Figure 4.

Mechanisms driving pain and three opportunities to reverse chronic or persistent pain. The cycle at the top left shows many mechanisms that can lead to persistent pain. One way that treatments can reverse persistent pain would be to directly target those mechanisms that caused the pain to become persistent to effectively reverse the cycle. Another way would be to employ endogenous resolution mechanisms, like resolvins, to reverse persistent pain in a manner that is not dependent on its cause. Finally, treatments that can take persistent pain to a new, acceptable set point could also be engineered. These might include employing viral vectors to introduce optogenetic control of nociceptor activity in persistent pain conditions.