Neurobiology of Acute and Chronic Pain

Pain is a complex phenomenon that may involve both peripheral and central neurobiological processes. Nociception is the unconscious registration of a noxious stimulus by the nervous system, while pain is a conscious experience. Neurobiological correlates of pain perception have been characterized from the initial point of tissue damage to its realization in the brain. Importantly, various pharmacological and psychological interventions exist that can target various points along this pathway. Evidence shows the nervous system remodels in response to chronic pain. More evidence-based treatments showing efficacy for chronic pain conditions are needed. Finally, an individualized and multidisciplinary approach in concordance with the biopsychosocial model of illness is often advocated. The neuroanaesthetist requires a nuanced understanding of pain, since many patients presenting for neurosurgical procedures suffer chronic pain.