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hi iamp;#39;m veronica carulla and iamp;#39;m joining you again for part two of ascending and descending control of pain in this module we will discuss acute to chronic pain and management strategies once again i have no financial relationships or conflicts of interest after this module you will be able to differentiate between acute and chronic pain describe the physiologic and psychological effects of pain understand the concept of multimodal pain management understand the relative potency of opioids and the various routes of administration and understand the role of neuromodulation in the treatment of chronic pain the transition from acute to chronic pain occurs in discrete pathophysiological steps involving multiple signaling pathways stimuli initiating a nociceptive response vary but receptors and endogenous defense mechanisms in the periphery interact in a similar manner regardless of the insult the duration and intensity of the initial stimulus leads to both peripheral and cen