Bringing Endometriosis to the Road of Contemporary Pain Science
Marcelo de França Moreira, Marco Aurélio Pinho Oliveira
Abstract
BACKGROUND: Endometriosis pain is mainly understood based on peripheral lesion characteristics and an outdated perspective equating nociception with pain. This limited view may divert understanding of interventions beyond peripheral logic, leading clinicians to see approaches targeting other processes as supplementary, limiting the effective addressing of treatment failure. Integrating critical advancements in pain and endometriosis can promote more comprehensive knowledge. OBJECTIVES: This article provides a conceptual framework focusing on overlooked or less clearly linked areas concerning the interplay between nociception and factors influencing endometriosis pain. It explores the complexity of nociceptive processing, the association between neuromerically connected structures, and the role of the brain in pain perception. Further, it emphasizes adopting mechanism-based understanding of pain that integrates neurobiological aspects of the nociceptive apparatus and related systems, shaped by psychosocial factors contributing to a possible negative spiral in those living with endometriosis. CONCLUSION: Aware of such a broader perspective can incentivize a balanced effort to inquire into peripheral lesion-related mechanisms and other domains potentially impacting endometriosis pain.