Nociceptive input to the dorsal horn is relayed to higher

centers in the brain via several ascending pathways: the

spinothalamic tract being classically considered as the
major pain pathway.
_ Multiple cortical areas are activated by painful stimuli
including: the primary and secondary somatosensory
cortices, the insula, the anterior cingulate cortex, and
the prefrontal cortex.
_ The modulation of nociceptive messages in spinal cord
neurons is dependent on the balance of inputs from
primary afferent nociceptors, intrinsic spinal cord
neurons, and descending systems projecting from
supraspinal sites.
INTRODUCTION
The somatosensory system processes four broadly distinct
sensory modalities: tactile, proprioceptive, thermal sensations,
and pain.1 According to the specificity theory,
each sensory modality is mediated by a separate class of
receptor and a distinct neuroanatomical pathway. However,
while this classification is by no means as rigid as
first thought,