Pathophysiology of Pain

Pathophysiology of Pain

Pain is a physical manifestation of something being wrong within the body. Pain is an indicator of an injury or of a physical illness. Often, it is one of the first indicators that there is something wrong with the health of the patient and anyone experiencing pain should seek medical attention. Acute, chronic, and referred pain are three very different things but are often confused, even by medical experts.

Pathophysiology:

Acute pain tends to begin suddenly and is usually a sharp pain. It is considered a symptom of a disease or physical injury (Acute 2008). Examples of acute pain can include, but are no means limited to: surgery and recovery, broken bones, burns, cuts, contusions, and muscle injury. There is always a cause for acute pain, although the cause may or may not be serious and therefore it always requires investigation. Within the body, the polymodal peripheral receptors create sensations which are unpleasant for the person. These are modulated in the dorsal horn as well as in the anterior columns of the spinal cord and then moves up to the cerebral cortex (Fink 2005,-page 277). It is within the cerebral cortex that the pain is registered and the patient then experiences the sensation.

Chronic pain is more long-term pain which tends to last beyond a period associated with temporary conditions. Long-term medical conditions like fibromyalgia can cause chronic pain (Understanding 2013). It is a more complicated type of pain than acute because the underlying cause of the pain is more important than treating the symptom itself, a process which can take a great deal of time and can frustrate the patient leading to depression and an exacerbation of symptoms. Patients dealing with chronic pain issues are abnormally sensitive to painful stimuli and this is attributed to a response to the activation of low-threshold mechanoreceptive A beta fibres. Three processes within the spinal cord are believed to be responsible for the different sensory processing in chronic pain patients: increased excitability, decreased inhibition, and structural reorganization (Woolf 1994,-page 525).

Referred pain is a more mysterious form of pain than the other two. Pain is felt in one part of the body but that is not the location of the medical problem or physical injury (Vecchiet 1999,-page 489). This can make the cause of the pain difficult for medical staff to locate and diagnose because they will often test in the region of pain and only look at referred pain as a possibility when all avenues here are examined. Besides the origination point of the symptom, there will be secondary hyperalgesia within the referred zone. Although science has not yet proved the exact reason for referred pain, it is largely believed that it is not central convergence mechanism, wherein the dorsal horn neurons diverge within the deep tissue. It is hypothesized that nociceptive input from the skeletal muscles refer to myotomes outside the areas of origin and are spread by central sensitization to spinal segments near the origin point.

Diagnosis:

In terms of diagnosis, the most important thing is to locate the underlying cause for the pain, whether it is acute, chronic, or referred (Woessner 2013). First, muscles, nerves, and tissues near the area of pain will be examined to determine if there is a direct cause of pain which can be linked to the patient. If this is not possible, then further examination and testing must be undertaken.