Pain Neuroscience, Neuroinflammation and Chronic Pain

In this Module we will introduce the Neuroimmune system including the immune cells and the mediators they release.  We will discuss the importance of having a balanced chemistry in order to resolve chronic inflammatory pathologies such as Knee osteoarthritis and chronic low back pain.

In this Module we will introduce the pro-inflammatory cytokines and discuss their effects peripherally, in the dorsal root ganglion, in the dorsal horn, and supra spinally.  We discuss the end stage effects of these mediators in chronic pain as well as psychosocial symptoms like depression and anxiety.

Next we look at the Pro-resolution cytokines and thier effects on resolving ongoing inflammation.  We discuss how these mediators prevent sensitization and their beneficial effects on psychosocial symptoms.

Here we discuss the lipid mediators.  Lipid mediators are derived solely from our diet and pro-inflammatory lipid mediators have powerful effects on the development of sensitization and psychosocial symptoms.  The modern diet consists almost exclusively of pro-inflammatory fatty acids.

Here we discuss the pro-resolution lipid mediators, now called Specialized Pro-resolving Mediators (SPMs) and their effect on dampening neuroinflammation, desensitizing nociceptors, and preventing sensitization.

Nerve growth factor release by peripheral macrophages plays a big role in the development of nociplastic changes and central sensitization.  We will also look at the NFkB pathway as a driver of ongoing inflammation and the factors that activate the NFkB pathway.

Here we will use lumbar discogenic pain as an example of how chemistry determines symptomatic vs asymptomatic disc degeneration, symptom severity, and why some patients develop chronic pain while others have full resolution.

Here we introduce the evolution of the chemistry that drives our homeostatic mechanisms.  We discuss how this chemistry is not conducive to our modern lifestyle and how this has led to an increase in chronic inflammatory diseases since the 1950s.

Here we look closely at the lifestyle variable that affect our chemistry including Obesity/BMI, metabolic health, and, dietary influences.

Here we look closely at the lifestyle variables that affect our chemistry including exercise, stress, sleep, and smoking.

Finally we will end by recapping the course content through our neuro-immune graphic.