Pain: Theories And Management

Pain is a feeling caused by a stimuli that is damaging, such as putting alcohol in a cut, burning a finger, and stubbing a toe. It is a phenomenon, which is complex and subjective to people.

Generally, pain is viewed as the most common reason for medical consult in many developed countries. This is because pain is a major symptoms of most medical conditions and it can interfere with a person’s activities of daily living; thus, it also disturbs a person’s quality of life.

While pain is a symptom in health and medicine, pain is a topic in ethical debates, particularly in euthanasia and physician-assisted suicide. Pain has been a topic in arguments to allow terminally ill patients to end their lives.

Pain Theories

There are several theories about pain, as per Physio Pedia.

The first theory is the intensive theory, which is based on Aristotle’s idea that pain comes from excessive stimulation of the sense of touch. According to this theory, the intensity and central summation of the stimulus that cause pain are also its critical determinants.

The next pain theory is the specificity theory, which was argued by Von Frey. According to Frey, the body has a distinct sensory system, which can be used for pain perception. The theory also says that pain is an independent sensation with specific peripheral sensory receptors for pain called nociceptors. As per the theory, the brain centers transmit the signals, which lead to the pain experience.

Another pain theory is Strong’s Theory. It states that pain was an experience involving a sensation caused by a noxious stimulus and the psychological reaction or displeasure.

Goldscneider is the proponent of the pattern theory. According to him, there is no distinct system for pain perception, as well as the pain receptors associated with other senses, such as the sense of touch. This theory suggests that people feel pain when specific patterns of neural activity happen, which includes particular activities that are of very high levels in the brain.

The Central Summation Theory, by Livingstone, suggests that nerve and tissue damage activates fibers that project to internuncial neuron pods in the spinal cord, which leads to an abnormal circuit with self-activating neurons. When the abnormal circuit becomes prologed, it will project information about pain perception.

Hardy, Goodell, and Wolff proposed the Fourth Theory of Pain. According to the theory, pain has two components – the perception of pain and the reaction towards it. It was noted that the reaction is a complex physiopsychological process that encompasses cognition, culture, experience, and psychological factors contributing to pain.

The sensory interaction theory involves two systems circling pain transmission – the fast and the slow system. According to the theory, the fast system inhibits transmission of the muscle fibers while the slow system is believed to conduct somatic and visceral afferents.

One of the most well-known pain theory is Mezack and Wall’s Gate Control Theory. According to the theory, pain is transmitted by small and slow fibers that enter the dorsal horn of the spinal cord and other cells transmit impulses from the spinal cord to the brain. The fibers may affect the smaller fibers that carry pain stimulation and they may either promote or inhibit stimulation.

Pain Management

There are different ways to manage pain. According to Web MD, mild pain can be relieved by medications like Tylenol (acetaminophen) or non-steroidal anti-inflammatory drugs (NSAID), which include naproxen, ibruprofen, and aspirin. They decrease inflammation, including swelling and irritation, which can reduce pain due to stiffness and muscle aches. Topical pain relievers like sprays, creams, or lotions, can also be applied to the skin.

Transcutaneous electrical nerve stimulation therapy or TENS can also be done to relieve pain. It uses electrical stimulation, which runs through electrodes, to reduce pain. The mode of action is to stimulate the nerve in the affected area and send signal to the brain to stir normal pain signal.

Mind-body therapies are also helpful in pain management. It involves visualization, guided imagery, hypnosis, and biofeedback. One may be asked to close his eyes and have a visual image of the pain, giving it shape, size, color, and movement. It can be slowly altered with a smaller and more pleasing image.

Relaxation techniques, such as yoga and medication, can also relieve stress-related pain. They can also strengthen the muscles without putting strain on the body.

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