Physiology · Central Nervous System

Pain physiology and modulation

7 min read

Definition

  • Pain (IASP) is an unpleasant sensory and emotional experience linked to actual or potential tissue damage.
  • A nociceptive stimulus is one capable of damaging tissue; the sensation it evokes is nociception.

Nociceptors and Pain Fibres

  • Nociceptors are free nerve endings, present throughout the body except the neural tissue of the brain; the meningeal coverings of the brain do contain nociceptors.

Aδ vs C fibre nociceptors

Feature

Fibre type

Aδ (mechanical) nociceptors
Myelinated, 1 to 5 µm diameter
C fibre (polymodal) nociceptors
Unmyelinated, 0.3 to 1.2 µm diameter

Conduction velocity

Aδ (mechanical) nociceptors
10 to 30 m/s
C fibre (polymodal) nociceptors
0.5 to 2 m/s

Stimuli

Aδ (mechanical) nociceptors
Intense mechanical only
C fibre (polymodal) nociceptors
Mechanical, thermal (45°C or higher) and chemical

Pain conveyed

Aδ (mechanical) nociceptors
Fast (first) pain
C fibre (polymodal) nociceptors
Slow (second) pain

Dorsal horn termination

Aδ (mechanical) nociceptors
Laminae I and V
C fibre (polymodal) nociceptors
Lamina II