The DOI matches its Crossref record; 203 of the 207 references it cites were found in a registry or an index.
When does acute pain become chronic?
Open accessAbstract
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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“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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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
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Acute pain: a multifaceted challenge – the role of nimesulide
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Metadata
- 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)
- 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
- Locations
- British Journal of Anaesthesia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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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