Christoph Stein

TL;DR: In this article, the authors describe current approaches to the diagnosis and assessment of neuropathic pain and discuss the results of recent research on its pathophysiologic mechanisms, and provide specific recommendations for use of these medications.

TL;DR: These studies indicate that the immune system can interact with peripheral sensory-nerve endings to inhibit pain and intrinsic modulation of nociception can occur at the peripheral terminals of afferent nerves.

TL;DR: Recently, evidence has begun to accumulate that opioid antinociception can be initiated by activation of opioid receptors located outside the central nervous system (CNS) as discussed by the authors, which is the earliest evidence that opioids exert analgesic effects through actions outside the CNS.

TL;DR: Findings point towards a regulatory function for nerve growth factor in vivo in the stimulation of sensory neuropeptide synthesis during prolonged inflammatory processes.

TL;DR: The treatment of severe pain with opioids has thus far been limited by their unwanted central side effects, but research promises new approaches, including opioid analgesics acting outside the central nervous system, targeting of opioid peptide–containing immune cells to peripheral damaged tissue, and gene transfer to enhance opioid production at sites of injury.