Introduction

Pain:-

Pain is a general term that describes uncomfortable sensations in the body. It stems from
activation of the nervous system.

Pain can range from annoying to debilitating. It may feel like a sharp stab or dull ache. It may
also be described as throbbing, pinching, stinging, burning, or sore.

Pain may be consistent, it may start and stop frequently, or it may occur only under some
conditions. It may be acute, developing suddenly and lasting for a short period of time. Or it
may be chronic, with ongoing sensations that last or return repeatedly over several months or
years.

Pain may be localized, affecting a specific part of your body. Or it may be generalized, such
as the overall body aches associated with the flu.

People respond to pain differently. Some people have a high tolerance for pain, while others
have a low tolerance. Pain is highly subjective.

Pain lets us know when something is wrong and gives us hints about the cause. Some pain is
easy to diagnose and can be managed at home. Other types of pain are signs of serious health
conditions that require medical attention to treat.

Causes

In some cases, pain is clearly caused by a specific injury or medical condition. In other cases,
the cause of the pain may be less obvious or unknown.

Some common causes of pain include:

 headache
 toothache

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  sore throat
 stomach ache or cramps
 muscle cramps or strains

 cuts, burns, or bruises
 bone fractures

Many illnesses or disorders, such as the flu, arthritis, endometriosis, and fibromyalgia, can

cause pain. Depending on the underlying cause, you may develop other symptoms as well.
For example, these may include fatigue, swelling, nausea, vomiting, or mood changes.

Types of pain

There are several different types of pain. It’s possible to experience more than one type at the
same time. If you’re in pain, identifying the type of pain may help your healthcare
professional narrow down the potential causes and develop a treatment plan.

Acute pain

Acute pain develops over a short period of time. It tends to occur suddenly, often as a result
of a known injury, illness, or medical procedure.

For example, acute pain may result from:

 injuries such as cuts, burns, muscle strains, or bone fractures

 illnesses such as food poisoning, strep throat, or appendicitis
 medical procedures such as injections, dental work, or surgery

Acute pain tends to be sharp, rather than dull. It usually goes away within a few days, weeks,
or months, after the cause has been treated or resolved.

Almost everyone experiences acute pain at some point in their lifetime.

Chronic pain

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Chronic pain lasts, or comes and goes, over multiple months or years. It may result from a
variety of health conditions, such as arthritis, fibromyalgia, chronic migraine, or cancer.
Some people also experience chronic pain following an injury, even after the initial injury has
healed.

In some cases, the cause of chronic pain is hard to identify. Some people experience chronic
pain when there’s no other evidence of underlying injury or illness. This is known as
functional pain.

The National Health Interview SurveyTrusted Source found that in 2019, roughly 1 in 5

adults in the United States had chronic pain. More than 7 percent had chronic pain that
frequently limited their activities at work or in wider life.

Nociceptive pain

Nociceptive pain is caused by tissue damage. For example, it may result from injuries such as
cuts, burns, bruises, or fractures. It may also result from certain health conditions that cause
tissue inflammation and damage, such as arthritis, osteoporosis, or inflammatory bowel
disease (IBD).

When nociceptive pain develops in your skin, muscles, ligaments, tendons, joints, or bones,
it’s known as somatic pain. When it develops in your internal organs, it’s known as visceral
pain.

Nociceptive pain may be acute or chronic, depending on the underlying cause. It may feel
achy, throbbing, or sharp.

Nociceptive pain affects almost everyone at some point in their lifetime.

Neuropathic pain

Neuropathic pain results from nerve damage, which may be caused by a variety of injuries
and illnesses. For example, you may experience neuropathic pain if one of the discs in your
spine slips out of place and puts pressure on a nerve.

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You may also develop neuropathic pain as a result of certain illnesses, such
as shingles, diabetes, multiple sclerosis, or cancer.

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Functional pain:- it is pain that’s caused by no obvious injury or damage to your body. It
tends to be chronic, although acute functional pain may also develop.

More than 15 percent of the world’s population has a functional pain syndrome, report
researchers in BJA Education. Examples of functional pain syndromes include:

 fibromyalgia, which causes widespread pain throughout the body

 irritable bowel syndrome (IBS), which causes abdominal pain
 temporomandibular dysfunction, which causes jaw pain
 chronic cardiac chest pain, which causes chest pain

Seek medical attention for your pain if it’s:

 the result of an injury or accident that may have caused substantial damage to your
body, including severe or uncontrollable bleeding, broken bones, or head injury
 an acute and sharp internal pain, which may be a sign of a serious problem such as a
ruptured appendix or bowel perforation
 located in your chest, back, shoulders, neck, or jaw and accompanied by other
potential signs or symptoms of a heart attack, such as pressure in your chest, shortness
of breath, dizziness, weakness, cold sweats, nausea, or vomiting
 interfering with your day-to-day life, including your ability to sleep, work, or take part
in other activities that are important to you

pain diagnose

If you seek medical attention for your pain, your healthcare professional will first do a
physical examination and ask you some questions. Be prepared to describe the pain
specifically, including when it started, when it is most intense, and whether it is mild,
moderate, or severe.

Your doctor may also ask you:

 how the pain affects your life

 if you have other symptoms

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  if there are triggers that make the pain worse
 if you have any diagnosed health conditions
 if you’ve had any recent injuries or illnesses
 if you have recently changed your diet or exercise routine
 if you’re taking medications or supplements

Depending on your symptoms and medical history, your doctor may order one or more of the
following tests to check for potential causes of your pain:

 blood tests, urine tests, stool tests, or cerebral spinal fluid tests to check for signs of
infection or other illnesses
 endoscopy to check for signs of damage or other problems in your respiratory,
gastrointestinal, urinary, or reproductive tract
 X-ray, CT scan, MRI scan, or ultrasound scan to check for signs of damage in your
muscles, ligaments, tendons, bones, nerves, or internal organs
 biopsy to collect a sample of tissue for analysis
 nerve function tests to learn how your nerves are working
 psychological tests to check for conditions such as depression

If they can’t find any signs of underlying damage that may be causing the pain, you might
have a functional pain syndrome. These syndromes are diagnosed based on symptoms, after
other potential causes are ruled out.

pain treatment

Treatment for pain depends on the underlying issue or injury that’s causing it, if known.
Acute pain will generally go away once the cause has been treated or resolved. Chronic pain
can be more difficult to manage, especially if it’s functional pain that results from an
unknown cause.

If you have pain that’s caused by an injury, it might heal naturally with time or you might
need medication, surgery, or other medical attention. If your pain is caused by an infection, it
might resolve on its own or you might need medication or other treatments.

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If you have a chronic health condition such as arthritis, cancer, or chronic migraine, your
doctor might prescribe medication, surgery, or other therapies to help treat it.

Your healthcare professional might also recommend treatments to ease the pain itself. For
example, they may recommend or prescribe:

 over-the-counter pain relievers, 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 you learn how to adapt your daily activities and
environments to limit pain

Your doctor may also recommend complementary therapies, such as:

 biofeedback, in which a therapist uses electronic devices to help you learn how to
consciously control body functions such as breathing
 acupuncture or acupressure, in which a practitioner stimulates certain pressure points
on your 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 you focus your mind in ways intended to relieve stress and
tension
 tai chi or yoga, which combine gentle movements and deep breathing to stretch and
stimulate your muscles and ease tension
 progressive muscle relaxation, in which you consciously tighten and then relax
different muscle groups to promote natural relaxation
 guided imagery, in which you visualize calming images

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Your doctor may also recommend lifestyle changes or home remedies to help manage pain.
For example, they might encourage you to:

 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 your pain worse
 take steps to limit and ease stress
 get regular gentle exercise
 get enough sleep
 lose weight

For minor injuries that don’t require medical attention, follow the general rule of RICE:

 Rest the injured area

 Ice the injured area, by applying a towel-wrapped cold pack or ice pack for 10 to 20
minutes at a time
 Compress the injured area, by wrapping it in an elastic bandage tightly enough to
provide support, but not so tightly that it causes numbness
 Elevate the injured area above your heart

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 REFERENCE

1. Hudspith MJ, Siddall PJ, Munglani R. Physiology of pain. In: Hemming HC, Hopkins
PM, eds. Foundations of Anesthesia. 2nd ed. London, UK: Mosby; 2006. p267.
2.  Hudspith MJ, Siddall PJ, Munglani R. Physiology of pain. In: Hemming HC, Hopkins
PM, eds. Foundations of Anesthesia. 2nd ed. London, UK: Mosby; 2006. p268. 
3. Dubin AE, Patapoutian A. Nociceptors: the sensors of the pain pathway. The Journal
of Clinical Investigation, Volume 120, Number 11, November 2010, p3761.
4.  National Pharmaceutical Council and Joint Commission on Accreditation of
Healthcare Organizations. Pain: Current Understanding of Assessment, Management,
and Treatments. Reston, VA: National Pharmaceutical Council; 2001. 
5.  American Chronic Pain Association.
https://www.theacpa.org/conditions-treatments/conditions-a-z/neuropathic-pain/.
Accessed 2020-02-14 at 4.41.19 PM.