PAIN

Pain is an uncomfortable sensation in the body that usually signals an injury or illness. . It

stems from activation of the nervous system. Pain is a sign/symptom not a definitive

diagnosis

Types of pain based on the duration

The types of pain based on the duration according Beaumont (2023) are

Acute pain

Acute pain means the pain is short in duration, lasting from minutes to about three months

(less than six months). Acute pain also tends to be related to a soft-tissue injury or a

temporary illness, so it typically subsides after the injury heals or the illness subsides. Acute

pain from an injury may evolve into chronic pain if the injury does not heal correctly or if the

pain signals malfunction.

Chronic pain

Chronic pain is longer in duration. It can be constant or intermittent. For example, headaches

can be considered chronic pain when they continue over many months or years – even if the

pain is not always present. Chronic pain is often due to a health condition, like arthritis,

fibromyalgia, or a spine condition.

Types of pain based on the origin

The types of pain according to Reno (2023) the origin of pain include

Nociceptive Pain

Nociceptive pain arises from the stimulation of specific pain receptors. These receptors,

called nociceptors, can respond to heat, cold, vibration, stretching and chemical stimuli

released when tissues are irritated or injured. Some examples of Nociceptive pain include:

 Sprains
 Inflammation

 Obstructions

 Bone fractures

 Myofascial pain: sensitive areas of tight muscle fibers can form in the muscles after injuries

or overuse. These sensitive areas are called trigger points. A trigger point in a muscle can

cause strain and pain throughout the muscle. When this pain persists and worsens, it is called

myofascial pain syndrome.

 Burns, bumps and bruises

 Pelvic pain caused by Irritable Bowel Syndrome

Neuropathic Pain

Neuropathic pain (Nerve Pain) occurs as a result of structural damage and/or dysfunction

within the nervous system. Since neuropathic pain often presents in widespread dysfunction

throughout the body, the initial cause of the pain is often difficult to track. An example of

neuropathic pain is Reflex Sympathetic Dystrophy (RSD).

Mixed Pain

In some conditions, pain appears to be caused by a mixture of nociceptive and neuropathic

factors. An initial nervous system dysfunction or injury may trigger the release of

inflammatory mediators, resulting in a subsequent neuropathic inflammation, causing the

quality of pain to change to burning, throbbing or tingling type of pain. Examples of mixed

pain include migraine headaches and myofascial pain.

Other types of Pain

Radicular pain

Radicular pain is a very specific type of pain that can occur when the spinal nerve is

compressed or inflamed. It radiates from the back and hip into the leg(s) by way of the spine

and spinal nerve root. People who have radicular pain may experience tingling, numbness,
and muscle weakness. Pain that radiates from the back and into the leg is called

radiculopathy. It’s commonly known as sciatica because the pain is due to the sciatic nerve

being affected.

Referred pain

This type of pain is felt at sites distant from where the tissue damage occurs. This pain

perceived at a location other than the site of the painful stimulus/ origin

Functional pain
Functional pain is pain that is caused by no obvious injury or damage to the body. It tends to
be chronic although acute functional pain may also develop. Examples of functional pain
syndromes include:

 fibromyalgia, which causes widespread pain throughout the body

 Irritable bowel syndrome (IBS), which causes abdominal pain

 chronic cardiac chest pain, which causes chest pain

Pain Process

The pain process according Collegium (2023) to are

The neurophysiologic process of pain can be divided into four stages: transduction,

transmission, pain modulation, and perception. At every point in the process, the intensity

and propagation of pain signals can be either inhibited or facilitated by neural pathways. This

capacity to modulate signalling may account, in part, for wide variations in pain perception

between different individuals who sustain the same injury.

Transduction

Transduction occurs when a stimulus, such as pressure, thermal energy (heat), or chemical

irritation, is converted into a nerve signal or action potential. This occurs at the ends of

sensory nerve cells known as nociceptors whose terminals are sensitive to this type of

activation.
Transmission

Transmission is the process of transferring pain information from the peripheral to the central

nervous system. Signals are transmitted along the axons of nociceptors. From here, neurons

project to the brainstem, thalamus, and hypothalamus, as well as to reflex arcs to mediate an

avoidance response.

Modulation

Pain modulation refers to up or down regulation of pain signals throughout the spinal cord

and the brain. Many of these signals never reach consciousness because they are dampened

by intrinsic modulatory activity within the central nervous system. The gate control theory,

advanced by Melzack and Wall, focused on descending pathways from the brain to the spinal

cord that inhibited pain signalling. The current view is that signals originating in the brain can

both inhibit and facilitate pain signal transmission.

Perception

Perception of pain is the awareness, typically an uncomfortable awareness associated with a

specific area of the body. It depends on the transmission of pain signals through the thalamus

to the cortex and limbic system. At this point in pain processing, perception of the pain

experience is influenced by social and environmental cues, as well as by cultural conditioning

and past personal experiences.

Pain management

The management of pain can be divided in to two namely

Pharmacologic pain management

Non- pharmacologic pain management

Pharmacologic pain management

  Over-the-counter pain relievers (analgesics), such as acetaminophen, aspirin, or
ibuprofen

 Prescription anti-inflammatory drugs, such as as corticosteroids or certain types of

cox-2 inhibitors

 Opioid medications, which may be prescribed for acute pain following an injury or
surgery

 Antidepressant or anti-seizure medications, which may be prescribed for some types

of neuropathic pain or functional pain syndromes

 Physical therapy, which may help relieve pain caused by injuries or certain health
conditions such as arthritis or multiple sclerosis

 Occupational therapy, which may help one learn how to adapt one’s daily activities
and environments to limit pain

Non- pharmacologic pain management

 Biofeedback, in which a therapist uses electronic devices to help one learn how to
consciously control body functions such as breathing

 Acupuncture or acupressure, in which a practitioner stimulates certain pressure points

on the body to help relieve chronic pain

 Massage, in which a therapist rubs, kneads, or presses on muscles or other soft tissues
to help ease tension and pain

 Meditation, in which one focus the mind in ways intended to relieve stress and tension

 Tai chi or yoga, which combine gentle movements and deep breathing to stretch and
stimulate the muscles and ease tension

 Progressive muscle relaxation, in which one can consciously tighten and then relax
different muscle groups to promote natural relaxation

 Guided imagery, in which one visualize calming images

Life style modification

Life style modification that can promote coping with pain

 apply a towel-wrapped cold pack or ice to reduce painful swelling and inflammation
caused by injuries or chronic conditions such as arthritis

 apply heating pads or take warm baths to ease muscles stiffness, soreness, or cramps

 limit or avoid certain activities or triggers that make the pain worse

 take steps to limit and ease stress

 get regular gentle exercise

 get enough sleep

 lose weight