PAIN-MODULATION

SUMMARY

1. Several ascending pathways are involved in transferring and modulating nociceptive input.
2. Neurotransmitter release depends on ligand-gated or voltage-gated channels.

FIBERS
3. Aδ and C fibers convey nociceptive information primarily to superficial laminae (I and II) and deep laminae (V and VI) of the dorsal horn.
4. Aβ fibers transmit innocuous, mechanical stimuli to deeper laminae (III through VI).

LAMINAE
5. Lamina I plays an important role in relaying information on the current state of tissues.

WIND-UP
6. Amplified evoked response due to prolonged depolarization of the postsynaptic cell which causes voltage-dependent magnesium removal & allowing additional sodium and calcium to enter the cell.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.