Our bodies sense painful stimuli through certain receptors located in the skin, in joints and many internal organs. Specialized nerve fibers relay these signals coming from the periphery to the brain, where pain becomes conscious. “The spinal cord is placed between these structures as kind of a pain filter”, says Hanns Ulrich Zeilhofer, Professor at the Institute of Pharmaceutical Sciences at ETH Zurich and at the Institute of Pharmacology and Toxicology of the University of Zurich.
That filter assures that pain is not evoked by everyday stimuli like light touch. This is accomplished by inhibitory nerve cells located in the spinal dorsal horn that release the messenger molecule-amino butyric acid (GABA) at specialized contacts between neighboring nerve cells, so-called synapses. GABA then activates chloride channels on those neighboring cells which relay the pain signals to the brain.
In patients with chronic inflammatory diseases, such as rheumatoid arthritis or after nerve damage, for example following injuries, the pain inhibiting action of GABA becomes severely compromised. Pain signals are then conducted to the brain nearly unfiltered. Benzodiazepines, such as the sedative drug Valium®, which enhance the action of GABA, alleviate chronic pain when they are applied directly to the spinal cord via an injection into the spinal canal.