Pain is a highly complex phenomenon involving sensory, affective and cognitive components. This paper reviews the nociceptive (noxious sensory) system associated with trauma to the hand. Potential physiological mechanisms that may generate altered pain states and complicate presenting features in clients are focused upon. Specific attention is given to peripheral nociception and the potential role of the limbic system in the integration of sensory, cognitive and affective domains. Mechanisms of cellular plasticity contributing to pain states such as allodynia, hyperalgesia, hyperesthesia, sympathetic and referred pain are offered. Potential therapeutic ways of modulating pain and influencing the frequency and patterning of nociceptive information are considered.
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