Pain

We can't live without it, but many of us struggle to live with it. Pain has an essential biological function, but too much — or the wrong sort — ruins lives and puts a sizeable dent in economic productivity. By David Holmes, infographic by Mohamed Ashour.

The dearth of treatment options for chronic pain has led to widespread over-prescription of strong opioids. But some innovative thinking is building a promising pipeline.

Pain researchers' arguments for using only male rodents in preclinical pain research don't hold up to scrutiny, says Jeffrey S. Mogil.

Technology for peering into the brain is revealing a pattern of pain, and differences between the acute and chronic forms.

People with neuropathic pain have struggled to find relief with conventional drugs. Researchers are investigating whether more meaningful pain classifications could help.

Although genetics studies have so far failed to revolutionize pain treatments, some researchers think that a host of discoveries are just around the corner.

Armed with a clearer understanding of how placebos work, researchers are suggesting that inactive substances might be used to mitigate chronic pain.

The 'war on drugs' has left many in developing nations with no access to strong painkillers. But governments in these countries are learning to stop worrying and love the poppy.

For thousands of years people have sought explanations for pain and ways to ease it. Despite a better understanding of the mechanisms behind the sensation, much remains baffling, and the search for better treatments continues. By Stephanie Pain

In a longitudinal brain imaging study, patients with subacute back pain were followed over the course of 1 year. Initially greater functional connectivity of nucleus accumbens with prefrontal cortex predicted pain persistence, implying that corticostriatal circuitry is causally involved in the transition from acute to chronic pain.

A large literature has demonstrated the important role of spinal microglia in chronic pain processing. This paper demonstrates that microglia are required in male but not female mice. In female mice, a similar function appears to be subserved by adaptive immune cell, likely T lymphocytes.

Anterior insula (AI) and medial anterior cingulate cortex (mACC) are activated by self and vicarious pain, disgust and fairness, yet the overlap of these representations are not known. Here the authors provide evidence for shared neural codes in the left AI and mACC and distinct codes in the right AI.

Janine A. Clayton and Francis S. Collins unveil policies to ensure that preclinical research funded by the US National Institutes of Health considers females and males.

The paraventricular nucleus of the thalamus to the nucleus accumbens pathway mediates physical signs and aversive memory of opiate withdrawal.

Chronic pain is a common problem that incurs substantial costs to the individual and society as a whole. The efficacy of currently available medications is limited, prompting the exploration of alternative therapeutic approaches. Here, Jensen et al. summarize the state of knowledge regarding the efficacy and mechanisms of four different neuromodulatory interventions—hypnosis, meditation training, noninvasive brain stimulation, and neurofeedback—for the treatment of chronic pain.

Placebo effects are positive effects on health that arise from the response of the brain to the contextual information that accompanies the delivery of a treatment. In this Review, Wager and Atlas examine the neural mechanisms that underlie such effects, focusing on placebo analgesia.

The medial prefrontal cortex (mPFC) is implicated in pain regulation, yet the underlying mechanisms are poorly understood. Here the authors establish a critical role for mPFC in regulating pain sensation and pain-related anxiety, mediated by activation of the cyclin-dependent kinase 5 signalling pathway.