A Review of Select Centralized Pain Syndromes

• Main Authors: David R. Spiegel, Aparna Chatterjee, Aidan L. McCroskey, Tamana Ahmadi, Drew Simmelink, Edward C. Oldfield, Christopher R. Pryor, Michael Faschan, Olivia Raulli
• Format: Article
• Language: English
• Published: SAGE Publishing 2015-01-01
• Series: Health Services Research & Managerial Epidemiology
• Online Access: https://doi.org/10.1177/2333392814567920

Pain can be broadly divided into 3 classes, including nociceptive or inflammatory pain (protective), neuropathic (pathological, occurring after damage to the nervous system), or centralized (pathological, due to abnormal function but with no damage or inflammation to the nervous system). The latter has been posited to occur when descending analgesic pathways are attenuated and/or glutamatergic transmission is facilitated. Additionally, this “pain prone phenotype” can be associated with early life trauma and a suboptimal response to opiates. This article will review the relationships between centralized pain syndromes (ie, fibromyalgia, chronic low back pain), childhood sexual abuse, and opiate misuse. Finally, treatment implications, potentially effecting primary care physicians, will be discussed.