title: Scratching the surface: the processing of pain from deep tissues.
abstract: Although most pain research focuses on skin, muscles, joints and viscerae are major sources of pain. We discuss the mechanisms of deep pains arising from somatic and visceral structures and how this can lead to widespread manifestations and chronification. We include how both altered peripheral and central sensory neurotransmission lead to deep pain states and comment on key areas such as top-down modulation where little is known. It is vital that the clinical characterization of deep pain in patients is improved to allow for back translation to preclinical models so that the missing links can be ascertained. The contribution of deeper somatic and visceral tissues to various chronic pain syndromes is common but there is much we need to know.
authors.affiliation: Department of Neuroscience, Physiology & Pharmacology, University College London, Gower Street, London, WC1E 6BT, UK.
authors.forename: Shafaq
authors.initials: S
authors.lastname: Sikandar
authors.affiliation: Section for Surgical Pathophysiology, Julianne Marie Centre, Rigshospitalet, Copenhagen University, Copenhagen 2100 KBH Ø, Denmark.
authors.forename: Eske Kvanner
authors.initials: EK
authors.lastname: Aasvang
authors.affiliation: Department of Neuroscience, Physiology & Pharmacology, University College London, Gower Street, London, WC1E 6BT, UK.
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Dickenson
mesh_terms: D059350:Chronic Pain / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D007596:Joints / Q000503:physiopathology; D009132:Muscles / Q000503:physiopathology; D059225:Nociception / Q000502:physiology*; D017933:Peripheral Nervous System / Q000503:physiopathology; D014781:Viscera / Q000503:physiopathology; D059265:Visceral Pain / Q000503:physiopathology* / Q000523:psychology
keywords: allodynia; central sensitization; convergence; cutaneous; herniotomy; hyperalgesia; hysterectomy; joints; monoamines; muscle; neuropeptides NGF; nociception; osteoarthritis; pain