Article: PDF OnlyPain Mechanisms and Management: A Central PerspectiveMannion, Richard J. M.D., Ph.D.; Woolf, Clifford J. m.d., Ph.D.Author Information Neural Plasticity Research Group, Department of Anesthesia and Critical Care, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts Address correspondence to Dr. Clifford J. Woolf, Neural Plasticity Research Group, Department of Anesthesia and Critical Care, Massa-chusetts General Hospital and Harvard Medical School, 149 13th Street, Room 4310, Charlestown, MA 02129; e-mail: [email protected] The Clinical Journal of Pain: September 2000 - Volume 16 - Issue 3 - p S144-S156 Buy Abstract Although pain is always intense and unpleasant, the capacity to experience this sensation is, under normal circumstances, fundamental to the preservation of bodily integrity. Clinically, however, after injury to peripheral tissue or directly to the nervous system, spontaneous and evoked pain manifest that serve no physiologic function, are crippling to patients, and are difficult to treat. Here, we review the specific role of the dorsal horn of the spinal cord in the mechanisms of nociceptive protective pain and the spinal plasticity that occurs after nerve and tissue injury. This spinal neuronal plasticity is shown to be a key contributor to pathologic pain hypersensitivity. The potential for the molecular mechanisms responsible for the spinal plasticity in revealing new targets for future treatment is also discussed. Copyright © 2000 Wolters Kluwer Health, Inc. All rights reserved.