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Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states

Yarnitsky, David·2010·Current Opinion in Anaesthesiology

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Abstract

PURPOSE OF REVIEW: There is a growing body of knowledge on pain modulation in various disease states. This article reviews the state of the art regarding the clinical relevance of pain inhibition as revealed by 'pain inhibits pain' test paradigms, trying to organize the clinically relevant data, and emphasizing the pathophysiology of pain. In line with recent experts' recommendations, the term conditioned pain modulation (CPM) will be used, replacing the previous terms 'diffuse noxious inhibitory control (DNIC)' or 'DNIC-like' effects. RECENT FINDINGS: Most of the work in this context was done on the idiopathic pain syndromes, such as irritable bowel syndrome, temporomandibular disorders, fibromyalgia, and tension type headache. The pattern of reduced CPM efficiency seems common to these syndromes and an assertion is made that low CPM efficiency, reflecting low pain inhibitory capacity, is a pathogenetic factor in the development of the idiopathic pain syndromes. Low CPM efficiency was shown to be predictive of acute and chronic postoperative pain, and, in some reports, to be associated with neuropathic pain levels. SUMMARY: Low CPM efficiency is associated with higher pain morbidity and vice versa. Further work is awaited on clarifying plasticity of CPM and its relevance to selection and efficacy of pain therapy.

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Authors: Yarnitsky, D.
Affiliations: Technion – Israel Institute of Technology (IL)
Corresponding author: Yarnitsky, David
ORCID: Yarnitsky, David
Venue: Current Opinion in Anaesthesiology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2010-10
Volume: 23
Issue: 5
Pages: 611-615
ISSN: 0952-7907 (ISSN-L)
DOI: 10.1097/aco.0b013e32833c348b
OpenAlex: W2004607543
Cited by: 745
References: 38
Citations by year: 2026: 39 · 2025: 42 · 2024: 43 · 2023: 38 · 2022: 55 · 2021: 62 · 2020: 55 · 2019: 57 · 2018: 58 · 2017: 61 · 2016: 51 · 2015: 38 · 2014: 54 · 2013: 54 · 2012: 22
FWCI: 2.95
Type: journal article
Language: en
Open access: closed
Locations: Current Opinion in Anaesthesiology (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 › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords: conditioned pain modulation, diffuse noxious inhibitory control, pain inhibition, fibromyalgia, irritable bowel syndrome, temporomandibular disorders, tension-type headache, postoperative pain, neuropathic pain, pain pathophysiology, pain management
MeSH terms: Acute Disease, Mental Disorders, Chronic Disease, Conditioning, Psychological, Humans, Terminology as Topic, Pain, Pain, Postoperative, Postoperative Pain, Peripheral Nervous System Diseases

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Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states

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