Spinal delivery of drugs in pain control

This chapter shows that spinal systems encode information that is sufficient to engender a pain state. Encoding occurs by multiple mechanisms manifesting a complex pharmacology. Importantly, these advances in the biology of pain have led to an implementation of several of these insights into clinical pain management. The focus on spinal drug delivery has achieved its goals by virtue of the distinct pharmacology of sensory encoding (e.g. light touch versus tissue injury). As such, it provides validation of the Cartesian assertion that pain at the spinal level has a specific encoding. The routine ability to deliver drugs acutely and chronically into the intrathecal space, along with the multiple targets and methods for intervening in the biology of specific neural nets and the importance of the spinal cord in pain processing, suggest that the continued development of agents for spinal delivery will yield important advances in the control of pain.