Pain: from neurobiology to disease^∗

Abstract

Pain exacts a tremendous toll on those who suffer, their families, and society because of its prevalence and functional impact in the face of a relative dearth of consistently effective therapeutic interventions devoid of deleterious consequences. Based on an operational definition of disease, the current understanding of the variety of factors that impact the likelihood of developing pain, the prognosis for its severity and duration with or without therapy, as well as the efficacy of the available therapeutic interventions, we argue that all but the most transient of pain should be viewed as a disease. The current understanding of the neurobiology of pain is reviewed as are the variety of mechanisms that contribute to the initiation and maintenance of ongoing pain and hypersensitivity observed following injury. Evidence in support of the therapeutic efficacy of several of the most commonly used therapeutic strategies is also briefly summarized.