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The Anatomical Substratum of Pain Evidence Derived from Morphometric Studies on Peripheral Nerve

Published online by Cambridge University Press:  18 September 2015

P.K. Thomas
P.K. Thomas*
Affiliation:
Department of Neurology, Royal Free Hospital, Gray’s Inn Road, London WCIX 8LF, England
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Summary

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Earlier theories as to the anatomical basis of pain postulated a direct ‘pain pathway’ from specific receptors in the periphery. Anatomical studies linked this with small myelinated and unmyelinated fibers in the peripheral nerves. Subsequently, hypotheses were advanced which postulated that pain depended upon particular spatial and temporal patterns of sensory input into the nervous system rather than upon specific sets of fibers.

More recent physiological studies have demonstrated the existence of peripheral receptors that respond exclusively to noxious stimuli and morphometric studies on peripheral neuropathies in man clearly implicate small myelinated and unmyelinated axons in the conduction of pain. Morphometric studies have also shown that spontaneous pain in neuropathies may be associated with a selective loss of small fibers. These observations therefore support the earlier concept of a specific nociceptive pathway involving small caliber fibers in the peripheral nerves. It is evident that this afferent pathway is capable of modification in the spinal cord both by peripheral inputs and by descending impulses. The notion of a ‘pain pathway’ as such is probably best avoided.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 1 , Issue 2 , May 1974 , pp. 92 - 97
Copyright
Copyright © Canadian Neurological Sciences Federation 1974

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