By unconscious or covert processing of pain we refer to nascent interactions that affect the eventual deliverance of pain awareness. Thus, internal processes (viz., repeated nociceptive events, inflammatory kindling, reorganization of brain networks, genetic) or external processes (viz., environment, socioeconomic levels, modulation of epigenetic status) contribute to enhancing or inhibiting the presentation of pain awareness. Here we put forward the notion that for many patients, ongoing sub-conscious changes in brain function are significant players in the eventual manifestation of chronic pain. In this review, we provide clinical examples of nascent or what we term pre-pain processes and the neurobiological mechanisms of how these changes may contribute to pain, but also potential opportunities to define the process for early therapeutic interventions.

中文翻译：

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对疼痛的潜意识（潜在）处理及其演变为有意识的意识。

通过对疼痛的无意识或隐蔽处理，我们指的是影响疼痛意识最终传递的新生互动。因此，内部过程（即重复伤害性事件、炎症点燃、大脑网络重组、遗传）或外部过程（即环境、社会经济水平、表观遗传状态的调节）有助于增强或抑制疼痛意识的表现。在这里，我们提出了这样一种观点，即对于许多患者来说，大脑功能的持续潜意识变化是慢性疼痛最终表现的重要因素。在这篇综述中，我们提供了新生或我们称之为前疼痛过程的临床例子，以及这些变化如何导致疼痛的神经生物学机制，