Pathos (Dec 2023)
Pathogenetic role of the pain threshold Hypothetical therapeutic perspectives based on the use of drugs to elevate it
Abstract
The pain threshold determines the extent of pain perception, and in some cases, its manifestation. Therefore, it is important in certain situations to increase the pain threshold. Measuring the pain threshold is challenging due to its approximate nature. The threshold depends on the number and function of Nav1.7 sodium channels and nerve growth factor (NGF). Unfortunately, we lack therapeutic tools to selectively act on these sodium channels. The clinical use of tanezumab, a drug that can counteract NGF, has not been approved. It is potentially dangerous to misuse drugs that can increase the pain threshold as it may divert attention from treating the underlying cause of pain or even dangerously limit its protective function. However, they can be particularly useful in pathologies where the main pathogenetic mechanism is a reduced pain threshold, such as migraine, musculotensive headache, trigeminal neuropathy, phantom limb pain, fibromyalgia, and others. They are also helpful in situations where pain is no longer useful for diagnostic purposes and when it is due to an incurable condition like cancer.
