Criticism of this model arises from its inability to explain why there is a delay between the onset of referred pain after local pain stimulation. Experimental evidence also shows that referred pain is often unidirectional. For example, stimulated local pain in the anterior tibial muscle causes referred pain in the ventral portion of. The role of the primary afferent nociceptors is explained. Dental pain is described as a form of acute pain and the mechanism of nociception is fundamental. Peripheral and central sensitization can evolve. The second part covers the pharmacological aspects. Local anesthetics reduce impulse transmission by interfering with. Pain. Feb;74() Adaptation to metastatic cancer pain, regional/ local cancer pain and non-cancer pain: role of psychological and behavioral factors. Turk DC(1), Sist TC, Okifuji A, Miner MF, Florio G, Harrison P, Massey J, Lema ML, Zevon MA. Author information: (1)Department of Anesthesiology, University of.