Readers have access to legions of books dealing with the molecular, genetic, neurochemical, neurophysiological, neuroanatomical, neuroradiological and psychological aspects of pain as well as with the clinical approaches to pain from various medical disciplines. Why then is it necessary to publish a book on the pathophysiologyofpain perception? Pain can result either from noxious events due to lesions, injuries, diseases, etc. , or from disturbances in the system transducing, transforming, and processing the potential pain signal or from an interaction of both. Under certain pathological conditions, the pain-processing system, which includes both physiological and psychological components, can produce the experience of pain in the absence of any peripheral noxious event. This book primarily ex amines these pathological alterations in the pain-signalling system, and the authors provide information on the functioning of the pain-processing system under normal and pathological conditions. The understanding of pain perception is essential for optimal diagnosis and treatment of acute and chronic pain. Considerable evidence now indicates that alterations in pain per ception are characteristic of many clinical pain states. Whether disturbed pain perception is a truly etiological or only a maintaining factor-c-or even a mere epiphenomenon of chronic functional pain-is reviewed in detail by L. Arendt-Nielsen, C. R. Covelli, R. B. Fillingim,]. M. Gillespie, T. Graven-Nielsen, E. Kosek, S. Lautenbacher, M. Peters, A. Pielsticker, DO. Price, G. B. Rollman, P. Svensson and G. N. Verne for headache, back pain, fibromyalgia, myofascial pain, temporomandibular pain disorder, irritable bowel syndrome and menstrual cycle-related pain disorders.

Zusammenfassung
Considerable evidence indicates that alterations in pain perception are characteristic of many clinical pain states. This book examines these pathological alterations in the pain-signaling system, focusing on the functioning of the pain processing system under normal and pathological conditions.

Inhalt

1. Basic Physiology of Pain Perception.- to Nociception, Acute and Chronic Pain.- Animal Studies on Nociception and Pain.- The Peripheral Nociceptive System.- The Central Pain System.- The Physiology of Nociceptive Processing in the CNS.- References.- 2. Assessment of Pain Perception.- Experimental Methods For Pain Induction.- Experimental Methods of Pain Assessment.- Summary.- References.- 3. Disturbances of Pain Perception in Primary Headache: Migraine, Tension-type, and Cluster Headaches.- Epidemiology.- Pain and Functional Impairment.- Psychological Antecedents, Causes and Sequels.- Muscle Tension and Vascular Reactions.- Central Factors.- Disturbance of Pain Perception.- Summary.- References.- 4. Disturbances of Pain Perception in Chronic Back Pain.- Description of the Disorder.- Disturbances in Pain Perception.- Conclusions and Implications.- References.- 5. Disturbances of Pain Perception in Fibromyalgia.- Description of the Syndrome.- Disturbance of Pain Perception.- Concluding Remarks.- References.- 6. Disturbances of Pain Perception in Myofascial Pain Syndrome and other Musculoskeletal Pains.- Definition of MPS.- General Characteristics of MPS.- Trigger Points in MPS.- Referred Pain in Musculoskeletal Pain Conditions.- Hyperalgesia in Musculoskeletal Pain Conditions.- Summary.- References.- 7. Disturbances of Pain Perception in Temporomandibular Pain Syndrome.- Epidemiology.- Classification.- Contrasting Concepts.- Regional or Widespread Disorder.- Response to Non-Noxious Stimuli.- Hypervigilance.- Experimental Models of TMD.- Studies of Neurotransmitters.- Response to Stress.- Overview.- References.- 8. Disturbances of Pain Perception in Irritable Bowel Syndrome.- Definition and Clinical Presentation.- Epidemiology.- IBS as a Neurologic Disorder.- Animal Models of Persistent Pain State Mechanisms.- Human Neural Imaging Studies of Persistent Pain Conditions.- Somatic Pain Testing in IBS Patients.- Serotonin and IBS.- Psychological Factors in IBS.- Conclusions.- References.- 9. Disturbances of Pain Perception in Menstrual Cycle-Related Disorders.- Pain Perception Across the Menstrual Cycle.- Dysmenorrhea.- Premenstrual Syndrome.- Menstrual Cycle Influences on Other Chronic Pain Disorders.- Conclusions.- References.- 10. Disturbances of Pain Perception in Disorders of the Peripheral Nervous System.- Diabetic Polyneuropathy.- Complex Regional Pain Syndrome (CRPS).- Herpes Zoster.- Trigeminal Neuralgia.- Lumbosacral Radiculopathy.- References.- 11. Disturbances of Pain Perception in Disorders of the Peripheral and Central Nervous System.- General Considerations.- The Clinical Diagnosis of Neuropathic Pain.- Syndromes which may be Accompanied by Neuropathic Pain.- References.- 12. Pain Perception in Psychiatric Disorders.- Anxiety.- Schizophrenia.- Depression.- Anorexia Nervosa and Bulimia Nervosa.- Borderline Personality Disorder.- References.- 13. Alterations in Pain Perception in Cardiovascular Disease.- Cardiovascular Variables and Pain Perception.- Mechanisms of Blood Pressure-Related Hypoalgesia.- Pain Perception in Coronary Artery Disease and Other Cardiac Diseases.- Conclusions and Future Directions.- References.- 14. Perception of Pain during Pregnancy and Labor.- Physiological Changes During Pregnancy.- Pain and Discomfort in Pregnancy.- Physiology of Labor.- Labor Pain.- Memory for Labor Pain.- Factors Affecting Pain during Labor.- The Effect of Acupuncture on Pain and Use of Analgesics during Labor.- The Role of Endogenous Opioids in Pain Processing during Pregnancy and Labor 206.- Experimental Studies of Pain Perception in Pregnancy and Labor.- Conclusion.- References.- 15. The Importance of Quantitative Sensory Testing in the Clinical Setting.- Applications of QST.- Advantages and Disadvantages of QST.- Is QST Clinically Relevant?.- Future Directions for Clinical Applications of QST.- References.