Rewards, perils and pitfalls of untangling spinal pain circuits

Pain is a complex perception that is fundamental to our daily survival. Under normal circumstances, it serves an important protective function to guard against tissue damage or alert the body to dangerous environments. Under pathological states, however, the perception of pain can become chronic, maladaptive, resistant to treatment, and presents a serious clinical and societal problem. A wealth of literature suggests that disruption of sensory processing within the spinal cord contributes to chronic pain, but our limited understanding of spinal circuitry in health and disease remains a barrier to the development of new therapeutic strategies. The aim of this brief review is to outline current thinking about how individual components of functionally distinct spinal microcircuits can be identified and manipulated to determine their role in influencing our perception of pain in acute and chronic states.