Central Sensitization: Central Mechanisms of Neuroma and Neuropathic Pain

Central sensitization refers to hyperexcitability of nociceptive pain signaling pathways in response to non-noxious stimuli and is notoriously difficult to manage medically. Untreated neuromas have the potential to produce central sensitization, and thus avoidance of central sensitization is an important rationale for surgical management of neuromas. This chapter describes the anatomy and physiology of the nociceptive system, as well as the molecular mechanisms that underlie central sensitization. We also provide clinical examples of central sensitization as well as surgical approaches to the management of central sensitization.