Distributed system of nociception as a physiological basis forpain experience in humans

Abstract

The human nociceptive system is a complex sensory system that encompasses the peripheral, spinal and supraspinalparts of the nervous system. The article presented here focuses on a critique of the serial model, which iscommonly used to discuss the nociceptive system. The serial model proposes a hierarchical structure, where informationis conducted from the nociceptor through the dorsal horns of the spinal cord to the higher areas of the centralnervous system. A disturbance of the system at one of its lower levels should result in disruption of the integrationof nociceptive information by higher neural centers. However, this model seems to obscure the actual principlesby which the nociceptive system processes information (Coghill, 2020) and is only vaguely reflected in the resultsof animal and human studies. The simplification of the nociceptive system – common in polish textbooks – maylead to a limited understanding of the mechanisms of pain sensation and the utilization of ineffective therapeuticinterventions. In this article, the nociceptive system is discussed in terms of recently proposed distributed (parallel)model. The nociceptive system should not be simplified. Its complexity argues for the use of complex and distributedtherapeutic approaches.