pain

a symptom of some physical hurt or disorder

"the patient developed severe pain and distension" emotional distress

a fundamental feeling that people try to avoid

"the pain of loneliness" a somatic sensation of acute discomfort

"as the intensity increased the sensation changed from tickle to pain" a bothersome annoying person

"that kid is a terrible pain" something or someone that causes trouble

a source of unhappiness

"washing dishes was a nuisance before we got a dish washer"

"a bit of a bother"

"he's not a friend, he's an infliction" cause bodily suffering to and make sick or indisposed cause emotional anguish or make miserable

"It pains me to see my children not being taught well in school"

'Pain''' ''is also the name of a musical group, for further information see Pain (band)''According to the International Association for the Study of Pain (IASP), one should distinguish between pain and nociception. Pain is a subjective experience that accompanies nociception, but can also arise without any stimulusstimuli. It includes the emotionemotional response. Nociception is a neurophysiologyneurophysiologic term and denotes the activity in the nerve pathways. These pathways transmit the unpleasant signals that are not always painful. Although pain can be associated with biological tissuetissue damage or inflammation, this is often not the case.Despite its unpleasantness, pain is a critical component of the body's defense system. It is part of a rapid warning and defense relay instructing the motoneuronmotor neurons of the central nervous system to minimize detected physical harm. The gate control theory of pain is a theory concerning how cognitive and emotional factors might dramatically influence painful sensations. It focuses on different pain states at the brain, rather than at the perceived site of injury.

Nociception - Nociception is the physiological sense for perception of physiological pain. Nociception does not describe psychological pain.Nociceptors are the free nerve endings of neurons that have their cell bodies outside the spinal column in the dorsal root ganglion and are named based upon their appearance at their sensory ends. These sensory endings look like the branches of small bushes. The interpretation of pain occurs when the nociceptors are stimulated and subsequently transmit signals through sensory neurons in the spinal cord, which releases glutamic acidglutamate, a major exicitory neurotransmitter that relays signals from one neuron to another and ultimately to the thalamus, in which pain perception occurs. From the thalumus, the signal travels to the cerebrum, at which point the individual becomes fully aware of the pain. Interestingly, the brain itself is devoid of nociceptive tissue, and hence cannot experience pain (thus a headache is not pain in the brain itself). Some evolutionary biologists have speculated that this lack of nociceptive tissue might be due to the fact that any injury of sufficient magnitude to cause pain in the brain has a sufficiently high probability of being fatal that development of nociceptive tissue therein would have little to no survival benefit.If pain is defined as a signal of present or impending tissue damage effected by a harmful stimulus then the ability to experience pain or irritation is observable in most multi-cell (biology)cellular organisms. Even some plants have the ability to retract from a noxious stimulus. Whether this sensation of pain is equivalent to the human experience is debatable.

Interpretation of pain - The unpleasantness of pain encourages an organism to use any means at its disposal to disengage from the noxious stimuli that it assumes cause the pain. It may, of course, have incorrectly determined the cause. Preliminary pain can serve to indicate that an injury is imminent, such as the ache from a "soon-to-be-broken" bone. Pain may also promote the healing process as most organisms will protect an injured region from further damage in order to avoid further pain. Despite its unpleasantness, pain is an important part of the existence of humans and other animals.The study of pain has in recent years diverged into many different fields from pharmacology to psychology and neurobiology. Pain has also provided an interested take for the search for the neural correlates of consciousness, as pain has many subjective psychological aspects besides the physiological nociception.

Types of pain - Acute pain is defined as short-term pain or pain with an easily identifiable cause. Acute pain is the body's warning of present damage to tissue or disease. It is often fast and sharp followed by aching pain. Acute pain is centralized in one area before becoming somewhat spread out. This type of pain responds well to medications.Chronic pain is medically defined as pain that has lasted 6 months or longer. This constant or intermittent pain has often outlived its purpose, as it does not help the body to prevent injury. It is often more difficult to treat than acute pain. Expert care is generally necessary to treat any pain that has become chronic. An anterior cingulectomy, neurosurgury that disconnects the anterior cingulate gyrus, can be used in extreme cases to treat chronic pain. Post-surgery the patient will still feel the sensation of pain, but not the accompanying emotion.The experience of physiological pain can be grouped into four categories according to the source and related nociceptors (pain detecting nerves). Cutaneous pain is caused by injury to the skin or superficial tissues. Cutaneous nociceptors terminate just below the skin, and due to the high concentration of nerve endings, produce a well-defined, localised pain of short duration. Example injuries that produce cutaneous pain include paper cuts, minor (first degree) burns and lacerations.Somatic pain originates from ligaments, tendons, bones, blood vessels, and even nerves themselves, and are detected with somatic nociceptors. The scarcity of pain receptors in these areas produces a dull, poorly-localised pain of longer duration than cutaneous pain; examples include sprained ankle and broken bones. Visceral pain originates from body organs. Visceral nociceptors are located within body organs and internal cavities. The even greater scarcity of nociceptors in these areas produces a pain usually more aching and of a longer duration than somatic pain. Visceral pain is extremely difficult to localise, and several injuries to visceral tissue exhibit referred pain"referred" pain, where the sensation is localised to an area completely unrelated to the site of injury. Myocardial ischaemia (the loss of blood flow to a part of the heart muscle tissue) is possibly the best known example of referred pain; the sensation can occur in the upper chest as a restricted feeling, or as an ache in the left shoulder, arm or even hand.Gate control theory of painPhantom limb pain is the sensation of pain from a limb that one no longer has or no longer gets physical signals from - an experience almost universally reported by amputees and quadriplegiaquadriplegics.Finally, neuropathic pain ("neurasthenianeuralgia") can occur as a result of injury or disease to the nerve tissue itself. This can disrupt the ability of the sensory nerves to transmit correct information to the thalamus, and hence the brain interprets painful stimuli even though there is no obvious or documented physiologic cause for the pain.

Classification of pain - Pain can be functionally classified into fast pain and slow pain.

Fast pain - Fast pain is felt within 0.1 s of application of the pain stimulus. It can be described as sharp, acute, pricking pain and includes mechanical and thermal pain. It is mediated by type !A<sub>δ Slow pain - Slow pain is an aching, throbbing, burning, chronic pain. Chemical pain is an example of slow pain. It is mediated by slower type C pain fibres at rates of between 0.5-2 m/s

Pain receptors - All pain receptors are free nerve endings. There are mechanical, thermal and chemical pain receptors. They are found in skin, on internal surfaces such as periosteum and joint surfaces. Deep internal surfaces are only weakly supplied with pain receptors and will propagate sensations of chronic, aching pain if tissue damage in these areas is experienced. Pain receptors do not adapt to stimulus. In some conditions, excitation of pain fibres becomes greater as the pain stimulus continues, leading to hyperalgesia.

Children and pain - Children have been proven to be markedly more sensitive to pain, but this is something that is commonly dismissed as a fear reaction or a lack of coping abilities. Research has been carried out on children on how they can cope with pain due to increased sensitivity and it has been established that strategies that remove pain can help prevent long-term increases in sensitivity as the nervous system is still developing.

Transmission of pain signals in the central nervous system - There are 2 pathways for transmission of pain in the CNS. These are the neospinothalamic tract (for fast pain) and the paleospinothalamic tract (for slow pain).</sub>

Pathway for Fast Pain - Fast pain travels via type !A<sub>δPathway for Slow Pain - Slow pain is transmitted via slower type C fibres to lamina II and III of the dorsa horns, together known as the substantia gelatinosa. Second order neurons take off and terminatein lamina V, also in the dorsal horn. Third order neurons then take off and join fibres from the fast pathway, crossing to the opposite side via the anterior commisure, and travelling upwards through the anterolateral pathway. These neurons terminate widely in the brain stem, with one tenth of fibres stopping in the thalamus, and the rest stopping in the medulla, pons and mesencephalon. Slow pain is poorly localized .

The analgesia system of the central nervous system - The analgesia system is mediated by 3 major components : the periaquaductal grey, the nuclear raphe magnus, and the pain inhibitory complex of the dorsal horns of the spinal cord.

Referred pain - Referred pain is a phenomenon which arises when visceral pain fibres and pain fibres from the skin synapse on the same second order pain fibres. Thus pain arising from the viscera appear to come from the skin.Referred pain is a pain present in an area removed or distant from the actual site of pain.

Pain and alternative medicine - A recent nccam.nih.gov - survey by U.S. National Center for Complementary and Alternative MedicineNCCAM found pain was the most common reason to use complementary and alternative medicine (CAM). Among American adults who used CAM in 2002, 16.8% used CAM to treat back pain; 6.6% for neck pain; 4.9% for arthritis; 4.9% for joint pain; 3.1% for headache; and 2.4% used CAM to treat recurring pain. (Some survey respondents may have used CAM to treat more than one of these pain conditions.)One such alternative, traditional Chinese medicine, views pain as a qi "blockage" equivalent to electrical resistance, or as "stagnation of blood" – theorized as dehydration inhibiting metabolism. Traditional Chinese treatments such as acupuncture are more effective for nonPhysical traumatraumatic pain than traumatic pain.

See also -</sub>

Analgesics: drugs that reduce pain

Anesthesia: including general anesthesiageneral and local anesthesialocal

Pain and pleasure: the relationship between the two sensations

Pain asymbolia: condition allowing the perception of pain without suffering

Algolagnia: the paraphilia of deriving pleasure from certain kinds of pain

Motivation: the human brain tries to avoid what it thinks generates pain and seeks what it thinks generates pleasure

Pain medicine

Pain scale

Meaning of pain

Schmidt Sting Pain Index

External links -

iasp-pain.org - International Association for the Study of Pain - scientific multidisciplinany body

pain.remedica.com - International Journal of Pain Medicine and Palliative Care

!lower-back-pain-answers.com - Lower Back Pain Answers

thenakedscientists.com - Sea Snails (Conus) harbour powerful new painkillers - the ACV1 snail polypeptide appears to be a potential analgesic

newscientist.com - Fish capable of experiencing pain (rainbow trout may show pain responses, contrary to popular belief) - New Scientist 2003

thenakedscientists.com - Developments in the neuroscience of pain

? childsdoc.org - Children and pain treatment

knee-pain.co.uk - Knee Pain InfoSensory_system !Category:NociceptionCategory:P ain !de:Schmerzes:Dolorfr:Douleurhe :כאבhi:दर्दio:Dolor oit:Dolorenl:Pijnpl:Bólpt:Dor simple:Painsv:Smärtatl:Sakit< /text>

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Postural Orthopedics
A system of therapeutics for relief of chronic pain and reduction of spinal scoliosis by reduction of postural stress by use of 1) a heel lift to level the pelvis, measured radiographically, 2) foot orthotics to correct flattened feet and rolled-in ankles, and 3) gentle manual manipulation to reduce accumulated restriction reflective of prior postural imbalance and superimposed traumas.
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American Academy of Pain Management
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