"Heaven has no pain"

This farewell lecture is focused on pain and treatment of chronic pain. Almost every individual is familiar with pain but it should be recognized that in particular chronic pain is among the worst, maybe the worst and it is unbearable for a human being. The question still remains how to develop new treatments. In the Netherlands alone between 600,000 and 800,000 persons suffer from inexplicable chronic pain. And at the moment about 30-50% of these patients cannot be adequately treated. These patients are living in a hell and it is aimed to remove them and bring them little by little to “paradise” and/or “heaven”. From a fundamental molecular point of view, the process of “central sensitization” and conditioning is pivotal with a focus on what happens at the pain gate in the spinal cord. The question remains how to close the spinal pain gate as this will not allow signals to be transferred to the brain, where a complex pain-matrix network is localized.  In this farewell lecture the present status, impact, and future of not only neurofeedback but also interventional techniques in particular spinal cord stimulation and epigenetic molecular changes in neonates during the development of the spinal pain gate as well as the development of new pharmacological approaches based on nanobody drug-delivery techniques is presented. The role of A.I. and its possible future role in treatments of chronic pain patients is briefly discussed. 

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