NEUROPATHIC PAIN-PERIPHERAL MECHANISMS

SUMMARY

1. Sensitization of nociceptors by local chemical inflammatory changes (substance P, serotonin, bradykinin, histamine, COX and lipoxygenase pathways).

2. Ectopic activity from damaged, demyelinated, or regenerating nerve sprouts.

3. Noradrenergic sensitivity.
4. Lowering of neuronal threshold for firing at ectopic areas by accumulation of Na⁺ and Ca²⁺ channels.

5. Changes at the more proximal dorsal root ganglion (spontaneous activity).

6. Loss of central GABAergic inhibition.

7. Opioid receptor down-regulation.

8. Interneuron cell death.

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.