · doi:10.1146/annurev-pharmtox-010715-103042 · Cited by 56 · see citing works
The Major Brain Endocannabinoid 2-AG Controls Neuropathic Pain and Mechanical Hyperalgesia in Patients with Neuromyelitis Optica
Pellkofer, H., Havla, J. B., Hauer, D., Schelling, G., Azad, S. C., Kümpfel, T., Magerl, W., & Huge, V. (2013) · PLoS ONE · doi:10.1371/journal.pone.0071500 · Cited by 56 · see citing works
Randomized Controlled Trial on the Influence of Intraoperative Remifentanil versus Fentanyl on Acute and Chronic Pain after Cardiac Surgery
de Hoogd, S., Ahlers, S. J. G. M., van Dongen, E. P. A., van de Garde, E. M. W., Daeter, E. J., Dahan, A., Tibboel, D., & Knibbe, C. A. J. (2017) · Pain Practice · doi:10.1111/papr.12615 · Cited by 55 · see citing works
An update on analgesics
Power, I. (2011) · British Journal of Anaesthesia · doi:10.1093/bja/aer126 · Cited by 55 · see citing works
Stress and pain response after oligofructose induced-lameness in dairy heifers
Bustamante, H., Rodríguez, A. R., Herzberg, D. E., & Werner, M. P. (2015) · Journal of Veterinary Science · doi:10.4142/jvs.2015.16.4.405 · Cited by 54 · see citing works
RETRACTED ARTICLE: Anti-hyperalgesic properties of a flavanone derivative Poncirin in acute and chronic inflammatory pain models in mice
Afridi, R., Khan, A. U., Khalid, S., Shal, B., Rasheed, H., Ullah, M. Z., Shehzad, O., Kim, Y. S., & Khan, S. (2019) · BMC Pharmacology and Toxicology · doi:10.1186/s40360-019-0335-5 · Cited by 53 · see citing works
Retracted
Nociception and role of immune system in pain
Verma, V., Sheikh, Z., & Ahmed, A. S. (2014) · Acta Neurologica Belgica · doi:10.1007/s13760-014-0411-y · Cited by 55 · see citing works
Preemptive analgesia with Ketamine for Laparoscopic cholecystectomy
Singh, H., Kundra, S., Singh, R., Grewal, A., Kaul, T., & Sood, D. (2013) · Journal of Anaesthesiology Clinical Pharmacology · doi:10.4103/0970-9185.119141 · Cited by 52 · see citing works
Chronic Pain after Lower Abdominal Surgery: Do Catechol-O-Methyl Transferase/Opioid Receptor μ−1 Polymorphisms Contribute?
Kolesnikov, Y. A., Gabovits, B., Levin, A., Veske, A., Li, Q., Dai, F., & Belfer, I. (2013) · Molecular Pain · doi:10.1186/1744-8069-9-19 · Cited by 52 · see citing works
Pain and sensitization after total knee replacement or nonsurgical treatment in patients with knee osteoarthritis: Identifying potential predictors of outcome at 12 months
Arendt‐Nielsen, L., Simonsen, O., Laursen, M. B., Roos, E. M., Rathleff, M. S., Rasmussen, S., & Skou, S. T. (2018) · European Journal of Pain · doi:10.1002/ejp.1193 · Cited by 51 · see citing works
Acute Pain Is Associated With Chronic Opioid Use After Total Knee Arthroplasty
Hsia, H.-L. J., Takemoto, S. K., de Ven, T. V., Pyati, S., Buchheit, T., Ray, N. D., Wellman, S. S., Kuo, A. C., Wallace, A. W., & Raghunathan, K. (2018) · Regional Anesthesia & Pain Medicine · doi:10.1097/aap.0000000000000831 · Cited by 51 · see citing works
Social impairment of individuals suffering from different types of chronic orofacial pain
Cioffi, I., Perrotta, S., Ammendola, L., Cimino, R., Vollaro, S., Paduano, S., & Michelotti, A. (2014) · Progress in Orthodontics · doi:10.1186/s40510-014-0027-z · Cited by 49 · see citing works
Acute to chronic pain transition in extremity trauma: A narrative review for future preventive interventions (part 2)
Berube, M., Choinière, M., Laflamme, Y. G., & Gélinas, C. (2016) · International Journal of Orthopaedic and Trauma Nursing · doi:10.1016/j.ijotn.2016.04.001 · Cited by 50 · see citing works
Painful temporomandibular disorders and central sensitization: implications for management—a pilot study
Campi, L. B., Jordani, P. C., Tenan, H. L., Camparis, C. M., & Gonçalves, D. A. D. G. (2016) · International Journal of Oral and Maxillofacial Surgery · doi:10.1016/j.ijom.2016.07.005 · Cited by 47 · see citing works
Mechanisms behind the Development of Chronic Low Back Pain and Its Neurodegenerative Features
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Provoked vestibulodynia: current perspectives
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Authors: Voscopoulos, C., & Lema, M.
Affiliations: University at Buffalo, State University of New York (US)
Venue: British Journal of Anaesthesia
Publisher: Elsevier BV
Published: 2010-12
Volume: 105
Pages: i69-i85
ISSN: 0007-0912 (ISSN-L)
DOI: 10.1093/bja/aeq323
OpenAlex: W2124105819
Cited by: 473
References: 207
Citations by year: 2026: 16 · 2025: 29 · 2024: 26 · 2023: 39 · 2022: 38 · 2021: 33 · 2020: 38 · 2019: 27 · 2018: 29 · 2017: 36 · 2016: 48 · 2015: 35 · 2014: 23 · 2013: 27 · 2012: 16
FWCI: 1.78
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 2560 d)
Locations: British Journal of Anaesthesia (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords: acute pain, chronic pain, pain transition, nociception, dorsal horn, spinal cord, cyclooxygenase-2, IL-1β, NMDA receptor, microglia, allodynia, hyperalgesia, hyperpathia, prostaglandins, endocannabinoids, ion channels, pain modulation, analgesic drug development
MeSH terms: Acute Disease, Chronic Disease, Humans, Neural Pathways, Neuralgia, Neuronal Plasticity, Pain, Pain, Postoperative, Postoperative Pain, Signal Transduction, Disease Progression

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