PAIN is one of the most common and debilitating complaints that afflicts about 100 million Americans annually, accounting for 20 percent of doctors’ visits and 12 percent of all prescriptions. It is the most common cause of long-term disability and missed work. There are two categories of pain. Adaptive pain involves a survival mechanism protect- ing an organism from an injury and promotes healing. Maladaptive or chronic pain represents pathologic functioning of the nervous system.
Pain sensation begins in the peripheral nervous system, precipitated by a noxious stimulus activating specialized nociceptors, which transmit pain signal to spinal cord column and then to the central nervous system where it is processed as pain perception.
Types of pain include nociceptive pain, which involves an injury to body tissues (somatic), internal organs (viscera) and musculoskeletal system; or inflammatory and mechanical/ compressive pain.
Neuropathic pain arises from abnormal neural activity secondary to disease, injury or dysfunction of the nervous system. For example diabetic neuropathy, trigeminal neuralgia, reflex sympathetic dystrophy, postherpetic neuralgia, phantom limb pain, and pain from spinal cord injuries or stroke.
There are multiple mechanisms that lead to persistent pain, including changes in the chemical environment of pain receptors due to tissue inflammation; augmentation of sensitivity by central nervous system to initial pain stimulus; increased sensory inflow from site of injury; structural changes to sensory neurons; primary sensory neuron degeneration and reduction in inhibition pathway to pain stimuli, leading to increased excitability.
The choice of pain management depends on the types of pain one has. Please contact our office for more details on the matter discussed.