Neuropathic pain is caused by damage to sensory orspinal nerves, which send inaccurate pain messages tohigher centers.26 For example, in diabetic neuropathy,the origin of foot pain is not in the tissue, but rather,the peripheral nerves. The disease attacks the peripheralnerves, resulting in an aberrant signal interpreted by thebrain as pain in the feet. Centralized pain is the result ofamplification of peripheral signals due to persistent central nervous system dysfunction.22 Pain may be presentdespite a lack of a clear peripheral cause. A classic example is fibromyalgia.25 The Clauw metaphor is that theelectric guitar is a quiet instrument until the amplifier(brain) is plugged in. The central nervous system amplification makes the pain impossible to ignore