"Pain is like Love, it's all-consuming: when you have it, not much else matters and there is nothing you can do about it."
Overall background and aims (A. Curt (chair), H.U. Zeilhofer (co-chair))
Chronic pain is a largely unmet medical problem, with an estimated prevalence at about 19% in the general society (Kennedy et al., 2014), likely to further increase due to demographic and lifestyle changes. The complex nature of pain arises from the interaction of multiple neural systems along the whole neuraxis, i.e., peripheral nerves, spinal cord, brain stem and the brain, impacted by complex cognitive and affective processes. Independent of the diverse clinical presentations of chronic pain conditions, a common underlying pathophysiological mechanism is ongoing sensitization along the nociceptive neuraxis (Arendt-Nielsen et al., 2017). Sensitization processes are, in most cases, initiated by afferent inputs but maintained and modulated by supra-spinal centers. The balance between facilitating and inhibiting mechanisms is likely to differ across various pain conditions and individual patients. Therefore, the overall objective of this CRPP is to dissect the impact of peripheral, spinal and supra-spinal processes that cause sensitization and modulation in order to provide a framework for mechanistically founded therapies across disease entities. Such personalized targeting of pain mechanisms will be an important step toward precision medicine in chronic pain conditions.