Pathophysiology Of Pain Essay

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Pathophysiology Of Pain Essay

Pathophysiology Of Pain Essay

The neurological system affects all parts and functions of the body through nerve stimulation. Nerves also control the sensation and perception of pain. While pain can be described in a variety of ways, it is essentially labeled according to its duration and source. As an advanced practice nurse evaluating a patient, you need to consider the following questions: Does the pain quickly come and go, or is it persistent and ongoing? Does the pain arise at the source of injury or in another location? In this Discussion, you compare three common types of pain—acute, chronic, and referred.Pathophysiology Of Pain Essay Paper

 

To Prepare

  • Review :
    • Chapter 14- Pain, Temperature, Sleep, and Sensory Function in the Huether and McCance  Understanding pathophysiology text- and
    • Chapter 7- Nervous System Disorders in Hammer and McPhee book- .Pathophysiology of Disease text
  • Identify the pathophysiology of acute, chronic, and referred pain. Consider the similarities and differences between these three types of pain.
  • Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.Pathophysiology Of Pain Essay Paper

Discussion Posting:

Post a 3-5 paragraph description of the pathophysiology of acute, chronic, and referred pain, including similarities and differences between them. Then, explain how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

1Language is always inadequate in the face of pain .Though pain remains a universal experience, physicians face many challenges in treating pain. Despite decades of research, doctors have few ways to measure pain objectively. Pain is a self-reported, often invisible, problem. This makes the experience of suffering entirely subjective. Furthermore, pain is difficult to treat because every person experiences it different, and it can even exist without an apparent underlying cause. Besides the physical agony of pain, suffering takes an emotional and mental toll on patients and their families. Additionally, the complexity of pain revolves around the idea that physical pain is essentially unshareable. The feeling of suffering does not translate through traditional communication. Therefore, the approaches to pain requires intentional diligence by the physician and the patient.The primary challenge in treating pain remains in the incommunicable nature of suffering and the variability in which pain is felt. 3 Physical pain involves two primary guarantees. First, physical pain will create agony and suffering. Second, physical pain will be almost entirely inexpressible. In her book, The Body in Pain, Elaine Scarry develops the argument that pain does not just defy language, it destroys language. It is impossible to convey to other people the feelings and extent of personal pain. Personal physical pain is always only a personal experience. With this idea, doctor ‘s face endless Pathophysiology Of Pain Essay Paper

In its simplest form, the pain circuit in the body can be described as follows: pain stimulates pain receptors, and this stimulus is transferred via specialised nerves to the spinal cord and from there to the brain.

The pain stimulus is processed in the brain, which then sends an impulse down the spinal cord and via appropriate nerves which command the body to react, for instance by withdrawing the hand from a very hot object.Pathophysiology Of Pain Essay Paper

Perception of the pain stimulus: from the pain receptors to the brain

Pain receptors
Pain receptors are present everywhere in the body, especially the skin, surfaces of the joints, periosteum (the specialised lining around the bone), walls of the arteries, and certain structures in the skull. Other organs, such as the gut and muscles, have fewer pain receptors. It is interesting to note that the brain itself does not have any pain receptors at all, and is therefore insensitive to pain.Pathophysiology Of Pain Essay Paper

Pain receptors are free nerve endings. There are three types of pain receptor stimuli: mechanical, thermal and chemical. A mechanical stimulus would be, for example, high pressure or stretching, and a thermal pain stimulus would be extreme heat or cold.

Chemical pain receptors can be stimulated by chemicals from the outside world (e.g. acids), but also by certain products present in the body and released as a result of trauma, inflammation or other painful stimuli. Examples of these substances are bradykinins, serotonin, potassium ions and acids (such as lactic acid, which causes muscle pain after heavy exercise).Pathophysiology Of Pain Essay Paper

Compounds called prostaglandins are released with painful stimuli, and although they don’t directly stimulate pain receptors, they do increase their sensitivity. Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) decrease the effect of prostaglandins, that is why they work as painkillers. Paracetamol operates in the central nervous system and the NSAIDs are peripheral-acting substances.

Pain nerve fibres – fast pain and slow pain
From the pain receptors, the pain stimulus is transmitted through peripheral nerves to the spinal cord and from there to the brain. This happens via two different types of nerve fibre: “fast pain” and “slow pain” fibres.Pathophysiology Of Pain Essay Paper

What is “fast pain” and “slow pain”?
A pain stimulus, e.g. if you cut yourself, consists of two sensations. The first one is the so-called “fast pain” sensation, and is experienced as a sharp pain. After a few seconds, this becomes a sensation of “slow pain”, which is a duller and more of a burning pain. This slow pain normally lasts for a few days or weeks, but if inappropriately processed by the body, it can last for several months and give rise to chronic pain.

Fast pain, like pricking yourself with a needle or touching a burning object, is mainly related to painful stimuli of the skin, mouth and anus.Pathophysiology Of Pain Essay Paper

It is transmitted by relatively thick nerve fibres, although this term is relative because they are still microscopically thin, with a diameter of two- to five-thousandth of a millimetre. These nerves are called A-delta fibres. Because of their relative thickness, they allow the pain stimulus to be transferred very fast (at a speed of 5 to 30 metres per second), hence the name. This allows the body to withdraw immediately from the painful and harmful stimulus in order to avoid further damage.

Fast pain is well localised, meaning that a person can normally describe very accurately where exactly the pain is. The pain is sharp and “cutting”.

The pain does not radiate, i.e. you feel it on a very particular spot. It is difficult to overcome this type of pain, even with strong painkillers. This means that if surgery needs to be performed, the pain of the incision cannot be taken away with strong opioids alone.Pathophysiology Of Pain Essay Paper

However, infiltration of the affected area or the nerve with a local anaesthetic will take away all sensation, including any sharp pain. This is what happens in surgery performed under local anaesthetic.

Slow pain, which starts immediately after the fast pain, is transmitted by very thin nerve fibres called C-nerve fibres (their diameter is between 0.2 and one thousandth of a millimetre). Because of their size, the pain impulse can only be transmitted slowly to the brain, at a speed of less than 2 metres per second. The response of the body is to hold the affected body part immobile (guarding, spasm or rigidity), so that healing can take place.Pathophysiology Of Pain Essay Paper