Mechanisms of sympathetic pain

McMahon, S B

doi:10.1093/oxfordjournals.bmb.a072494

Cited by 94Pain Mechanisms and TreatmentsPain Management and TreatmentIon Channels and Receptors

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Mechanisms of sympathetic pain

McMahon, S B·1991·British Medical Bulletin

DOI 10.1093/oxfordjournals.bmb.a072494

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Abstract

In some chronic pain states, notably causalgia and reflex sympathetic dystrophy, activity in sympathetic efferent neurones can exacerbate the pain and sympathectomies relieve it. These patients are said to have sympathetically maintained pain (SMP). In normal tissue, activity in postganglionic sympathetic efferents does not produce pain, nor is it capable of activating nociceptive sensory neurones. It can, however, induce modest firing in some mechanoreceptors. SMP is often held to result from a vicious circle of events which include changes in peripheral and central somatosensory processes, and most importantly a positive feedback element in the form of sympathetic efferent neurones which, by activating sensory neurones in the periphery, completes the vicious circle. Several specific hypotheses have been advanced as to the primary pathophysiological cause of pain in these patients. Suggestions, largely deriving from observations on animal models, include: ephaptic transmission, adrenergic receptors on sensory neurones, indirect coupling of sympathetic and sensory neurones, sensitization of nociceptive afferents, and, in the central nervous system, sensitization of dorsal horn neurones. All these suggestions have some supporting evidence, but none are able to adequately explain all the disturbances seen in patients with SMP.

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From Endocannabinoid involvement in endometriosis. (2010) · cites this paper as [36]

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Authors: McMahon, S. B.
Affiliations: St Thomas' Hospital (GB)
Corresponding author: McMahon, S B
ORCID: McMahon, S B
Venue: British Medical Bulletin
Publisher: Oxford University Press (OUP)
Published: 1991-07
Volume: 47
Issue: 3
Pages: 584-600
ISSN: 0007-1420 (ISSN-L)
1471-8391
DOI: 10.1093/oxfordjournals.bmb.a072494
OpenAlex: W1906123128
Cited by: 93
References: 0
Citations by year: 2026: 1 · 2024: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2017: 3 · 2016: 1 · 2015: 2 · 2014: 3 · 2013: 3 · 2012: 3
FWCI: 1.69
Type: journal article
Language: en
Open access: closed
Locations: British Medical Bulletin (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Life Sciences › Neuroscience › Sensory Systems › Ion Channels and Receptors
Keywords: sympathetically maintained pain, complex regional pain syndrome, causalgia, nociceptors, ephaptic transmission, pain pathophysiology
MeSH terms: Chronic Disease, Humans, Models, Neurological, Pain, Sympathetic Nervous System

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Mechanisms of sympathetic pain

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