The physiology of pain

Abstract This article reviews the basic anatomy and physiology of the normal pain system. During recent years, our knowledge of the pain system has been expanded, with increasing insight into the peripheral and central mechanisms underlying both acute and chronic pain. Several differences in the pain system exist for superficial and deep pain. Descending control mechanisms seem to be important in controlling pain, and neuroplastic changes with central reorganisation are frequently seen in patients suffering from pain. This new knowledge will help in understanding and treating patients with chronic pain syndromes.