Understanding pain is essential to preserve and restore health and to relive suffering.
function of the pain sensory system -
1.to protect the body
2. To maintain homeostasis.
ACUTE Pain- treatment with nsaid and understanding the etiology
CHRONIC PAIN- important part of this process is to identify specific and realistic functional goals for therapy.
A primary responsibility of all physicians is to minimize the physical and emotional discomfort of their patients. Familiarity with pain mechanisms and analgesic medications is an important step toward accomplishing this aim
Peripheral mechanism:- A peripheral nerve consists of the axons of three different types of neurons: primary sensory afferents, motor neurons, and sympathetic postganglionic neurons.
A large proportion of Aδ and C fiber afferents innervating viscera are completely insensitive in normal noninjured, noninflamed tissue and cannot be activated by known mechanical or thermal stimuli and are not spontaneously active.But in presence of inflammatory mediators, these afferents become sensitive to mechanical stimuli.
Nociceptor-Induced Inflammation- Most nociceptors contain polypeptide mediators, including substance P, calcitonin gene related peptide (CGRP), and cholecystokinin, that are released from their peripheral terminals when they are activated.
CENTRAL MECHANISM:-
The Spinal Cord and Referred Pain :- he major neurotransmitter released is glutamate, which rapidly excites the second-order dorsal horn neurons. Primary afferent nociceptor terminals also release substance P and CGRP, which produce slower and longer-lasting excitation of the dorsal horn neurons. The axon of each primary afferent contacts many spinal neurons, and each spinal neuron receives convergent inputs from many primary afferents.
Examples of pain:- Postherprtic neuralgia, Diabetic neuropathy,migraine headache, chronic low bachache , Rheumatic arthritis, tension headache,cancer, central post stroke pain.
Summary- pain is the pin point of disease and identifying the factor is important to prevent long term complication.
Engaging question :- When pain arises don’t go for relief immediately first find the cause to relieve it forever.
MBH/PS
