Background of pain management
Pain is a complex and multidimensional phenomenon. It is now generally accepted that a system theoretical approach is necessary to understand the phenomenon of pain. In this respect, the pain experience is regarded as a complex response resulting from the interplay of interdependent neurological, endocrine, immunological, and psychological subsystems. These subsystems communicate via common pathways and messenger substances (neurotransmitters, peptides, cytokines, and hormones) and thus form an overarching protective system with the aim of optimizing the survival of the organism as an open, adaptive system in interaction with its environment. We only speak of pain when the process of awareness (at the cortical level) has taken place and the person has interpreted pain as such. The processes preceding this we call nocisensory. Peripheral and central sensitization pain are the result of a complex interplay of interdependent subsystems that form an integrated system.