The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.
New developments in the understanding and management of persistent pain
Abstract
PURPOSE OF REVIEW: It is proposed that central rather than peripheral factors may be important in pain chronicity. We review recent empirical findings on these processes and discuss implications for treatment and prevention. RECENT FINDINGS: The literature on neuroimaging of pain and on learning processes shows that learning-induced functional and structural brain changes involving sensorimotor, as well as limbic and frontal, areas are important in the transition from acute to chronic pain. These alterations share many similarities with brain changes in emotional disorders and the specificity for pain needs to be determined. Further important contributors to chronic pain may be disturbed processing of the body image, impaired multisensory integration and faulty feedback from interoceptive processes. These findings have led to new treatment approaches that focus on the extinction of aversive memories, restoration of the body image and normal brain function and include approaches such as brain stimulation, mirror training, virtual reality applications or behavioral extinction training. SUMMARY: We propose that chronic pain is characterized by learning-related and memory-related plastic changes of the central nervous system with concomitant maladaptive changes in body perception. These alterations require new treatments that focus on the alteration of central pain memories and maladaptive body perception.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“GL challenges harm expectations that cause fear and avoidance, which have a particularly salient influence on pain-related functional outcomes[14; 52; 70; 71] and treatment responsiveness[54].”
From A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain (2024) · cites this paper as [14]
Citations
Cites
Harnessing neuroplasticity for clinical applications
Cramer, S. C., Sur, M., Dobkin, B. H., O'Brien, C., Sanger, T. D., Trojanowski, J. Q., Rumsey, J. M., Hicks, R., Cameron, J., Chen, D., et al. (2011) · Brain · doi:10.1093/brain/awr039 · Cited by 1,259
Legrain, V., Iannetti, G. D., Plaghki, L., & Mouraux, A. (2011) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2010.10.005 · Cited by 854
Pain and the brain: specificity and plasticity of the brain in clinical chronic pain
Apkarian, V. A., Hashmi, J. A., & Baliki, M. N. (2011) · Pain · doi:10.1016/j.pain.2010.11.010 · Cited by 782
Baliki, M. N., Chialvo, D. R., Geha, P. Y., Levy, R. M., Harden, R. N., Parrish, T. B., & Apkarian, A. V. (2006) · The Journal of Neuroscience · doi:10.1523/jneurosci.3576-06.2006 · Cited by 756
The use of visual feedback, in particular mirror visual feedback, in restoring brain function
Ramachandran, V., & Altschuler, E. L. (2009) · Brain · doi:10.1093/brain/awp135 · Cited by 747
Reversing pathological neural activity using targeted plasticity
Engineer, N. D., Riley, J. R., Seale, J. D., Vrana, W. A., Shetake, J. A., Sudanagunta, S. P., Borland, M. S., & Kilgard, M. P. (2011) · Nature · doi:10.1038/nature09656 · Cited by 662
Intrinsic brain connectivity in fibromyalgia is associated with chronic pain intensity
Napadow, V., LaCount, L., Park, K., As‐Sanie, S., Clauw, D. J., & Harris, R. E. (2010) · Arthritis & Rheumatism · doi:10.1002/art.27497 · Cited by 645
Phantom percepts: Tinnitus and pain as persisting aversive memory networks
Ridder, D. D., Elgoyhen, A. B., Romo, R., & Langguth, B. (2011) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1018466108 · Cited by 635
Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function
Seminowicz, D. A., Wideman, T. H., Naso, L., Hatami-Khoroushahi, Z., Fallatah, S., Ware, M. A., Jarzem, P., Bushnell, M. C., Shir, Y., Ouellet, J. A., et al. (2011) · The Journal of Neuroscience · doi:10.1523/jneurosci.5280-10.2011 · Cited by 622
A multisensory investigation of the functional significance of the “pain matrix”
Mouraux, A., Diukova, A., Lee, M., Wise, R. G., & Iannetti, G. D. (2010) · NeuroImage · doi:10.1016/j.neuroimage.2010.09.084 · Cited by 581
Research works printed but not linked: 1
- Flor, 2006, Phantom limb pain: a case of maladaptive CNS plasticity Nat Rev, Neurosci, 7, 873
Cited by
Sorted by citations
Items 101–125 of 125
Power, C. K., Galvin, D., Foto, T., Mahmoud, A. A. A., & Kostopoulos, N. G. (2019) · Pain Studies and Treatment · doi:10.4236/pst.2019.73003 · Cited by 1
Complex Regional Pain Syndrome
Stralka, S. W. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-52479-7.00037-5 · Cited by 1
Psychological Approaches to the Management of Pain, Cognition and Emotion
Nicholas, M. K. (2015) · Springer eBooks · doi:10.1007/978-3-319-12033-1_10
GPCR models of pain in cardiovascular diseases: Contributions of kinins and endothelins
Houde, M., Semaan, W., Rae, G. A., & D’Orléans-Juste, P. (2012) · Drug Discovery Today Disease Models · doi:10.1016/j.ddmod.2012.07.002
Symptom-specific neurorehabilitation: sensory and motor dysfunctions
Selzer, M. E., Clarke, S., Cohen, L. G., Kwakkel, G., & Miller, R. H. (2014) · Cambridge University Press eBooks · doi:10.1017/cbo9780511995590.028
Steck, A. J., & Steck, B. (2015) · Springer eBooks · doi:10.1007/978-3-319-21287-6_11
The essence of the experience of chronic pain
Ojala, T. (2016) · Manual Therapy · doi:10.1016/j.math.2016.05.319
Shipton, E. A. (2016) · Springer eBooks · doi:10.1007/978-3-319-28821-5_19
Yoga Therapy Langhana Breathing Practice for Chronic Pain Management
Binello, G., Luca, S. D., Nastri, M., Mazzola, A., Calcagno, M. D. L., & Honorio, J. (2016)
Chronic Pain, Diathesis-Stress Model of
Flor, H. (2013) · Springer eBooks · doi:10.1007/978-3-642-28753-4_1099
Self-citation(2019) · Elsevier eBooks · doi:10.1016/b978-3-437-21882-8.00017-7
Simons, L. E., Hess, C. W., Choate, E., Orden, A. R. V., Tremblay-McGaw, A. G., Menendez, M., Boothroyd, D. B., Parvathinathan, G., Griffin, A. T., Caruso, T. J., et al. (2022) · doi:10.2196/preprints.40705
Wauters, A., Ryckeghem, D. M. L. V., Noel, M. E., Mueri, K., Soltani, S., & Vervoort, T. (2024) · Pain · doi:10.1097/j.pain.0000000000003263
Ko, P.-S., Lee, M.-C., Chen, Y.-H., Lien, S.-B., Chen, C., Wang, C.-C., Fan, W.-H., Chen, Y., & Su, S. (2025) · Medicine · doi:10.1097/md.0000000000042239
(2022) · Elsevier eBooks · doi:10.1016/b978-3-437-21884-2.00033-7
Chronic pain is linked to a resting-state neural archetype that optimizes learning from punishmentsPreprint
Scarlatti, F., Dormegny-Jeanjean, L. C., Schefzik, R., Banaschewski, T., Bokde, A. L. W., Brühl, R., Desrivières, S., Garavan, H., Gowland, P. A., Grigis, A., et al. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.07.11.664303 · Cited by 1
Self-citationNeural and psychosocial signatures of the comorbidity between pain and affective symptoms
Scarlatti, F., Dormegny-Jeanjean, L. C., Schefzik, R., Foucher, J., Banaschewski, T., Bokde, A. L. W., Brühl, R., Desrivières, S., Garavan, H., Gowland, P. A., et al. (2025) · PAIN Reports · doi:10.1097/pr9.0000000000001353 · Cited by 1
Self-citationBeiner, E., Baumeister, D., Buhai, D.-V., Löffler, M., Löffler, A., Schick, A., Ader, L., Eich, W., Sirazitdinov, A., Malone, C., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26552533
Self-citationCoulombe-Lévêque, A., Bonin, R. P., & Léonard, G. (2026) · Pain · doi:10.1097/j.pain.0000000000004013 · Cited by 1
Coulombe-Lévêque, A., Lafrenaye, S., Brunet, A., Morin, M., Marchand, S., & Léonard, G. (2026) · Journal of Pain · doi:10.1016/j.jpain.2026.106375
Tagaras, K., Pandria, N., Reppou, S. E., Bamidis, P. D., & Antoniou, P. E. (2026) · Springer proceedings in business and economics · doi:10.1007/978-3-032-11983-4_27
Touche, R. L., Cuenca‐Martínez, F., Hernández, J. V., Paris‐Alemany, A., Sorrel, M. Á., & Reina‐Varona, Á. (2026) · Pain Research and Management · doi:10.1155/prm/5805413
Virtuell kognitiv-perzeptives Heimtrainingsprogramm bei chronischen Schmerzen der oberen Extremität
Lamprecht, J., Flöther, L., Fischer, A., & Saal, S. (2026) · Der Schmerz · doi:10.1007/s00482-026-00970-5
Lyndon, S., & Nedeljkovic, S. (2026) · Pain · doi:10.1097/j.pain.0000000000004123
Metadata
- Authors
- Flor, H.
- Affiliations
- Heidelberg University (DE)
- Corresponding author
- Flor, Herta
- ORCID
- Flor, Herta
- Venue
- Current Opinion in Psychiatry
- Published
- 2012-03
- Volume
- 25
- Issue
- 2
- Pages
- 109-113
- ISSN
- 0951-7367 (ISSN-L)
- OpenAlex
- W2076438733
- Cited by
- 125
- References
- 28
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 8 · 2023: 6 · 2022: 13 · 2021: 7 · 2020: 4 · 2019: 9 · 2018: 8 · 2017: 10 · 2016: 11 · 2015: 11 · 2014: 11 · 2013: 8 · 2012: 4
- FWCI
- 14.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Keywords
- chronic pain, central sensitization, neuroplasticity, pain memory, extinction training, body image, multisensory integration, interoception, mirror training, virtual reality, brain stimulation, neuroimaging of pain, transition from acute to chronic pain, pain management
- MeSH terms
- Body Image, Brain, Conditioning, Operant, Humans, Neuronal Plasticity, Perception, Self Concept, Empirical Research, Chronic Pain, Pain Management, Neuroimaging
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
