Conceptualizing pain throughout human evolution has not been easy, but in general terms it can be said that it is a defense mechanism that sends warning signals to protect the organism. Before starting pain treatment, it is necessary to identify the type of ailment.
Pain is defined as both a sensory and emotional experience that causes unpleasantness. To perceive pain, it is necessary to activate the sensitive nervous system and the nerve pathways responsible for responding to tissue nociceptive stimuli.
Data of interest
- As we age, the pain increases.
- Women are more prone to pain than men.
- Pain affects the individual, family, social and economic levels.
- A large percentage of the youth community experiences Ache Head, while older people suffer from pain in the extremities.
Difference between pain and suffering
Suffering is considered a subjective sensation in which there may be a biological, psychological and social factor. That means, a person can experience intense pain without suffering. Such is the case with the experience during theHe Birth.
On the other hand, anguish, anxiety or depression are part of suffering. This means that everything that causes wear and tear on the nervous system is part of it. The patient is afraid of experiencing horrible pain.
Anatomy and physiology of pain
When the body receives the stimulus, they are activated nerve receptors, joints, nerve fibers located in skin tissue and muscles. Once captured, pain turns into impulses. Of which there are three types:
- Mechanoreceptors: skin pressure.
- Thermoreceptors: Activated by extreme temperatures.
- Polymodal receptors: nociceptive, mechanical, thermal and chemical stimuli.
The substances that released when there is pain are the same as the alteration or tissue damage. These include histamine and serotonin. Others are:
- Potassium and hydrogen ions.
- Bradycine from the bloodstream.
- Prostaglandins and leukotrienes from damaged tissue.
When these substances are released, the nerve impulse that aims to lower the threshold of other local nerve fibers and, in this way, an increase in activity (secondary hyperalgesia) is avoided
Hyperalgesia is when different pain states lead to situations where normally non-painful stimuli become painful. While painful ones become even more intense.
Nerve fibers
- A-fibers: These are classified into alpha, beta, gamma and delta types. They are responsible for conducting nociceptive impulses. They are small in size and conduct nerve impulses at 5 to 50 meters per second.
- C fibers: its conduction is slow compared to delta A fibers. These fibers respond to chemical, mechanical and thermal stimuli. There are approximately 200 C-type fibers per square centimeter of skin.
Transmission of nerve impulses to the spinal cord
The spinal cord works like a filter; that is, it deletes or amplifies messages according to their importance. First, nerve fibers are found in the dorsal horn of the medulla to connect with neurons and interneurons.
The neurons are called laminae I, II, III and are located at any level of the dorsal horn. In this way the A fibers come into contact with the neurons and from there they travel to the spinothalamic and spinoreticular tracts to the higher centers.
While the C fibers connect with these neurons producing spinal reflexes and that is when acute or chronic pain occurs. The pain likewise rises through the strokes but more slowly. They then reach the reticular formation and from there to the limbic system and hypothalamus.
types of pain
To apply pain treatment, it is necessary to identify what type it is. These are classified taking into account factors such as: duration, location and intensity.
Duration
- Sharp: limited in time and rarely due to a psychological symptom. Take neuropathic pain for example.
- chronic: It is pain of unlimited duration and is accompanied by a psychological component.
Pathogenesis
- Neuropathic: It is due to a direct stimulus in the central nervous system. It is prickly and with a burning sensation.
- nociceptive: It is the most common and is classified as: somatic and visceral.
- Psychogenic: It affects the psychosocial level of the person.
Position
- somatic: It is characterized by being a localized, excruciating pain that radiates along the nerve pathways.
- Visceral: this pain is continuous and deep. For example colic, liver metastases and pancreatic cancer.
Course
- Continuous: it is persistent throughout the day and does not go away.
- irruptive: It is produced by movement or some voluntary action of the person concerned.
Intensity
- Bland: Allows you to carry out daily activities.
- Moderate: interferes with daily activities.
- Acute: It is so strong that it doesn’t even allow for rest.
Pain treatment
The analgesic indication is essential for the treatment of pain. Especially in case of chronic pain. However, prior evaluation is required before ingesting the drug.
First, you need to do a detailed study to find out what cause the pain, rate its duration, and determine if it interferes with sleep.
There is, however, the visual analog scale: this method is considered the most effective and consists of a rule line identified from 0 to 10. The patient identifies a degree of pain with numbers. Moreover, therapeutic methods can be chosen as a pain treatment that reduces pain and allows sleep.
painkiller
- Opioid painkillers. They provide quick relief from moderate to severe pain. They act on the central nervous system where the target receptors are located.
- Weak or minor opiates. Indicated for mild to moderate pain. The most representative are codeine and tramadol.
- Major opioids or narcotics. They are indicated for patients with severe pain. Morphine is used and known.
Recommendations for the use of an analgesic
The first thing to do before starting pain treatment is to know the type of pain and its intensity. later it is necessary Act immediately at the first symptoms to prevent more intense pain.
Next, the most viable route must be sought: oral, rectal, or topical. Finally, you must follow the exact schedule when taking the pain reliever so that you don’t have pain drops.
Pain often goes from being a symptom to being something annoying and inconvenient that you have to fight with adequate therapy. By treating pain, a large number of organic and psychological alterations that are a consequence of the painful situation are avoided.
If you feel constant or severe pain, you need to see a doctor as soon as possible.. A professional will be able to determine if it is due to some other disease or if pain treatment should be started.
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