Clinical and Preclinical Molecular Imaging in Chronic Pain—Implications for Analgesic Use and Misuse

Abstract Analgesic misuse is a major and expensive health issue. Among several others, the inability to identify chronic-pain-generating foci is a contributing factor, leading to empirical treatments and interventions. Chronicity of pain occurs because of maladaptive cellular and molecular changes in the nervous system, which are divorced from the initial injury, if any. Clinical imaging techniques used currently depend on discovering anatomic abnormalities and, thus, are not sufficiently specific or sensitive to pinpoint causes of chronic pain. Molecular imaging can detect functional abnormalities that are a part of the maladaptive pathology of chronic pain syndromes. This chapter describes various molecular imaging techniques used to image pain processing and perception in the central nervous system, as well as pain generation in the peripheral nervous system.