Stress and Alterations in the Pain Matrix: A Biopsychosocial Perspective on Back Pain and Its Prevention and Treatment.

摘要: The genesis of chronic pain is explained by a biopsychosocial model. It hypothesizes an interdependency between environmental and genetic factors provoking aberrant long-term changes in biological psychological regulatory systems. Physiological effects physical stressors may play crucial role these maladaptive processes. Specifically, demands on the stress response system moderate central processing influence descending serotonergic noradrenergic signals from brainstem, regulating nociceptive at spinal level. However, underlying mechanisms this pathophysiological interplay still remain unclear. This paper aims to shed light possible pathways (exercise) potential neurobiological consequences treatment pain, highlighting evolving concepts promising research directions pain. Two forms (exercise mindfulness-based reduction as exemplary therapies), their interaction, dose-response will be discussed more detail, which might pave way better understanding alterations matrix help develop future prevention therapeutic concepts.