Pain
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There are several different types of pain, which exist for different
reasons, and any understanding of how to treat pain requires an
understanding of what pain is.
Some types of pain sensors and nerves carry information rapidly to the
brain and spinal cord are react to sharp pinpricks giving an immediate
response which is to withdraw the hand, or limb from the sharp, hot or
cold object and hopefully avoid injury. Other types of fibres carry
pain information from damaged muscles and deeper structures that give
aching or deep painful sensations. It is this type of pain that
produces a more emotional response due to the effect it has on the
brain; it can be involved in creating a sad or depressive response to
the pain that is seperate from, but associated with the pain itself,
and which presumably exists to dissuade the individual from repeating
the action that caused the pain.
It is thought that other nerves bring information that feeds into the
experience of this type of pain, so that pain sensation can be
amplified by previous pain, tiredness, sadness and a whole host of
other stimuli to result in more pain being experienced in the brain. On
the other hand, stimulation of touch sensors results in stimulation of
nerves which act to block part of the pain pathway and decrease the
amount of pain experinced by the individual, which presumably accounts
for why rubbing the affected area makes it feel better.
Most medical pain relieving medicines that are used commonly work on
reducing inflammation at the point where sensors respond to pain (e.g.
Non steroidal anti-inflammatory drugs) because inflamamtion is
responsible for amplifying the stimulation of pain transmitting nerves.
However others, such as morphine and other opiates act directly on the
brain and spinal cord to block the experience of pain.
Massage and physical therapies (or even simply rubbing or stroking a
painful area) work both by reducing muscle spasm which can be involved
in amplifying pain, and by stimulating touch sensors which act in the
spinal cord to reduce the pain information that passes to the brain.
Acupuncture is thought to work in a similar way as it stimulates
the nerves that carry touch information and thereby reduces pain
transmission to the brain. In addition, it is also known to
stimulate endorphin release which acts like morphine on the brain to
reduce the experience of pain. Also, acupuncture has been shown to
trigger the release of other chemicals which promote blood flow,
healing and relaxation.
When chronic pain exists, a vicious circle comes into play that
involves pain reducing mobility, which in turn causes stiffness and
further pain. Although this system exists to prevent the action that
caused the pain it often exists long after the original injury, and
prevents activity which could help relive pain. Often, if sufficient
pain relief can be given that the individual can become more
mobile, controlled exercise can be used to improve mobility and
strength which can in turn reduce the pain associated with a damaged or
weak joint, limb or part of the back. Exercise also stimulates
endorphin release, which in itself helps reduce the experience of pain,
and with this kind of approach the 'vicious circle' can be turned
backwards so the individual's pain becomes progressively more reduced,
or more controlled.