Skip to main content
Anesthesia Progress logoLink to Anesthesia Progress
. 1990 Mar-Jun;37(2-3):133–135.

Hyperalgesic Pain: A Review

Jon D Levine, Yetunde O Taiwo
PMCID: PMC2190333  PMID: 1964769

Abstract

Pain induced by a stimulus that is normally not painful is referred to as hyperalgesic pain. Inhibition of arachidonic acid metabolism and/or sympathectomy have been found to be effective treatment for this type of pain. We propose that the lowered pain threshold is induced by arachidonic acid metabolites produced in inflamed tissue or by sympathetic postganglionic neurons after nerve injury. The most extensively studied hyperalgesic mediators are prostaglandin E2 (PGE2) and prostacyclin (PGI2), products of the cyclooxygenase pathway of arachidonic acid metabolism, whose production is inhibited by nonsteroidal antiinflammatory analgesics (NSAIAs). Recent studies, however, have demonstrated that products of the NSAIA-resistant lipoxygenase pathway of arachidonic acid metabolism are also hyperalgesic. Their production is inhibited by corticosteroids and current experimental agents.

Full text

PDF
133

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ARMSTRONG D., DRY R. M. L., KEELE C. A., MARKHAM J. W. Observations on chemical excitants of cutaneous pain in man. J Physiol. 1953 May 28;120(3):326–351. doi: 10.1113/jphysiol.1953.sp004898. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Delius W., Hagbarth K. E., Hongell A., Wallin B. G. Manoeuvres affecting sympathetic outflow in human skin nerves. Acta Physiol Scand. 1972 Feb;84(2):177–186. doi: 10.1111/j.1748-1716.1972.tb05168.x. [DOI] [PubMed] [Google Scholar]
  3. Devor M., Jänig W. Activation of myelinated afferents ending in a neuroma by stimulation of the sympathetic supply in the rat. Neurosci Lett. 1981 Jun 12;24(1):43–47. doi: 10.1016/0304-3940(81)90356-6. [DOI] [PubMed] [Google Scholar]
  4. Ferreira S. H., Moncada S., Vane J. R. Prostaglandins and the mechanism of analgesia produced by aspirin-like drugs. Br J Pharmacol. 1973 Sep;49(1):86–97. doi: 10.1111/j.1476-5381.1973.tb08270.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ferreira S. H. Prostaglandins, aspirin-like drugs and analgesia. Nat New Biol. 1972 Dec 13;240(102):200–203. doi: 10.1038/newbio240200a0. [DOI] [PubMed] [Google Scholar]
  6. Hannington-Kiff J. G. Relief of Sudeck's atrophy by regional intravenous guanethidine. Lancet. 1977 May 28;1(8022):1132–1133. doi: 10.1016/s0140-6736(77)92387-x. [DOI] [PubMed] [Google Scholar]
  7. Huskisson E. C. Antiinflammatory drugs. Semin Arthritis Rheum. 1977 Aug;7(1):1–20. doi: 10.1016/s0049-0172(77)80002-4. [DOI] [PubMed] [Google Scholar]
  8. Lembeck F., Popper H., Juan H. Release of prostaglandins by bradykinin as an intrinsic mechanism of its algesic effect. Naunyn Schmiedebergs Arch Pharmacol. 1976 Jul;294(1):69–73. doi: 10.1007/BF00692786. [DOI] [PubMed] [Google Scholar]
  9. Levine J. D., Fye K., Heller P., Basbaum A. I., Whiting-O'Keefe Q. Clinical response to regional intravenous guanethidine in patients with rheumatoid arthritis. J Rheumatol. 1986 Dec;13(6):1040–1043. [PubMed] [Google Scholar]
  10. Levine J. D., Gooding J., Donatoni P., Borden L., Goetzl E. J. The role of the polymorphonuclear leukocyte in hyperalgesia. J Neurosci. 1985 Nov;5(11):3025–3029. doi: 10.1523/JNEUROSCI.05-11-03025.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Levine J. D., Lam D., Taiwo Y. O., Donatoni P., Goetzl E. J. Hyperalgesic properties of 15-lipoxygenase products of arachidonic acid. Proc Natl Acad Sci U S A. 1986 Jul;83(14):5331–5334. doi: 10.1073/pnas.83.14.5331. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Levine J. D., Lau W., Kwiat G., Goetzl E. J. Leukotriene B4 produces hyperalgesia that is dependent on polymorphonuclear leukocytes. Science. 1984 Aug 17;225(4663):743–745. doi: 10.1126/science.6087456. [DOI] [PubMed] [Google Scholar]
  13. Levine J. D., Taiwo Y. O., Collins S. D., Tam J. K. Noradrenaline hyperalgesia is mediated through interaction with sympathetic postganglionic neurone terminals rather than activation of primary afferent nociceptors. Nature. 1986 Sep 11;323(6084):158–160. doi: 10.1038/323158a0. [DOI] [PubMed] [Google Scholar]
  14. Loh L., Nathan P. W. Painful peripheral states and sympathetic blocks. J Neurol Neurosurg Psychiatry. 1978 Jul;41(7):664–671. doi: 10.1136/jnnp.41.7.664. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Rackham A., Ford-Hutchinson A. W. Inflammation and pain sensitivity: effects of leukotrienes D4, B4 and prostaglandin E1 in the rat paw. Prostaglandins. 1983 Feb;25(2):193–203. doi: 10.1016/0090-6980(83)90104-1. [DOI] [PubMed] [Google Scholar]
  16. Soter N. A., Lewis R. A., Corey E. J., Austen K. F. Local effects of synthetic leukotrienes (LTC4, LTD4, LTE4, and LTB4) in human skin. J Invest Dermatol. 1983 Feb;80(2):115–119. doi: 10.1111/1523-1747.ep12531738. [DOI] [PubMed] [Google Scholar]
  17. WINDER C. V. Aspirin and algesimetry. Nature. 1959 Aug 15;184:494–497. doi: 10.1038/184494a0. [DOI] [PubMed] [Google Scholar]
  18. Wall P. D., Gutnick M. Ongoing activity in peripheral nerves: the physiology and pharmacology of impulses originating from a neuroma. Exp Neurol. 1974 Jun;43(3):580–593. doi: 10.1016/0014-4886(74)90197-6. [DOI] [PubMed] [Google Scholar]

Articles from Anesthesia Progress are provided here courtesy of American Dental Society of Anesthesiology

RESOURCES