Altered pain responses in the brainstem and spinal cord could contribute to hyperalgesia. Rempe et al. administered a moderately painful mechanical stimulus to the arms of healthy volunteers before and after pain sensitization with heat and capsaicin. Functional MRI scans showed that mechanical pain alone increased activity in the dorsolateral pontine tegmentum, which negatively correlated with activity in the spinal cord dorsal grey matter. After sensitization, activity of the pain modulation areas in the brainstem decreased and spinal cord dorsal grey matter activity increased, implicating reduced descending inhibition in hyperalgesia.