Pain - biography
"You are now leaving pain."You are now leaving pain.February 2008 Pain ModulesEach module contains 10 expertly selected and abstracted articles on pain.Practicing pain management physicians provide personal responses to your pain related inquiries.The "Ask the Pain Doctor" service is for information only.We have compiled for your use a list of over 3000 of pain specialists and pain management clinics from all over the globe.Select a state or province for more information and a map providing directions to the clinic.For pain in the sense of "suffering", see Suffering.For other uses, see Pain (disambiguation).Pain is the conscious experience of sensorial information and a feeling of unpleasantness that can manifest as a result of nociception.Neuropathic pain differs from nociceptive pain in that it involves damage to the nerve resulting in the sensation of pain.There is also central pain in which the pain is generated in the brain from some form of lesion, and which is the most difficult for medical professionals to treat.Occasionally pain may be psychogenic, meaning caused by mental illness; however this is exceedingly rare.As a part of the body's defense system, pain triggers mental and physical behavior that seek to end the painful experience.It is also a feedback system that promotes learning, making repetition of the painful situation less likely.Insensitivity to pain
3 Management and therapy of pain
3.Sources of pain
5 Some possible causes of pain by region
5.Definitions of pain
7 Physiology of nociception
7.Intensity
Pain may range in intensity from slight through severe to agonizing and can appear as permanent or intermittent.It may be experienced as sharp, throbbing, dull, nauseating, burning, shooting or a combination of these.The threshold of pain might have wide variation between individuals.Some pain sensations may be diffuse or referred.Referred pain, usually happening in visceral disease, occurs when sensory fibres from the viscus enter the same segment of the spinal cord as somatic nerves i.The sensory nerve from the viscus stimulates the closely associated nerve in the spinal cord and the pain perceived at the sensorial area of the brain is perceived as originating in the area supplied by the somatic nerve.An example is the left shoulder pain associated with heart damage.This subjective localisation of pain to an area of the body defines some kind of pain as neck pain, cutaneous pain, kidney pain, or the painful uterine contractions occurring during childbirth.This common usage of pain is not entirely consistent with the scientists' model of pain being a subjective experience.Does it seem to be getting better, or getting worse, or does it remain the same?The person who is suffering the pain should describe the pain, rather than saying what they think you would like to hear.How much of it is there?Where is the pain located?Does the pain radiate (i.Does it go anywhere else?Did it start elsewhere and now localised to one spot?How long does an episode last?When did the pain start, at what time?How often does it occur?Is it sudden or gradual?When do you usually experience it: daytime?Is it accompanied by other signs and symptoms?Does it ever occur before, during or after meals?Does it occur seasonally?Other questions to ask when assessing a person in pain: Any medication or allergies?Any history of pain?Inability to experience pain, as in the rare condition congenital insensitivity to pain or congenital analgesia, is a cause of physical damage due to unawareness.Insensitivity to pain may also be caused by Hansen's disease or other forms of nerve damage.CIP presents in early childhood with a child frequently getting injuries, such as broken bones and bruises, because they fail to develop the normal avoidance of pain and so take risks others would not.While such conditions are extremely rare, they may present a picture of child abuse to the health care provider who frequently reports to child protection, the police, or other agencies.Management and therapy of pain
Pain can be acute or chronic.The distinction between acute and chronic pain is not based on its duration of sensation, but rather the nature of the pain itself.It is usually treated simultaneously with pharmaceuticals or appropriate techniques for removing the cause and pharmaceuticals or appropriate techniques for controlling the pain sensation, commonly analgesics.Acute pain serves to alert after an injury or malfunction of the body.General physicians have only elementary training in chronic pain management and patients suffering from it are referred to specialists.Chronic pain may have no apparent cause or may be caused by a developing illness or imbalance.Sometimes chronic pain can have a psychosomatic or psychogenic cause.Chronic pain was originally defined as pain that has lasted 6 months or longer.It is now defined as "the disease of pain."The one consistent fact of chronic pain is that, as a disorder, it cannot be understood in the same terms as acute pain.The failure to treat acute pain properly may lead to chronic pain in some cases.Other therapies
Hypnosis as well as diverse perceptional techniques provoking altered states of consciousness have proven to be of important help in the management of all types of pain.Cutaneous pain is caused by injury to the skin or superficial tissues.Examples of injuries that produce cutaneous pain include paper cuts, minor cuts, minor (first degree) burns and lacerations.Somatic pain originates from ligaments, tendons, bones, blood vessels, and even nerves themselves.Myofascial pain usually is caused by trigger points in muscles, tendons and fascia, and may be local or referred.Visceral pain originates from body's viscera, or organs.The even greater scarcity of nociceptors in these areas produces pain that is usually more aching and of a longer duration than somatic pain.Visceral pain is extremely difficult to localize, and several injuries to visceral tissue exhibit "referred" pain, where the sensation is localized to an area completely unrelated to the site of injury.Myocardial ischaemia (the loss of blood flow to a part of the heart muscle tissue) is possibly the best known example of referred pain; the sensation can occur in the upper chest as a restricted feeling, or as an ache in the left shoulder, arm or even hand.The popularized term "brain freeze" is another example of referred pain, in which the vagus nerve is cooled by cold inside the throat.Referred pain can be explained by the findings that pain receptors in the viscera also excite spinal cord neurons that are excited by cutaneous tissue.Since the brain normally associates firing of these spinal cord neurons with stimulation of somatic tissues in skin or muscle, pain signals arising from the viscera are interpreted by the brain as originating from the skin.Phantom limb pain, a type of referred pain, is the sensation of pain from a limb that has been lost or from which a person no longer receives physical signals.Neuropathic pain, can occur as a result of injury or disease to the nerve tissue itself.This can disrupt the ability of the sensory nerves to transmit correct information to the thalamus, and hence the brain interprets painful stimuli even though there is no obvious or known physiologic cause for the pain.Neuropathic pain is, as stated above, the disease of pain.It is not the sole definition for chronic pain, but does meet its criteria.Some possible causes of pain by region
Visceral pain sensation is often referred by the CNS to a dermatome region which may be far away from the originating organ.Examples of this include the heart which originates in the neck, thus producing the classical pain and arm pain experienced during acute cardiac pain.Definitions of pain
Experts in pain have proposed a variety of definitions."Pain is whatever the experiencing person says it is; existing whenever he or she says it does.Margo McCaffrey, RN MS
"Pain is a category of complex experiences, not a single sensation produced by a single stimulus".Nociception refers to the system that carries signals of damage and pain from the tissues; it is the physiological event that accompanies pain.Deep internal surfaces are only weakly supplied with pain receptors and will propagate sensations of chronic, aching pain if tissue damage in these areas occurs.In some conditions, excitation of pain fibers becomes greater as the pain stimulus continues, leading to a condition called hyperalgesia.Transmission of nociception to the central nervous system
There are two ways for nociceptive information to reach the central nervous system, the neospinothalamic tract for 'fast spontaneous pain' and the paleospinothalamic tract for 'slow increasing pain'.The axons of these neurons travel up the spine to the brain and cross the midline through the anterior white commissure, passing upwards in the contralateral anterolateral columns.Fast pain is felt within a tenth of a second of application of the pain stimulus and is a sharp, acute, prickling pain felt in response to mechanical and thermal stimulation.Paleospinothalamic tract
Slow pain is transmitted via slower type C fibers to laminae II and III of the dorsal horns, together known as the substantia gelatinosa.Impulses are then transmitted to nerve fibers that terminate in lamina V, also in the dorsal horn, synapsing with neurons that join fibers from the fast pathway, crossing to the opposite side via the anterior white commissure, and traveling upwards through the anterolateral pathway.Slow pain is stimulated by chemical stimulation, is poorly localized and is described as an aching, throbbing or burning pain.Effects in CNS
When the nociceptors are stimulated they transmit signals through sensory neurons in the spinal cord.If the signals are sent to the reticular formation and thalamus, the sensation of pain enters consciousness in a dull poorly localised manner.From the thalamus, the signal can travel to the somatosensory cortex in the cerebrum, when the pain is experienced as localised and having more specific qualities.Nociception can also cause generalized autonomic responses before or without reaching consciousness to cause pallor, diaphoresis, bradycardia, hypotension, lightheadedness, nausea and fainting.Analgesia
The body possesses an endogenous analgesia system, which can be supplemented with analgesic drugs to regulate nociception and pain.There is both an analgesia system in the central nervous system and peripheral receptors that decreases the grade in which pain reaches the higher brain areas.The perception of pain can be modified by the body according to gate control theory of pain.Thus, rubbing a bumped knee seems to relieve pain by preventing its transmission to the brain.Pain is also "gated" by signals that descend from the brain to the spinal cord to suppress (and in other cases enhance) incoming nociception (pain) information.Genotype and pain
Pain may be experienced differently depending on genotype (i.People having this disorder are completely ignorant to pain, and can perform without pain any kinds of self mutilation or damage.In the families studied, this has ranged from biting of the person's own tongue leading to damage, through to street acts with knives, to death from injuries due to a failure to have learned limits on injury through experience of pain.CAM to treat back pain; 6.CAM to treat recurring pain.Some survey respondents may have used CAM to treat more than one of these pain conditions.Traditional Chinese treatments such as acupuncture are said to be more effective for nontraumatic pain than traumatic pain.The NIH's 1997 Consensus Statement on Acupunture notes that research has been mixed, partly due to difficulties with designing clinical studies with the proper controls.NIH which showed statistical evidence for the treatment's positive effect only amongst patients with moderate to severe pain, a small subsection of the study.The concept of pain has played an important part in the study of philosophy, particularly in the philosophy of mind.The question of what pain actually consists in is still open since any evaluation is dependent upon what subject one approaches the question from.Identity theorists assert that the mental state of pain is completely identical with some physical state caused by various physiological causes.Functionalists consider pain to be defined completely by its causal role (ie in the role it has in bringing about various effects) and nothing else.Some theologians and other spiritual traditions have much to say about the nature of pain and its various spiritual consequences, especially its role in growth, understanding, compassion, and in providing an aspect of life to be overcome.Survival benefit
Despite its unpleasantness, pain is an important part of the existence of humans and other animals; in fact, it is vital to survival.Pain encourages an organism to disengage from the noxious stimulus associated with the pain.Pain may also promote the healing process, since most organisms will protect an injured region in order to avoid further pain.People born with congenital insensitivity to pain usually have short life spans, and suffer numerous ailments such as broken bones, bed sores, and chronic infection.The study of pain has in recent years diverged into many different fields from pharmacology to psychology and neurobiology.Interestingly, the brain itself is devoid of nociceptive tissue, and hence cannot experience pain.Thus, a headache is not due to stimulation of pain fibers in the brain itself.Rather, the membrane surrounding the brain and spinal cord, called the dura mater, is innervated with pain receptors, and stimulation of these dural nociceptors (pain receptors) is thought to be involved to some extent in producing headache pain, been the vasoconstriction of peripheral vessels another common cause.Some evolutionary biologists have speculated that this lack of nociceptive tissue in the brain might be because any injury of sufficient magnitude to cause pain in the brain has a sufficiently high probability of being fatal that development of nociceptive tissue therein would have little to no survival benefit.Chronic pain, in which the pain becomes pathological rather than beneficial, may be an exception to the idea that pain is helpful to survival, although some specialists believe that psychogenic chronic pain exists as a protective distraction to keep dangerous repressed emotions such as anger or rage unconscious.It is not clear what the survival benefit of some extreme forms of pain (e.Pain and nociception in other species
Pain is defined as a subjective conscious experience.The presence or absence of pain even in another human is only verifiable by their report; "Pain is whatever the experiencing person says it is, and exists whenever he says it does."Currently, it is not scientifically possible to prove whether an animal is in pain or not, however it can be inferred through physical and behavioral reactions.In veterinary science all uncertainty is overcome by assuming that if something would be painful for a human then it would be painful for an animal.Where possible, analgesics are used preemptively if there is any likelihood of pain being caused to an animal.Nursing management of the patient in pain.The Challenge of Pain.Feinstein B, J Langton, R Jameson, F Schiller.Experiments on pain referred from deep somatic tissues.Increased sensitivity to thermal pain and reduced subcutaneous lidocaine efficacy in redheads."Scientists noted that Chinese veterinarians used acupuncture to do surgery on animals, thereby refuting the argument that the painkilling characteristics of acupuncture was one big placebo effect ascribable to cultural conditioning (no cow on earth will go along with unanaesthetized surgery just because it has a heavy investment in the cultural mores of the society in which it dwells.The best demonstration of this is what is called a subtraction experiment: block the activity of endogenous opioids by using a drug that blocks the opiate receptor...National Institutes of Health Consensus Panel."Curcumin attenuates thermal hyperalgesia in a diabetic mouse model of neuropathic pain.""Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis."Nursing management of the patient in pain.Philadelphia, Pa: JB Lippincott 1972.Look up pain, nociception, painful, hurting, dolor in Wiktionary, the free dictionary.What ever happens on tour stays on tour?Everything you read or see on this blog is exclusively uncensored.MUSIC IS everything to me.Center discuss pain management practice and issues.Pain: How Can You Tell if Your Child is in Pain?Pain Pills: How to Manage Your Medication to Avoid Addiction.ABC for their coverage of this important subject.APF spoke out on behalf of the 76.Caregiver Speaks Up: It Doesn't Have to Be This Hard.Services and providers for Pain in the U.Pain is a feeling triggered in the nervous system.Pain may be sharp or dull.You may feel pain in one area of your body, such as your back, abdomen or chest, or you may feel pain all over, such as when your muscles ache from the flu.Pain can be helpful.Without pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment.Once you take care of the problem, pain usually goes away.However, sometimes pain goes on for weeks, months or even years.This is called chronic pain.Sometimes chronic pain is due to an ongoing cause, such as cancer or arthritis.Sometimes the cause is unknown.Fortunately, there are many ways to treat pain.Treatment varies depending on the cause of pain.Pain relievers, acupuncture and sometimes surgery are helpful.Integrative Pain Therapy(Continuum Center for Health and Healing, Beth Israel Medical Center, Dept.Prolotherapy: An Effective Treatment for Chronic Pain?Symptom Management: Pain(Beth Israel Medical Center, Dept.Myofascial Pain Syndrome(Beth Israel Medical Center, Dept.Pain Quiz: Are You Fooled by Familiar Pain Myths?What Does the Future Hold for Marijuana for Pain?Article: Effect of abuse history on pain reports and brain responses...Glossary(Beth Israel Medical Center, Dept.Why Do I Have Pain?Physiother Advanced Muscle Pain Therapywww.Great pains have been taken to repair the engine perfectly.Your sarcasm pained me.After all that free beer, we were feeling no pain.Pain, ache, agony, anguish are terms for sensations causing suffering or torment.Pain and ache usually refer to physical sensations (except heartache); agony and anguish may be physical or mental.Pain suggests a sudden sharp twinge: a pain in one's ankle.Ache applies to a continuous pain, whether acute or dull: headache; muscular aches.Agony implies a continuous, excruciating, scarcely endurable pain: in agony from a wound.Muscle or Joint Pain?See us to get out of pain fast.An unpleasant sensation occurring in varying degrees of severity as a consequence of injury, disease, or emotional disorder.The pangs of childbirth.Great care or effort: take pains with one's work.Informal A source of annoyance; a nuisance.To cause pain to; hurt or injure.To be the cause of pain.Synonyms: These nouns denote a sensation of severe physical discomfort: abdominal pain; aches in my leg; the pangs of a cramped muscle; aspirin that alleviated the smart; a stitch in my side; the throes of dying; a twinge of arthritis.The verb meaning "to inflict pain" is first recorded c.Phrase to give (someone) a pain "be annoying and irritating" is from 1908; localized as pain in the neck (1924) and pain in the ass (1934), though this last may be the original, unrecorded sense and the others euphemisms.Pains "great care taken (for some purpose)" is first recorded 1528 (in the singular, in this sense, it is attested from c.Share This
pain In addition to the idioms beginning with pain, also see at pains; feel no pain; for one's pains; growing pains; no pain, no gain; on pain of.Example: It pained her to admit that she was wrong.
