UCSF Pain Management Center
Institute of Medicine
American Academy of Arts and Sciences

Howard Fields, MD, PhD founded the UCSF Pain Management Center and has made major contributions to the understanding and treatment of neuropathic pain, and the understanding of mechanisms of pain modulation and placebo analgesia.

He received his MD and PhD in Neuroscience at Stanford in 1965-66. After Internal Medicine training at Bellevue Hospital in New York, he spent three years as a research neurologist at Walter Reed Army Institute of Research. Following clinical training in neurology at the Boston City Hospital Service of Harvard Medical School in 1972, he joined the faculty of the University of California San Francisco.

Dr. Fields’ major interests are in nervous system mechanisms of pain and substance abuse with a focus on how endogenous opioids contribute to these mechanisms. His group was the first to demonstrate the clinical effectiveness of opioids for neuropathic pain and of topical lidocaine for post-herpetic neuralgia. In laboratory studies he discovered and elucidated a pain modulating neural circuit that is required for opioids to produce analgesia. He also discovered that placebo analgesia is blocked by an opioid antagonist.

His recent work has centered on the problem of addiction, and he has begun to delineate the molecular and cellular circuitry of drug reward. His laboratory discovered nerve cells in the striatum that selectively encode the magnitude of a reward. They have also shown how the neurotransmitter dopamine contributes to motivation and reward based choice. His latest work focused on the neurobiology of opioid reward.



Recent Sessions at Neurovations Events

2019 Napa Pain Conference

2018 Napa Pain Conference


Honors & Awards

  • 2019 Legacy Lecture, Napa Pain Conference
  • Founder’s Award, American Academy of Pain Medicine
  • Mitchell Max Award for Neuropathic Pain Research, American Academy of Neurology
  • Raymond D. Adams Lecture. American Neurological Association
  • Cotzias Lecture, American Academy of Neurology


Select Publications

  • Basbaum, A. I., & Fields, H. L. (1978). Endogenous pain control mechanisms: review and hypothesis. Annals of neurology4(5), 451-462.
  • Baron, R., Levine, J. D., & Fields, H. L. (1999). Causalgia and reflex sympathetic dystrophy: does the sympathetic nervous system contribute to the generation of pain?. Muscle & nerve22(6), 678-695.
  • Robbins, W. R., Staats, P. S., Levine, J., Fields, H. L., Allen, R. W., Campbell, J. N., & Pappagallo, M. (1998). Treatment of intractable pain with topical large-dose capsaicin: preliminary report. Anesthesia & Analgesia86(3), 579-583.
  • Rowbotham, M. C., Davies, P. S., & Fields, H. L. (1995). Topical lidocaine gel relieves postherpetic neuralgia. Annals of neurology37(2), 246-253.
  • Fields, H. L. (Ed.). (2013). Pain Syndromes in Neurology: Butterworths International Medical Reviews (Vol. 10). Butterworth-Heinemann.
  • Adams, J. E., Hosobuchi, Y., & Fields, H. L. (1974). Stimulation of internal capsule for relief of chronic pain. Journal of neurosurgery41(6), 740-744.
  • Baron, R., Fields, H. L., Jänig, W., Kitt, C., & Levine, J. D. (2002). National Institutes of Health Workshop: reflex sympathetic dystrophy/complex regional pain syndromes—state-of-the-science.
  • Oaklander, A. L., & Fields, H. L. (2009). Is reflex sympathetic dystrophy/complex regional pain syndrome type I a small‐fiber neuropathy?. Annals of neurology65(6), 629-638.
  • Schwartz, D. M., Fields, H. L., Duncan, K. G., Duncan, J. L., & Jones, M. R. (1998). Experimental study of tetrodotoxin, a long-acting topical anesthetic. American journal of ophthalmology125(4), 481-487.
  • Goadsby, P. J., & Fields, H. L. (1998). On the functional anatomy of migraine. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society43(2), 272-272.