Why Does Pain Persist After Healing?

HPHR Paper · Intermediate

Pain Doesn’t Only Travel Up

Pain has traditionally been explained as an ascending process in which nociceptive information travels from injured tissues through the spinal cord to the brain. Although this model accurately describes an important component of pain physiology, contemporary neuroscience has demonstrated that it represents only part of a far more dynamic system. A substantial body of experimental and human neuroimaging research has established that the brain continuously influences spinal nociceptive processing through descending pathways that regulate, facilitate, or inhibit sensory transmission before it contributes to conscious pain perception.¹–³ Appreciating these descending regulatory systems fundamentally changes the way persistent pain is understood and broadens the questions clinicians should ask during assessment.