Health Information
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Understanding This Symptom
Medical Definition
Subject Matter Expert Verified
Chronic pain is defined as pain persisting beyond the normal healing time of 3 months, lasting more than 6 months, or recurring at intervals over months or years.
It results from complex interactions between the nervous system, immune system, and brain's pain processing centers, where the pain signaling becomes dysfunctional and no longer serves a protective purpose.
This condition affects approximately 20% of the global population and significantly impacts quality of life, mental health, and functional capacity.
Quick Facts
What Optimal Health Looks Like
Understanding how your body functions when healthy helps identify dysfunction
In a healthy nervous system, nociceptors (pain receptors) detect potentially damaging stimuli including heat, mechanical pressure, and chemical signals, converting these into electrical signals that travel through A-delta (fast, sharp pain) and C-fiber (slow, dull pain) afferent nerves to the dorsal horn of the spinal cord.
The thalamus acts as a relay station, projecting pain signals to the somatosensory cortex for pain localization, the anterior cingulate cortex for emotional pain processing, and the prefrontal cortex for cognitive appraisal.
Descending modulatory pathways from the brainstem release endogenous opioids (endorphins, enkephalins) and serotonin/norepinephrine to inhibit pain signals at the spinal level, providing natural pain relief.
The HPA axis mounts appropriate stress responses without chronic activation.
Healthy Function
Your body is designed to maintain balance and self-regulate
How This Develops
Central Sensitization - prolonged nociceptive input leads to hyperexcitability of dorsal horn neurons, lowering pain thresholds and expanding receptive fields through wind-up phenomenon and long-term potentiation; (
Neuroplasticity - the brain's pain matrix (including insula, anterior cingulate, prefrontal cortex, thalamus) undergoes structural and functional reorganization, creating a persistent pain memory; (
Descending Pathway Dysfunction - impaired modulatory pathways fail to inhibit pain signals, reducing endogenous opioid release and serotonin/norepinephrine analgesia; (
Glial Cell Activation - microglia and astrocytes in the spinal cord and brain become persistently activated, releasing pro-inflammatory cytokines (IL-
Neurotransmitter Imbalance - elevated glutamate and substance P combined with reduced GABA create a state of neuronal hyperexcitability; (
NMDA Receptor Hyperactivity - calcium influx through NMDA receptors amplifies pain signals and contributes to central sensitization; (
Autonomic Nervous System Dysregulation - elevated sympathetic tone and reduced parasympathetic function maintain a state of physiological hyperarousal
Understanding the mechanism helps us target the root cause rather than just treating symptoms.
What Happens If Left Untreated
Understanding the consequences helps you make informed decisions about your health
Short-Term Consequences
Days to weeks
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Time Matters
Don't wait for symptoms to worsen. Early intervention leads to better outcomes.