Medical Science
| Open Access |
DOI: Pain as A Multidimensional Integrative System: Neurophysiological Foundations and Implications for Medical Education
Mustakimova Fatima Alifgatovna , Tashkent State Medical University, Tashkent, UzbekistanAbstract
Pain is a fundamental biological phenomenon serving both as a protective mechanism and a major clinical challenge. Despite decades of research, a significant gap persists between our understanding of pain neurophysiology and the quality of clinical pain management. This review examines pain as a multidimensional integrative system, synthesizing knowledge from peripheral nociception to cortical processing. It analyzes the historical evolution of pain theories, the specialized anatomy of nociceptive pathways, and key phenomena like peripheral and central sensitization. Drawing on International Association for the Study of Pain (IASP) standards, the paper presents original data on the current state of pain education in Uzbekistan and proposes a competency-based framework for integrating pain neuroscience into the medical curriculum at Tashkent State Medical University. This integrated, biopsychosocial curriculum aims to graduate physicians equipped to manage pain effectively across diverse clinical contexts.
Keywords
Pain, nociception, central sensitization
References
Basbaum AI, Bautista DM, Scherrer G, Julius D. Cellular and molecular mechanisms of pain. Cell. 2009;139(2):267-284.
Briggs EV, et al. Current pain education within undergraduate medical studies across Europe: APPEAL study. BMJ Open. 2015;5(8):e006984.
Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129-136.
Fields HL, Basbaum AI, Heinricher MM. Central nervous system mechanisms of pain modulation. In: McMahon SB, et al., eds. Wall and Melzack's Textbook of Pain. 5th ed. Elsevier; 2006.
International Association for the Study of Pain. IASP Interprofessional Pain Curriculum Outline. IASP Press; 2025.
Melzack R, Wall PD. Pain mechanisms: A new theory. Science. 1965;150(3699):971-979.
Mezei L, Murinson BB. Pain education in North American medical schools. J Pain. 2011;12(12):1199-1208.
Ministry of Health of the Republic of Uzbekistan. National Health Statistics Report 2023. Tashkent; 2024.
Shipton EE, et al. Pain medicine content, teaching and assessment in medical school curricula in Australia and New Zealand. BMC Med Educ. 2018;18(1):110.
Sudakov KV. The theory of functional systems: general postulates and principles of dynamic organization. Integr Physiol Behav Sci. 1997;32(4):292-306.
Tracey I, Mantyh PW. The cerebral signature for pain perception and modulation. Neuron. 2007;55(3):377-391.
Watt-Watson J, et al. A survey of prelicensure pain curricula in health science faculties in Canadian universities. Pain Res Manag. 2009;14(6):439-444.
Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(3 Suppl):S2-S15.
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Copyright (c) 2026 Mustakimova Fatima Alifgatovna
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