Pain
Pain is a feeling triggered in the nervous system. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen or chest or you may feel pain all over, such as when your muscles ache from the flu.
Pain can be helpful. Without pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment. Once you take care of the problem, pain usually goes away. However, sometimes pain goes on for weeks, months or even years. This is called chronic pain. Sometimes chronic pain is due to an ongoing cause, such as cancer or arthritis. Sometimes the cause is unknown.
Fortunately, there are many ways to treat pain. Treatment varies depending on the cause of pain. Pain relievers, acupuncture and sometimes surgery are helpful.
Pain motivates us to withdraw from damaging or potentially damaging situations, protect the damaged body part while it heals, and avoid those situations in the future. It is initiated by stimulation of nociceptors in the peripheral nervous system, or by damage to or malfunction of the peripheral or central nervous systems. Most pain resolves promptly once the painful stimulus is removed and the body has healed, but sometimes pain persists despite removal of the stimulus and apparent healing of the body; and sometimes pain arises in the absence of any detectable stimulus, damage or pathology. Social support, cultural values, hypnotic suggestion, excitement in sport or war, distraction, and appraisal can all significantly modulate pain’s intensity or unpleasantness.
Medicine treats injury and pathology to promote healing; and addresses distressing symptoms such as pain to relieve suffering during treatment and healing. When a painful injury or pathology is resistant to treatment and persists, when pain persists after the injury or pathology has healed, and when medical science cannot identify the cause of pain, the job of the physician is to relieve suffering. Transitory pain is usually managed by one practitioner with drugs such as anesthetics, analgesics and (occasionally) anxiolytics. The effective management of long term pain, however, frequently requires the coordinated efforts of a pain management team. The typical pain management team includes a medical practitioner, a clinical psychologist, a physiotherapist, an occupational therapist, and a nurse practitioner.
Inadequate treatment of pain is widespread throughout surgical wards, intensive care units, accident and emergency departments, in general practice, in the management of all forms of chronic pain including cancer pain, and in end of life care. This neglect is extended to all ages, from neonates to the frail elderly. African and Hispanic Americans are more likely to suffer needlessly in the hands of a physician than whites; and women’s pain is more likely to be undertreated than men’s.
Failure to provide adequate pain relief may be due to physicians’ fear of being accused of over-prescribing (See the cases of Drs William E. Hurwitz and Richard Paey), despite the rarity of such prosecutions; physicians’ poor understanding of the risks attached to opioid prescription; or physicians’ adherance to the biomedical model of disease which focuses on pathophysiology rather than quality of life, marginalizing pain management. As a result of two recent cases in California though, where physicians who failed to provide adequate pain relief were successfully sued for elder abuse, the North American medical and health care communities appear to be undergoing a shift in perspective. The California Medical Board publicly reprimanded the physician in the second case; the federal Center for Medicare and Medicaid Services has declared a willingness to charge with fraud health care providers who accept payment for providing adequate pain relief while failing to do so; and clinical practice guidelines and standards are evolving into clear, unambiguous statements on acceptable pain management, so health care providers can no longer avoid culpability by claiming that poor or no pain relief meets community standards
Pain Glossary
Following is some pain glossaries we frequently use in tramadol-ultracet.com pain relief resources:
Acute Pain
- The normal, predicted physiological response to an adverse chemical, thermal, or mechanical stimulus associated with surgery, trauma, and acute illness. It is generally time-limited and is responsive to Opioid therapy, among other therapies.
Addiction – A neurobehavioral syndrome with genetic and environmental influences that results in psychological dependence on the use of substances for their psychic effects and is characterized by compulsive use despite harm. Addiction may also be referred to by terms such as “drug dependence”, “drug addiction” and “psychological dependence”. Physical dependence and tolerance are normal physiological consequences of extended Opioid therapy for Pain and should not be considered addiction.
Allodynia -
Pain due to a stimulus which does not normally provoke pain. Two main types exist:-
- Mechanical (Tactile)
- Static mechanical allodynia – pain in response to light touch/pressure
- Dynamic mechanical allodynia – pain in response to brushing
- Thermal (hot or cold) allodynia – pain from normally mild skin temperatures in the affected area
Allo means “other” in Greek and is a common prefix for medical conditions that diverge from the expected. Odynia is derived from the Greek word “odune” or “odyne,” which is used in “pleurodynia” and “coccydynia” and is similar in meaning to words with -algia or -algesia in them. See also hyperalgesia and hyperpathia.
Analgesia -
Absence of pain in response to stimulation which would normally be painful.
Analgesic – Any substance which produces a state of analgesia
Analgesic Tolerance – The need to increase the dose of opioid (pain killer or reliever) to achieve the same level of analgesia. Analgesic Tolerance may or may not be evident during opioid treatment and does not equate with addiction.
Anaesthesia Dolorosa – Pain in an area or region which is anaesthetic.
Causalgia -
A syndrome of sustained burning pain, allodynia, and hyperpathia after a traumatic nerve lesion, often combined with vasomotor and sudomotor dysfunction and later trophic changes.
Central Pain -
Pain initiated or caused by a primary lesion or dysfunction in the central nervous system.
Chronic Pain – A pain state which is persistent and in which the cause of the pain cannot always be removed or is difficult to treat. Chronic Pain may be associated with a long term incurable or intractable medical condition or disease.
Dysaesthesia -
An unpleasant abnormal sensation, whether spontaneous or evoked by touching or rubbing.
Hyperalgesia –
An increased response to a stimulus which is normally painful. Hyperalgesia reflects increased pain on suprathreshold stimulation.
Hyperaesthesia -
Increased sensitivity to stimulation, excluding the special senses. The stimulus and locus should be specified and may refer to various modes of cutaneous sensibility including touch and thermal sensation without pain, as well as to pain.
Hyperpathia -
A painful syndrome characterized by an abnormally painful reaction to a stimulus, especially a repetitive stimulus, as well as an increased threshold. It may occur with allodynia, hyperesthesia, hyperalgesia, or dysesthesia.
Hypoalgesia -
Diminished pain in response to a normally painful stimulus.
Hypoaesthesia – Decreased sensitivity to stimulation, excluding the special senses.
Neuralgia –
Pain in the distribution of a nerve or nerves. Common usage, especially in Europe, often implies a paroxysmal quality.
Neuritis –
Inflammation of a nerve or nerves. Not to be used unless inflammation is thought to be present.
Neurogenic Pain -
Pain initiated or caused by a primary lesion, dysfunction, or transitory perturbation in the peripheral or central nervous system.
Neuropathic Pain -
Pain initiated or caused by a primary lesion or dysfunction in the nervous system.
Neuropathy -
A disturbance of function or pathological change in a nerve: in one nerve, mononeuropathy; in several nerves, mononeuropathy multiplex; if diffuse and bilateral, polyneuropathy.
Nociceptor -
A receptor preferentially sensitive to a noxious stimulus or to a stimulus which would become noxious if prolonged.
Noxious Stimulus -
A noxious stimulus is one which is damaging to normal tissues.
Pain –
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. Notes: Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life. Biologists recognize that those stimuli which cause pain are liable to damage tissue. Accordingly, pain is that experience we associate with actual or potential tissue damage. It is unquestionably a sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional experience. Experiences which resemble pain but are not unpleasant, e.g., pricking, should not be called pain. Unpleasant abnormal experiences (dysesthesias) may also be pain but are not necessarily so because, subjectively, they may not have the usual sensory qualities of pain.
Pain Threshold – The least experience of pain which a subject can recognize.
Pain Tolerance Level – The greatest level of pain which a subject is prepared to tolerate. As with pain threshold, the pain tolerance level is the subjective experience of the individual.
Paraesthesia – An abnormal sensation, whether spontaneous or evoked. Compare with dysesthesia.
Peripheral Neurogenic Pain – Pain initiated or caused by a primary lesion or dysfunction or transitory perturbation in the peripheral nervous system.
Peripheral Neuropathic Pain – Pain initiated or caused by a primary lesion or dysfunction in the peripheral nervous system.
Physical Dependence – A controlled substance is a physiologic state of neuro-addiction which is characterized by the emergence of a withdrawal syndrome if drug use is stopped or decreased abruptly, or if an antagonist is administered. Physical Dependence is an expected result of Opioid use. Physical Dependence, by itself, does not equate with addiction.
Pseudo Addiction - A pattern of drug seeking behaviour of pain patients who are receiving inadequate pain management that can be mistaken for addiction.
Substance Abuse – The use of any substance(s) for non-therapeutic purposes or use of medication for purposes other than those for which it is prescribed.
Tolerance – A physiologic state resulting from regular use of a drug in which an increased dosage is needed over time to produce the same effect, or a reduced effect is observed with a constant dose.
Low Back Pain – Pain at the base of the spine that can be caused by several factors.
Neck Pain – Neck pain is the sensation of discomfort in the neck area.
Shoulder Pain – A common cause of shoulder pain is soreness of the tendon.
Frozen Shoulder – A painful limitation of motion of the shoulder resulting from chronic inflammation of the rotator cuff.
Fibromyalgia – Also known as myofascial pain syndrome and fibromyositis.
Arthritis – Inflammation of a joint causing pain, swelling and stiffness.
Osteoarthritis – Degenerative disorder of joints.
Rheumatoid Arthritis – Chronic autoimmune disorder that causes chronic inflammation of the joints.
Cancer Pain – A look into the types of cancer pain and how cancer pain is categorized.
Canine Pain – Arthritis is one of the most common canine disorders.
Ear Pain Relief - Ear pain is any pain that occurs in any part of the inner, middle, or outer ear. This pain can be by itself or associated with other symptoms.
Foot Pain – is caused by a callus that forms on the bottom of your foot.
