Chronic Pain

pain

Pain is a feeling which we feel due to some injury or trauma. It may be burning, sharp, pricking or slow aching pain. It is in fact a helpful feeling by which a person become aware of the pathology which is going on within his body so diagnose can be made. It is a complex perception and it differs among different individuals.

Classification

Somatic Pain: The sense organs for somatic pain are the naked nerve ending and initial pain is sharp which is transmitted by fast conducting fibers and the more prolonged burning pain travels in the slow-conducting nerve fibers. The somatic pain is also given another name the parietal pain which occurs in the parietal surfaces e.g. parietal peritoneum, pleura or pericardium.

Visceral Pain: In case of visceral, there are special receptors, chemoreceptors, baroreceptors, osmoreceptors as well as stretch receptors that are sensitive to variety of stimuli. For example chemical stimuli, ischemia spasm of hollow viscus, stretching of connective tissues surrounding or within the viscera and excess distention of any hollow viscera. Essentially all the visceral pain originates in the chest and abdomen is of chronic aching suffering type of pain. The visceral pains are poorly localized and are often associated with nausea, vomiting, sweating and tachycardia. It can be referred to different sites.

Pain can be acute or it can be chronic.

Acute pain: This pain occurs on some injury or acute trauma or due to infection or inflammation. It is mostly self-limiting type of pain. Acute pain remains confined to time of injury and its severity. In some instances it may become chronic as well.

Chronic pain: Chronic pain occurs intermittently with pain free intervals as well. It occurs mostly in fibromyalgia, inflammatory bowel disease, chronic fatigue syndrome, endometriosis, any musculoskeletal disease conditions. The chronic type of pain has shown some resistance to medical treatment so that’s why it persists for longer time period.

Causes of Chronic Pain

The continuous stimulating pain carrying sensory receptors transmission to the dorsal horn may result in a wind up phenomenon which produces pathological changes that decrease the threshold for pain signals that is to be transmitted.  It may also generate sensory pain receptors to respond to pain signals. Non nociceptive nerve fibers are also able to produce and transmit pain signals. In chronic pain this process is difficult to stop or reverse once it has established.

Symptoms

The main symptom is the pain which comes and goes but always remains to re-occur. It may be mild to moderate or severe. There is also feeling of tightness and stiffness in the body. Pain is not only the symptom but it is accompanied by variety of other complaints. These are fatigue, decrease immunity, sleep disorders, depression, sadness, fear or decrease concentration in the work.

Diagnosis

It is made after taking complete history and physical examination. Some tests if done are better. MRI shows that different areas of brain even at rest are continually processing pains.

Treatment*

These days’ new techniques have been used to treat chronic pain with success. These include acupuncture and electrical stimulation of skin. The anticipation of the relief of pain is thought to stimulate the release of endorphins, which inhibits the normal pain pathway so patient does not feel pain.

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