Qu’est-ce que la douleur ? Définition et neurophysiologie

Abstract

Pain is an unpleasant sensory or emotional experience. The mechanism that generates pain can be nociceptive, neuropathic or nociplastic. The nociceptive nervous system physiologically protects our body. The painful message produced by mechanical, thermal, or chemical stimulation anywhere in the body travels through the nerves and then the spinal cord. It reaches the brain via two pathways transmitting information differently. After relay to the thalamus, the painful message is integrated at the cortical level according to a matrix system at three levels: information, perception, modulation. Neuropathic pain is caused by a dysfunction of the injured nervous system. The sensations are of particular quality and localized in a territory corresponding to the somatotopy of the nervous system. Nociplastic pain is secondary to a disturbance of the central nervous system which produces mixed sensations in various territories. These are frequently chronic pains whose genesis is complex, affecting the person suffering as a whole. Understanding the physiology of pain and identifying the generating mechanism makes it possible to adapt treatment modalities.