Med News Today -- Transitioning from acute to chronic pain

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Descent article on acute pain transition to chronic pain !!!

https://www.medicalnewstoday.com/articles/in-conversation-how-to-understand-chronic-pain?utm_source=ReadNext#Transitioning-from-acute-to-chronic-pain

An excerpt from about half way through this article:
We know that under a tissue [or nerve] injury of various sorts that we can activate signaling that normally is associated with what we call innate immunity. And one of the mediators of that is something called the toll-like receptor and it turns out that while those are normally there to recognize the presence of foreign bugs, for example, E. coli, those bugs have in their cell membrane, something called lipopolysaccharide, or LPS. We don't have that normally in our system, but it comes from bacteria," said Dr. Yaksh.

"You're born with it, you don't have to develop it. It's there all the time. What we've come to find out over the last years [t]hat there are many products that your body releases that will [a]ctivate those very same toll-like receptors," he added.

Toll-like receptors may prime the central immune system for heightened states of pain. In response to harmful stimuli, stressors, or tissue injury, especially in the microbiome or the gastrointestinal tract, the body starts to release products from inflammatory cells.

"When this happens, these products that are released from our own body can [a]ctivate these toll-like receptors, and there's [one] we call TLR4 [which] is present on inflammatory cells, and it's also present on sensory neurons," he explained.

Dr. Yaksh said that activating TLR4 itself doesn't cause as much pain, but that it sets the nervous system up to become more reactive.

Coupled with this priming, if there are other stressors present at the time—such as a bad diet or psychological distress, pointed out Dr. Guite— this can set off a whole cascade that can fuel this transition to chronic pain.