In this week's episode of the Spine & Nerve podcast, Dr. Nicolas Karvelas and Dr. Brian Joves nerd out about chronic pain pathways, specifically the changes that take place in the signaling over time. Chronic, persistent pain changes the physiologic signaling in the body. This means that it is not purely a nociceptive process.

Along the pathway, we have the classic components of transmission, transduction, modulation, and perception that are each involved in the signaling cascade of our nociceptive nervous system. Each one of these components can have signaling errors that can lead to chronic pain.

Today, we specifically discuss the modulation component and wind up. Wind up is the process by which the signaling in the body changes, so that when the pain signal comes into the central nervous system- it is stronger and lasts longer. The nerves fire more frequently and with greater strength. The longer this lasts in the body, the more wind up occurs. Eventually, the nerves can keep firing these signals without any ongoing stimulus- meaning that over time, even though the anatomy has "healed", the pain signals will still be firing continually. And thus, chronic pain.

The docs will also dive deep into glial cells- how they become a part of the modulation of these painful signals and ways that we may be able to intervene into this cascade.

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This podcast is for information and educational purposes only, it is not meant to be medical advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.