Pain

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Pain
Synonyms	Algia, dolor
Pronounce	N/A
Specialty	N/A
Symptoms	Discomfort, aching, throbbing, stabbing
Complications	Chronic pain, depression, anxiety
Onset	Sudden or gradual
Duration	Acute or chronic
Types	N/A
Causes	Injury, disease, inflammation, nerve damage
Risks	Surgery, trauma, infection, cancer
Diagnosis	Physical examination, medical history, imaging studies
Differential diagnosis	Neuropathy, fibromyalgia, arthritis
Prevention	Ergonomics, exercise, healthy lifestyle
Treatment	Analgesic, physical therapy, cognitive behavioral therapy
Medication	NSAIDs, opioids, antidepressants
Prognosis	Varies depending on cause
Frequency	Common
Deaths	N/A

Pain is a complex, multifaceted phenomenon that is both a sensory and an emotional experience associated with actual or potential tissue damage. Stemming from the Latin word "poena" signifying a penalty or a fine, pain involves a combination of physical sensation and psychological interpretation.

Neck pain 2

Distinction Between Pain and Nociception

Hyperalgesia and allodynia

As per the International Association for the Study of Pain (IASP), it's essential to discern between the concepts of pain and nociception. While 'pain' encompasses the subjective experience, typically accompanying nociception, it can also emerge absent any stimulus, encapsulating the emotional response. 'Nociception', however, is a neurophysiological term representing specific activity in nerve pathways. It serves as the transmission system for physiological pain but does not encompass psychological pain. Nociceptive pathways can transmit signals traditionally identified as 'painful', but these signals are not always interpreted as such.

The Importance of Pain

Despite the discomfort it brings, pain functions as a vital part of the body's defense mechanism. It forms a component of a swift warning relay system instructing the central nervous system's motor neurons to minimize perceived physical damage. Conditions like Congenital insensitivity to pain or Congenital Analgesia, where the ability to experience pain is absent, can lead to various health complications.

Common Forms of Pain

Headaches and back pain are the two most frequently reported forms of pain in the U.S. Pain is also specifically used to denote a painful uterine contraction occurring during childbirth.

Pain Classification

Pain can be classified according to various criteria, such as duration (acute or chronic), source (neuropathic, nociceptive, psychogenic), and location (localized or generalized).

Acute and Chronic Pain

Acute pain typically follows an injury and dissipates once the injury heals or is effectively treated. It acts as a biological alarm to warn us of potential bodily harm. Chronic pain, on the other hand, persists beyond the expected period of healing, lasting for months to years. It's often associated with conditions such as arthritis, cancer, and neuralgia.

Neuropathic, Nociceptive, and Psychogenic Pain

Neuropathic pain arises from injury to the nervous system itself, such as in cases of diabetic neuropathy or postherpetic neuralgia. It is often described as a burning or shooting pain. Nociceptive pain is a response to tissue injury or inflammation, as in cuts, sprains, or bone fractures. This kind of pain is often sharp, aching, or throbbing in nature. Psychogenic pain, also referred to as psychalgia or somatoform pain, is pain caused, increased, or prolonged by mental, emotional, or behavioral factors.

Pain Management

Pain management can be complex and requires a multifaceted approach. This may include pharmacological interventions such as analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), and opioids, as well as non-pharmacological interventions like physiotherapy, psychological therapy, and alternative treatments such as acupuncture.

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