Pain will always make itself felt. Pain can be searing, like after a burn or needle stick, or dull, like a forehead pain after a day’s work. Pain can also severely restrict movement, such as lower back pain after lifting weights. Pain is normally a protective function of the body and helps prevent damage to the body. But in some cases, pain loses its protective function and significantly impairs the quality of life. Pain is a feeling that has a complex structure, and the perception of pain varies greatly from person to person, even for identical injuries or conditions. Trodon can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed.
In 1931, the French physician Albert Schweitzer wrote: “Pain is a greater punishment of mankind than even death itself. Today, pain (especially chronic pain) has become a universal condition and a serious problem, both for the individual and for family and friends, and a costly problem of health care, which must support the individual suffering from both the physical and emotional effects of pain.
Ancient civilizations that have left information on themselves with inscriptions on stones testify that people used heat, water, pressure, and sunlight to treat pain. Ancient people attributed pain to evil forces (demons, magic) and so the treatment of pain was handled by shamans, priests, sorcerers who used herbs, rituals and ceremonies to relieve pain.
The people of Greece and Rome were the first to link the perception of pain with the brain and nervous system. But it was not until the Middle Ages during the Renaissance-1400-1500-that this idea had its greatest flowering. Leonardo, Da Vinci and his contemporaries concluded that the brain was the main organ responsible for sensation. Da Vinci also developed the theory that the spinal cord transmitted sensation to the brain.
In the 17th and 18th centuries, the study of the human body and the senses continued to be a source of the unknowable for human scientists. In 1664, the French philosopher René Descartes described what to this day is still sometimes called the “pain route. Descartes showed that pain in the legs reaches the brain and produces an effect comparable to the ringing of a bell.
In the 19th century, the study of pain became scientific, and clearer ways of treating pain emerged. Physicians discovered that drugs such as morphine, codeine, and cocaine could be used to treat pain. Over time, the study of drugs led to the creation of a drug such as aspirin, which does not have the side effect of addiction that is characteristic of drugs. Some time later, both general and local anesthesia drugs were developed, allowing pain-free surgery. It wasn’t until the 21st century that systemic explanations for pain began to emerge.
What is pain? The International Association for the Study of Pain defines it as: an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.
There are generally two main types of pain, acute pain and chronic pain, and they differ greatly from each other
Acute pain is most often the result of disease, inflammation or tissue damage. This type of pain usually occurs suddenly, such as after an injury or surgery, and may be accompanied by anxiety or emotional exhaustion. The cause of the acute pain can usually be diagnosed and treated, and the pain regresses over a period of time. In some cases, the pain may become chronic.
Chronic pain is thought to represent the disease itself. The pain may be exacerbated by environmental and psychological factors. Chronic pain persists for a longer period of time than acute pain and is resistant to most medical prescriptions. Typically, chronic pain creates serious problems for the patient. A person may have two or more concurrent chronic pain syndromes. Such syndromes may include: chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, temporomandibular joint dysfunction. It is possible that these syndromes share a common cause.
Hundreds of pain syndromes make up the spectrum of pain. There are the most harmless, fleeting sensations of pain, such as a needle prick. At the same time, there are intense pains, like those of childbirth or a heart attack or a trauma. In addition, pain can accompany cancer or the aftermath of severe trauma to the head or spinal cord.
Most commonly, pain syndromes are caused by the following conditions.
Arachnoiditis is a condition in which there is inflammation of the spiderous membrane of the brain. Arachnoiditis can be caused by infections or trauma. Arachnoiditis can lead to the development of headaches, which may be episodic or persistent.
Arthritis. Millions of people suffer from inflammatory diseases such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gout. These diseases are characterized by joint pain.
Many other inflammatory soft tissue diseases cause the development of painful manifestations, such as tendinitis, bursitis, myositis.
Back pain (including chronic) is the most common pain syndrome and is a kind of payment for the benefits of civilization and sedentary lifestyle. Back pain that irradiates into the leg is called lumboishalgia. As a rule, back pain is caused by problems in the intervertebral discs. Changes in the discs (herniated discs, disc protrusions) affect nerve structures and cause pain. Spondylolisthesis can also be the cause of pain, as this condition displaces one vertebra in relation to another and affects nerve structures, resulting in pain.
Radiculopathy is also one of the causes of pain and is caused by nerve root compression.
Spinal stenosis is a narrowing of the spinal canal. Most often, spinal canal stenosis is due to age-related changes and is manifested by leg pain and weakness in the legs.
Pain from burns can be very intense and cause great problems for medical professionals, as it is sometimes very difficult to control these painful manifestations. Grade 1 burns are the least severe; with grade 3 burns, pain can be excruciating and persist even after the burn has healed and become chronic pain.
Pain in cancer (cancer, sarcoma) can be caused both by direct tissue exposure (as the tumor grows, or metastasizes) and by intoxication of the body associated with the tumor process. In most cases, pain caused by tumors can be significantly reduced.
Headaches bother millions of people. There are three most common types of chronic headaches: migraines, cluster headaches and tension headaches.
Migraines are characterized by a headache with a throbbing sensation and are also accompanied by other symptoms such as nausea and visual disturbances. Migraine is more common in women than in men. Stress can provoke a migraine attack and the likelihood of developing a stroke in these patients.
Cluster headaches are characterized by excruciating piercing pain in half of the head, and they occur more often in men than women.
Tension headaches are often characterized by patients as a tightening hoop around the head.
Pain in the head or face may also be due to dental problems or peripheral nerve damage, due to trauma or inflammation (e.g., trigeminal neuralgia). Temporomandibular pain may be associated with temporomandibular joint disorders.
Muscle pain can range from muscle pain due to spasm or tension to pain with spastic muscle contraction in paralysis. Another source of muscle pain may be a condition such as fibromyalgia. Fibromyalgia is characterized by symptoms such as chronic fatigue stiffness, joint soreness and widespread muscle pain. Diseases such as polymyositis, dermatomyositis and myositis can also cause muscle pain and are caused by inflammation of muscle tissue. Muscle inflammation can be caused by infection or autoimmune processes associated with connective tissue diseases such as SLE or rheumatoid arthritis. Myofascial pain syndromes are characterized by trigger points located in the muscles. Myofascial pain syndromes are sometimes misdiagnosed and can cause long-term discomfort to the patient and impair quality of life. Fibromyalgia is considered a type of myofascial pain syndrome.
Neuropathic pain is a type of pain that can result from nerve damage (in the peripheral or central nervous system). Neuropathic pain can occur in any part of the body and often presents with a burning sensation. Such pain can be the result of diseases that cause damage to nerve fibers (e.g. diabetes, trauma, or, the toxic effects of chemotherapy in the treatment of cancer). The most common diabetic neuropathy is caused by damage to nerve fibers due to secondary vascular changes resulting from diabetes.
Phantom pain is a specific pain syndrome when the patient feels pain in limbs that have been amputated.
Postherpetic neuralgia can produce a chronic pain syndrome due to damage by the shingles virus to the sensitive nerve fibers.
Central pain syndrome, which can result from trauma to the brain or spinal cord.
Reflex sympathetic dystrophic syndrome is accompanied by burning pain and hypersensitivity to temperature. The syndrome is often caused by trauma or nerve damage and often the skin in the affected area becomes unnaturally shiny. In recent years, RSDS has come to be referred to as regional pain syndrome, whereas in the past it was referred to as causalgia.
Muscle pain can be caused by stressful muscle damage resulting from repetitive movements performed during work or other daily activities. Such muscle pain includes:
Writer’s spasm, which occurs in writers or musicians.
Tunnel syndromes (e.g., carpal tunnel syndrome caused by chronic wrist strain).
Tendinitis or tendovaginitis with damage to one or more tendons.
There are also other diseases that cause pain in the skin:
Vasculitis (inflammation of blood vessels);
Infections (including herpes simplex)
Tumors associated with neurofibromatosis
Sports injuries are frequent sources of chronic pain. Sprains, tendons, bruises, sprains and fractures are quite common terms in sports. As a rule, sports injuries and painful manifestations are acute and disappear after adequate treatment. Chronic pain manifestations are usually due to serious injuries (e.g., head or spinal injuries).
Central pain syndrome, which can result from trauma to the brain or spinal cord.
The injury can occur either at home, in the workplace or during sporting events, or as a result of a car accident. Any of these injuries can lead to severe disability and pain. Some patients who have had a spinal cord injury experience severe pain in the form of tingling or burning. These patients tend to be very sensitive to temperature effects on the skin. In these people, a slight touch can be perceived as a strong burning sensation because the transmission of signals to and from the brain is disrupted. This condition is called central pain syndrome or, if the lesion is in the thalamus (the center of the brain responsible for bodily sensation), thalamic pain syndrome. This pain syndrome is found in patients with multiple sclerosis, Parkinson’s disease, spinal cord injuries, or strokes. Central pain syndrome is very difficult to treat and requires a combination of measures including analgesics, antidepressants, anticonvulsants, and electrical stimulation.
Vascular diseases or injuries – such as cramps, coronary heart disease, circulatory disorders are also often the source of pain manifestations. Vascular pain bothers millions of people and occurs when the connection between blood vessels and nerves is disrupted. Ruptures, seizures, constriction or blockage of blood vessels, and conditions in which there is poor circulation (ischemia) of organs, tissues or extremities can lead to pain.
Currently, there are no objective methods of measuring pain, no methods of measuring pain intensity, and no methods of visualizing pain manifestations. Therefore, pain assessment has a subjective character and is based on the description of pain sensations and descriptions of its characteristics by the patient himself. A detailed description of pain allows in most cases to determine (assume) the cause of pain manifestations. But, nevertheless, instrumental methods and objective research methods allow to determine the morphological source of pain.
First and foremost these include:
EMG and ENMG allow us to determine the conduction of impulse along the nerve fibers and muscles and thus detect the presence of nerve fiber damage.
MRI. The most advanced method of neuroimaging allows for detailed tissue imaging.
Physical examination, including determination of neurological status, in which the doctor determines the state of reflex functions, sensitivity, coordination of movements and balance allows to detect clinical manifestations of diseases.
Radiography provides an image of bone tissues, and is most often used in the diagnosis of trauma.
Ultrasound allows you to determine changes in the soft tissues of blood vessels
Laboratory tests can determine the presence of inflammatory processes
NSAIDs and analgesics (including opioids) are most commonly prescribed for the treatment of pain. NSAIDs reduce inflammation and thus reduce (eliminate) pain, especially when pain is caused by inflammation (e.g., arthritis). For many years, scientists have been working on a drug that works in the same way as morphine, but without the negative side effects. Non-steroidal anti-inflammatory drugs work by blocking two enzymes, cyclooxygenase-1 and cyclooxygenase-2, both of which are involved in the synthesis of hormones called prostaglandins, which in turn are responsible for inflammation, fever, and pain. The newer COX-2 inhibitors primarily block cyclooxygenase-2 and have fewer gastrointestinal side effects than NSAIDs. However, taking these drugs should not be prolonged, as there is some evidence that these drugs increase the risk of heart attack.
Anticonvulsants. This group of drugs is mainly designed to treat epilepsy and seizures, but has shown effectiveness for some pain syndromes (such as trigeminal neuritis). These are drugs such as carbamazepine or gabapentin. The use of gabapentin is also possible for neuropathic pain.
Antidepressants are quite often prescribed to treat chronic pain syndromes in the same way as tranquilizers or neuroleptics. The effect of these medications is due to their effect on the central mechanisms of pain. In addition, tranquilizers (benzodiazepines) have a relaxant effect and reduce muscle spasm.
Myorelaxants (mydocalm, sardalud, baclofen) have a certain analgesic effect in the presence of muscle spasm.
Migraine medications include triptans-sumatriptan (Imitrex), naratriptan (Amerge), and zolmitriptan (Zomig)-and are used specifically to treat migraine. They can have serious side effects in some people and should therefore only be used under a doctor’s supervision.
Ointments containing both NSAIDs and substances such as capsicaine may also be used.
Chiropractic therapy can reduce back pain and restore the mobility of motor segments.
Physical therapy. There are quite a few different physical therapy techniques, which can reduce pain and relieve inflammation in various tissues or joints. Among modern methods such as percutaneous electroneurostimulation and laser treatment (both low-intensity and high-energy, such as HILT) are widespread.
Spinal cord stimulation is performed in some cases. Electrodes are surgically inserted into the epidural space and the electrodes are electrically pulsed by an electronic device placed on the patient’s body.
Brain stimulation is rarely used and usually involves stimulation of the thalamus. Brain simulation is used for a limited number of conditions, such as central pain syndrome, cancer pain, and phantom pain.
LFC. It has been proven that there is a clear link between chronic back pain and tight weak muscles. In such cases, even moderate physical activity can improve blood circulation in the muscles and reduce pain manifestations. Physical exercise also increases the production of substances such as endorphins, which have pain-relieving properties.
Surgery may be necessary to manage pain, especially spine-related pain or serious musculoskeletal injuries. Surgical treatments are aimed at decompressing nerve roots, and more recently, minimally invasive surgical techniques (such as microdiscectomy) have been developed. For severe pain syndrome caused by an oncological process, a rhizotomy operation may be performed, in which a nerve is incised closer to the spinal cord or a cordotomy may be performed. Selective nerve cell damage in the target area of the brain is also possible.
For peripheral pain syndromes, an operation such as a neuroectomy is performed, in which the damaged nerve is destroyed. It is also possible to inject special drugs (e.g. guanethidine) into the sympathetic nodes, this manipulation is called a sympathectomy, in cases where excessive vascular spasm must be relieved (e.g. in sympathetic dystrophic syndrome)
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