Evolutionary Perspective

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As described above, the nervous system changes following injury. The injured part becomes painful and sensitive because the peripheral receptor thresholds are decreased and central amplification occurs, making any signals "louder." This hypersensitivity following injury probably confers an evolutionary benefit by encouraging rest, preventing further damage, and allowing healing. The abnormal "settings" of the nervous system should return to normal after the injury has healed. Failure to return to normal would leave the nervous system in a sensitized state and this is probably one of the causes of chronic pain after surgery. Why the nervous system does not readjust is unknown, but animal work suggests that there is a genetic component to the development of neuropathic pain after injury.32, 33 There are many similarities between memory and chronic pain; long-term potentia-tion (LTP) is a mechanism common to both.34,35 In many ways, chronic pain represents a failure to forget.

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