CENTRAL VERSUS PERIPHERAL SUBSTRATES OF PERSISTENT PAIN - WHICH CONTRIBUTES MORE

Evidence that central sensitization needs to be maintained in an ongoi ng manner by nociceptive input from the periphery makes the peripheral drive, rather than the central amplification process, the highest pri ority target for understanding and control. To stop the peripheral dri ve is to kill two birds with one stone. Moreover, the amplification th at central sensitization does provide is selective and not necessarily striking in intensity. A ''magic bullet'' that neutralized central se nsitization would probably be less effective in controlling persistent pain than many investigators would like to believe.