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Neuroplasticity and pain: what does it all mean?

Recent findings have implications for how we conceptualise, assess and treat pain

The concept of neuroplasticity — the ability of the nervous system to change its structure and function — has captured the imagination of clinicians, researchers and the general public.1 The ability of the brain to reorganise itself is remarkable. For example, people who are visually impaired engage their visual cortex for fine sensory discrimination when using their hands. In these situations, neuroplasticity appears to be a positive adaptation to loss of function.

Recent neuroplasticity studies have shown that pain is associated with a host of functional, anatomical and chemical changes at many levels of the nervous system.2,3 The most intriguing and dramatic example of functional changes is the reorganisation that occurs at a cortical level, particularly in association with major trauma to the nervous system such as limb amputation or spinal cord injury.4,5 In these situations, it has been shown that regions of the cortical homunculus that normally…