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The fact of pain chronicity has been puzzling to many clinicians and researchers. This section discusses why chronicity should not be surprising or unusual.
The "issue" of chronicity is related to proportionality, and much theorizing has gone on to explain it. Discussion of chronicity and evidence that "normal" healing is often incomplete. NOT SURE IF this section belongs inside Pain Science 2??
Given the evidence pointing to activity-dependent maturation of pain pathways during early life, abnormal or excessive activity related to pain and injury during the neonatal period may have the potential to cause long-term changes in somatosensory and pain processing....Transient (=24-hour) inflammation of the rat hind....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 154
Ligaments are dull white, dense connective tissue structures that connect adjacent bones....Beyond 4% of elongation, they lose elasticity and become permanently laxed, causing joint hypermobility. In degenerated ligaments, subfailure was reported at earlier stages of elongation. At its best, natural healing may restore....
Deer, T. R. and Leong, M. S. eds., "Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches", Springer, 2013, 892
Biopsies from the areas with tendinosis and neovascularization followed by immunohistochemical analyses of specimens showed substance P (SP) in the nerves juxtapositioned to the vessels and in the nervi vasorum together with calcitonin gene-related peptide (CGRP) juxtapositioned to the vascular walls. The neurokinin-1 r....
Deer, T. R. and Leong, M. S. eds., "Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Integrative Approaches", Springer, 2013, 894-5
The duration of these pain states often exceeds the time taken for tissues to heal or for injured nerve fibres to regenerate. Causalgia tends to disappear as regeneration occurs, but sometimes it persists for years, as does neuralgic or phantom limb pain. Furthermore, in all of these syndromes pain may occur spontaneous....
Melzack, R. and Wall, P. D., "The Challenge of Pain (Reprint of 1988 edition)", Penguin Books, 2008, 76
We have reviewed evidence that prolonged tender states are produced by the massive release of peptides on to substantia gelatinosa cells. It has now been discovered that such compounds can produce striking changes of slow onset and very long duration, so that ionic channels in the nerve cell membrane and enzymes within....
Melzack, R. and Wall, P. D., "The Challenge of Pain (Reprint of 1988 edition)", Penguin Books, 2008, 107
End of included memoes/notes