Spinal cord

The spinal cord is the central communication highway between the brain and the body, carrying sensory information upward and motor commands downward.

It is also a major site of pain processing, where nociceptive signals are modulated before reaching the brain. Within the spinal cord, interactions between neurons, glial cells and neurotransmitters determine whether pain signals are amplified, dampened or blocked.

Chronic pain often involves maladaptive changes in the spinal cord, such as central sensitization and glial activation, which keep pain pathways overactive. Interventions like spinal cord stimulation (SCS), epidural injections and PRF at the level of the dorsal root ganglion target these pathways directly. Understanding the spinal cord’s role in pain has transformed treatment strategies, shifting focus from purely peripheral causes to central mechanisms of pain.