Conclusions

There is considerable experimental evidence for substantial changes in the nociceptive processing during disease processes in the deep tissue such as joint, muscle, and bone. Available data from patients show considerable convergence of experimental and clinical data, and they indicate that different levels of the neuraxis are rational targets for analgesic treatment. Still much more research is required in order to better understand and treat chronic pain because current treatments are often not sufficient. There may be several reasons for that. Long-term molecular changes in the nociceptive systems are still poorly understood. Furthermore, chronic pain often seems to be a state in which nociceptive and neuropsychological components interact. This interaction should be better explored and form the basis of an "integrative" treatment strategy.

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