If a patient experiences chronic pain despite typical analgesic treatment, which mechanism involving nociceptor signal transduction is most likely contributing to this resistance?

💡 Explanation

Chronic pain resistance often involves central sensitization; because repeated nociceptor activation can lead to increased NMDA receptor expression in the dorsal horn, this enhances pain signaling. Therefore, NMDA receptor upregulation is the most likely answer, rather than decreased substance P release which would reduce pain.

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