This paper shows interaction of stress and pain. It is worthy of reading and telling patients under our care of the affect of stress in their life and spine pain.  JMC
summary: The adrenal medulla modulates mechanical allodynia in a rat model of neuropathic pain. The stress response mediated by the adrenal medulla in rats subjected to chronic constriction injury of the sciatic nerve (cci) modulates their nocifensive behavior. Treatment with sk29661 (300 mg/kg; intraperitoneal (i.p.)), a selective inhibitor of phenylethanolamine n-methyltransferase (PNMT) that converts noradrenaline (na) into adrenaline (a), fully reverted mechanical allodynia in the injured hind paw without affecting mechanical sensitivity in the contralateral paw. The effect was fast and reversible and was associated with a decrease in the a to na ratio (a/na) in the adrenal gland and circulating blood, an a/na that was elevated by CCI. Denervation of the adrenal medulla by surgical splanchnectomy attenuated mechanical allodynia in neuropathic animals, hence confirming the involvement of the adrenal medulla in the pathophysiology of the cci model. Inhibition of phenylethanolamine n-methyltransferase (PNMT) appears to be an effective and probably safe way to modulate adrenal medulla activity and, in turn, to alleviate pain secondary to the injury of a peripheral nerve.  
from: Arribas-Blázquez M, Olivos-Oré LA, Barahona MV, et al. The Adrenal Medulla Modulates Mechanical Allodynia in a Rat Model of Neuropathic Pain. International Journal of Molecular Sciences. 2020 Nov;21(21). DOI: 10.3390/ijms21218325.

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