When a body part is damaged, the feeling and emotional experience of pain occur. Tissue injury can be prevented or mitigated by the body's response.
A signal is sent by nerve fibers to the brain, where it is interpreted by the brain. Each person's perception of pain is unique, as are the varied ways in which it can be felt and expressed. Pain can be difficult to diagnose and manage in some circumstances because of this variety.
Pain can be short- or long-term, and it can either be concentrated in a single area of the body or dispersed across the entire body.
What causes pain? What forms of pain are there? Why do we feel pain? How do you treat it?
A group of nerves known as nociceptors detect tissue injury and transmit this information through the spinal cord to the brain.
If, for example, your hand touches a heated surface, you'll feel an instantaneous contraction of your muscles because of the reflex arc in your spinal cord. The hand will be pulled away from the hot surface as a result of this contraction, reducing the risk of additional injury.
When a stimulus is delivered to the brain, the body's reflex is activated. As soon as a person receives a pain message, they feel an unpleasant feeling, which is called pain.
One's perception of pain is determined by the brain's ability to comprehend these signals and how well they can communicate with their nociceptor partners in this process.
Dopamine and other feel-good chemicals, such as serotonin, may be released by the brain in response to pain.
Why do we feel pain? Types of pain
Pain can be either acute or chronic.
Intense and short-lived, this sort of pain is common. When an accident or localized tissue damage occurs, the human body sends out a warning signal. Acute pain is generally relieved by treating the underlying damage.
The body's fight-or-flight reaction is triggered by acute pain, and this typically results in quicker heartbeats and respiration.
There are a variety of acute pains, including:
Somatic pain: In this type of pain, the skin or the soft tissues right underneath it are affected.
Visceral pain: Organs and cavities within the body are thought to be the source of this pain.
Referred pain: In contrast to the site of tissue destruction, a person may feel discomfort in their gastrointestinal tract. For instance, many patients who are having a heart attack complain of pain in their shoulders.
A chronic pain condition, unlike acute pain, has no known treatment. It is possible to have chronic pain that is either minor or severe. If you suffer from arthritis or migraines, you may experience constant pain. The discomfort recurs frequently but subsides between outbursts.
The sympathetic nervous system, which activates the fight-or-flight response in persons with chronic pain, gradually adjusts to the pain signal. An accumulation of electrical impulses in the central nervous system (CNS) might overstimulate the nerve fibers if enough acute pain episodes occur.
A windup toy analogy is used to describe this phenomenon, referred to as "windup" by the technical community. Faster and longer-lasting toys may be made by winding them up with more vigor than normal. When it comes to chronic pain, the same rules apply.
Pain can be described in a variety of ways, some of which are more specific.
Among them are:
Neuropathic pain: Peripheral neuropathy is a common ailment that happens when a peripheral nerve is damaged. Tenderness, numbness, tingling, or pain are all possible symptoms.
Phantom pain: phantom pain happens after a limb has been amputated. What that means is that you feel the pain in your missing leg, even if it is not actually there.
Central pain: As a result of infarction or other complications of the brain and spinal cord, this sort of pain is common. There is a constant, varying degree of pain in the central nervous system. A scorching, aching, or pressing ache is a common symptom reported by those suffering from central pain.
Doctors can provide a more precise diagnosis if they have a better grasp of how their patients express their pain.
Diagnosis of pain
A doctor can establish a diagnosis based on a patient's subjective account of their suffering. The doctor will obtain a history of the patient's pain because there is no objective scale for determining the type of pain.
Individuals will be asked to explain:
The nature of all pains, including stinging, burning, and stabbing
The location, intensity, and distribution of pain, i.e., how intense the pain is, where it originates, and how far it has spread.
What variables exacerbate and alleviate pain?
The times of day when pain is most prevalent.
A person's ability to operate normally and how they feel on a regular basis
An individual's capacity to comprehend their own pain
Many systems exist for identifying and grading pain. Clear communication between a patient and their doctor is the most critical aspect of obtaining an accurate diagnosis.
Doctors employ a variety of methods to alleviate pain, including:
Numerical rating scales: Pain is measured on a scale from 0 to 10, with 0 being no agony and 10 indicating the greatest pain possible. A patient's pain level can be tracked over time to see how treatment affects it or if their condition worsens.
Verbal descriptor scale: Children with cognitive impairments, elderly persons with cognitive impairments, autistic people, and those with dyslexia may benefit from this scale. By asking more specific questions than just plain old numbers, your doctor can zero in on the exact sort of pain you're experiencing.
Faces scale: From a concerned expression to an upbeat one, the doctor displays the individual in agony various expressions. This scale is mostly used by doctors while treating youngsters. Applied to autistic persons, the approach has demonstrated positive results.
Brief pain inventory: Doctors can better assess the impact of a patient's pain on their mood, activity level, sleep habits, and interpersonal connections by using this written questionnaire. Additionally, it tracks the pain's timeline to see if there are any trends.
Other indicators of pain
For those who have cognitive disabilities, there are nevertheless unmistakable symptoms of their distress. Among them are:
Groaning and moaning
Refusal of treatment
Fewer social encounters
A greater tendency to wander
Problems with sleep
Pain-relieving medication may be prescribed if the underlying disease is curable, or the doctor may choose to treat the pain.
Treatment and management of pain
Depending on the type of pain, doctors will employ a variety of approaches. If the therapy works for one type of pain, it might not work for another.
It is possible that curing the underlying cause of this sort of pain will eliminate the need for pain medication. An antibiotic can be used to treat a sore throat caused by a bacterial infection, thereby relieving discomfort.
The painkiller acetaminophen is one of several analgesics or narcotics. Hundreds of medicines, including over-the-counter and prescription pharmaceuticals, include it.
Acetaminophen, also known as Tylenol, is a painkiller and fever reducer. It can be used in combination with other compounds to treat allergies, coughs, flu, and cold symptoms.
For moderate to severe pain, doctors frequently give acetaminophen-containing medications.
But acetaminophen may seriously harm the liver if used at excessive levels. The prescribed dosage should never be exceeded.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Analgesics of the NSAID class are still another option. With their assistance, a person's ability to perform daily tasks may be restored. At various strengths, they can be purchased over the counter or by prescription. Analgesics like NSAIDs can be used to treat minor acute conditions, including headache, mild sprain, and low back discomfort.
Localized inflammation and discomfort caused by swelling can be relieved with NSAIDs. The digestive system may be affected by some medications, which may cause bleeding. Because of this, a doctor will keep an eye on a patient who is taking a large dose.
Before ingesting an analgesic, make sure to examine the label to see what's in it and what the recommended dose is. The prescribed dosage should never be exceeded.
The most severe acute pains, such as those caused by surgery, burns, cancer, and bone fractures, are treated with these medications. Opioids are extremely addictive, create withdrawal symptoms, and diminish their potency over time, making them dangerous. They must be prescribed by a physician.
Opioid dosages are carefully controlled and progressively reduced to minimize withdrawal symptoms in cases of severe trauma and pain.
All pharmaceutical alternatives should be thoroughly discussed with a doctor, including any health issues and existing medication.
When used by persons with certain chronic conditions, opioids can have life-threatening negative effects on them. For example, they might worsen the symptoms of COPD by causing respiratory depression.
Chronic pain treatment
Non-drug treatments for pain relief are plenty. Some of these alternatives to medicine may be more appropriate for those with chronic pain.
Among the treatments offered are:
Acupuncture: This involves inserting very fine needles at specific pressure points, which may reduce pain.
Nerve blocks: A nerve block injection can numb the group of nerves that are responsible for causing pain in a specific portion of the body, such as an arm or leg.
Psychotherapy: Chronic pain typically affects the pleasure of daily activities and makes working harder. There is also evidence that chronic pain can cause depression, which in turn worsens chronic pain. Changes in one's life can be implemented by a psychotherapist in order to lessen the severity of the suffering and build one's ability to cope.
Surgery: Chronic pain can be treated surgically in a number of ways. Among these are rhizotomy, decompression, and deep brain and spinal cord electrical stimulation.
Biofeedback: This mind-body approach teaches a person how to better direct their organs and autonomic processes like their heart rate through their conscious thoughts.
Relaxation therapies: Relaxation methods and exercises in the alternative and complementary medicine field are included below. Yoga, meditation, massage, distraction methods, and tai chi are just some of the disciplines that may be used to help someone overcome their fear.
Physical manipulation: A person's back can be relieved of stress by a physiotherapist or a chiropractor.
Physical therapy: In addition to improving mobility, physical therapy activities may help alleviate chronic pain.
Heat and cold therapy: Hot and cold packs might be helpful. Alternating or selecting from a variety of options is an option available. Topical drugs that are applied to the afflicted region might have a warming effect.
Rest: Rest may be the best option if the pain is caused by an accident or overuse of a section of the body.
Maintaining everyday activities, social involvement, and an active quality of life are all feasible with proper pain management.
Frequently Asked Questions
Where can I get treatment for pain?
For educational reasons, this article's advice and information are not designed to replace or dispute a physician's recommendations or judgment. After speaking with your doctor, follow any medical advice you get from this site or any other source. If you have any questions or concerns, feel free to make an appointment with one of our doctors at Atlas Pain Specialists.
About Dr. Sean Ormond
Dr. Sean Ormond is dual board-certified in Anesthesiology and Interventional Pain Management. He completed his anesthesia residency at Case Western University in Cleveland, Ohio where he served as Chief Resident, followed by an interventional pain management fellowship at Rush University in Chicago, IL. Following fellowship, Dr. Ormond moved to Phoenix and has been practicing in the Valley for a few years before deciding to start his own practice.