%0 Journal Article %@ 1435-1463 %A Lockwood, S %A Dickenson, AH %D 2020 %F discovery:10084013 %J Journal of Neural Transmission %K 5-hydroxytrptamine, Conditioned pain modulation (CPM), Descending controls, Diffuse noxious inhibitory controls (DNIC), Noradrenaline, Spinal cord %P 541-549 %T What goes up must come down: insights from studies on descending controls acting on spinal pain processing %U https://discovery.ucl.ac.uk/id/eprint/10084013/ %V 127 %X Descending controls link higher processing of noxious signals to modulation of spinal cord responses to their noxious inputs. It has become possible to study one key inhibitory system in animals and humans using one painful stimulus to attenuate another distant response and so eliciting diffuse noxious inhibitory controls (DNIC) or the human counterpart, conditioned pain modulation (CPM). Here, we discuss the neuronal pathways in both species, their pharmacology and examine changes in descending controls with a focus on osteoarthritis. We will also discuss the opposing descending facilitatory system. Strong parallels between DNIC and CPM emphasize the possibility of forward and reverse translation. %Z Copyright © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.