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It should be evident from the physiology of the SNS and the increased tone caused by pain, that chronic pain sufferers also suffer from chronically high sympathetic tone. The implications of this include ??? See Note 777.
Activity in nociceptors induces an increase in sympathetic discharge. This increased discharge is associated with the rise in blood pressure in acute pain states. Usually, the converse is not true: sympathetic activity does not affect the discharge of nociceptive neurons. In certain patients with pain, however, nocicept....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 28-9
[Caption of Fig. 13-6] A, These types of coupling depend on the activity of sympathetic neurons and on expression of functional adrenoceptors by the afferent neurons or mediation indirectly via blood vessels (blood flow). It can occur in the periphery (1), in the dorsal root ganglion (3), or possibly also in the lesi....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 205
...Flor and colleagues (1985) reported no differences in heart rate during resting baseline or during various stressors (brief cold pressor, mental math, discussion of personally relevant stress and pain episodes) between patients with CBP and healthy controls. On the other hand, Arntz [et al.] (1991) found lower hear....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 158
Thus, clinical data, as well as primate physiological data, suggest that in SMP [sympathetically maintained pain], release of NE from the sympathetic terminals activates nociceptors that express alpha-1-adrenoreceptors. The spontaneous activity and excitation of nociceptors by NE lead to central sensitization.
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 29
Pain dependent on activity in sympathetic neurons is referred to as sympathetically maintained pain. Sympathetically maintained pain includes ongoing pain and pain evoked by mechanical and cold stimulation. It may be present in complex regional pain syndrome types 1 and 2 and in other neuropathic pain syndromes...The....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 204-5
Rainville and colleagues (1999a) found that the increase in stimulus-evoked heart rate was significantly correlated with the change in pain unpleasantness induced by hypnosis, independent of changes in pain intensity, thus suggesting a direct functional interaction between pain affect and autonomic activation.
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 348
[Elevated baseline heart rate and high skin conductance reactivity has been observed in FMS patients.] Hassett and colleagues (2007) conducted biofeedback training in patients with FMS to manipulate suboptimal heart rate variability. They observed clinically significant decreases in depression and pain.
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 158
Ordinarily, the norepinephrine secreted directly into a tissue remains active for only a few seconds, demonstrating that its reuptake and diffusion away from the tissue are rapid. However, the norepinephrine and epinephrine secreted into the blood by the adrenal medullae remain active until they diffuse into some tissu....
Guyton, A. C. and Hall, J. E., "Textbook of Medical Physiology, Eleventh Edition", Elsevier Saunders, 2006, 751-2
In many instances, almost all portions of the sympathetic nervous system discharge simultaneously as a complete unit, a phenomenon called mass discharge. This frequently occurs when the hypothalamus is activated by fright or fear or severe pain. The result is a widespread reaction throughout the body called the....
Guyton, A. C. and Hall, J. E., "Textbook of Medical Physiology, Eleventh Edition", Elsevier Saunders, 2006, 758
Inflammation may lead to catechol sensitization of cutaneous nociceptors. Sympathetic stimulation and close arterial injection of norepinephrine (NE) also excite 35-40% of C-polymodal nociceptors in chronically inflamed rats.
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 21
In healthy tissue, the activities of the sympathetic nervous system have little effect on sensation except indirectly--producing goose bumps, chills, flushing and sweating--by their action on smooth muscle, blood vessels and sweat glands. However, in the presence of damage, their role becomes increasingly important with....
Melzack, R. and Wall, P. D., "The Challenge of Pain (Reprint of 1988 edition)", Penguin Books, 2008, 100
An important abnormality of damaged nerve membrane is that it becomes sensitive to chemicals released by the sympathetic nervous system. Specifically, the nerve develops alpha adrenergic receptors so that noradrenaline released from local sympathetic fibres or adrenaline in the blood excites the fibres. This is one of t....
Melzack, R. and Wall, P. D., "The Challenge of Pain (Reprint of 1988 edition)", Penguin Books, 2008, 112-3
…signals from the brain continue to flow to the body, some deliberately and some automatically, from brain quarters whose activities are never represented directly in consciousness. As a result, the body changes yet again, and the image you get of it changes accordingly. [The sense of self is the ongoing reading of bod....
Damasio, Antonio R., "Descartes' Error: Emotion, Reason, and the Human Brain", Penguin Books, 1994, 228
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Sympathetic Activity and Hyperalgesia (Last updated: Tue, Mar 11, 2025)
The Stress Response (Last updated: Tue, Mar 11, 2025)
Stress and Hypoalgesia (Last updated: Tue, Mar 11, 2025)
Sympathetically Increased and Maintained Pain (Last updated: Tue, Mar 11, 2025)
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Pain and the Sickness Response (This page is incomplete.)