The mechanisms of pain and the spinal blocking of pain signals.
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Pain can be interpreted as an intolerable sense of injury or harmful stimulation. It is not a disease but a symptom your body is making you aware of that something could be wrong. The function of pain is to prompt you to avoid, reduce, or get away from perceived danger. Although no one enjoys pain, we are better with it than without it due to certain diseases such as leprosy and diabetes mellitus where nerve damage can numb sense of pain and make a person not realize they have an injury resulting in the possibility of gangrene or amputation of a limb (Saladin, 2018 p 569).
There are two classifications of pain, nociceptive pain, and neuropathic pain. Nociceptive pain comes from tissue injury due to cuts, burns, and chemical irritations that are recognized by nerve endings called nociceptors (Saladin, 2018 p 569). You can find nociceptors in the skin, mucous membranes, and almost all the organs except the brain and liver. Nociceptors come about in the meninges and play a part in headaches since nociceptive pain has to do with inflammation it reacts to anti-inflammatory medications such as ibuprofen and aspirin (Saladin, 2018 p 569). Visceral, deep somatic, and superficial somatic pain are the three varying kinds of nociceptive pain. Visceral pain comes from the internal organs and is hard to find you can associate this type of pain when you have deficient blood flow like when you suffer a heart attack it’s linked to the sense of squeezing, cramping, and nausea. Deep somatic pain comes from bones, muscles, and joints and is experienced when you have fractures, arthritis, or sprains and lastly there’s superficial somatic pain which is felt on the skin from burns and cuts (Saladin, 2018 p 569).
Neuropathic pain comes from injuries to nerves, spinal cord, meninges, and brain. Examples of these are headaches, phantom limb pain and cancer. There are two types of nerve fibers that arbitrate pain responses called fast pain and slow pain. Fast pain is the instantaneous intense pain you feel from cuts and burns, and slow pain is the type of pain that is more like a throbbing aching sensation (Saladin, 2018 p 569).
It is difficult for physicians to pinpoint the origin of someone’s pain because pain travels and the feeling can stem from anywhere. Pain indicators get to the brain by two main pathways. Prompts from the head travel to the brainstem down four cranial nerves, the trigeminal (CN V), facial (CN VII), glossopharyngeal (CN IX), and vagus (CN X) (Saladin, 2018 p 569). Pain indicators from the neck and below travel down three ascending spinal cord tracts, the spinothalamic tract, spinoreticular tract, and gracile fasciculus (Saladin, 2018 p 569).
There are times you hear someone say they have joint or muscle pain but the truth is pain doesn’t occur in these outermost locations but only in the brain, it’s the awareness of signals from other organs, so it can be instinctive for someone to believe they have pain in their joints or muscles. As a result, techniques such as acupuncture, meditation or placebos help people effectively decrease pain (Saladin, 2018 p 570). The CNS has a pain-relieving system that can be compared to the effects of morphine, opium, and heroin, we have receptors for these drugs in our brain. Enkephalins, endorphins, and dynorphins are three analgesics in the body and are secreted by the CNS, the pituitary gland, digestive tract, and other organs when stressed or exercising (Saladin, 2018 p 571). Lastly, for pain to be recognized, indicators from the nociceptors must get past the posterior horn of the spinal cord and progress to the brain. Pain signals can be stopped at the posterior horn by a method called spinal gating. Descending analgesic fibers are nerve fibers that come from the brainstem, go down the spinal cord inside the reticulospinal tract and obstruct pain signals from getting to the brain (Saladin, 2018 p 571).
I found this topic extremely informative; I have always wondered how people who suffer severe trauma due to accidents seem not to appear like they are not in pain. I find it amazing to know that our own body has the capacity to produce its own analgesic to stop the body from feeling such intense and severe pain. This knowledge is something that will help me in my career path since once I am done with this class, I will be entering the nursing program. It also helped me understand better why when my husband suffered a motorcycle accident and had so many broken bones throughout his body he told me he didn’t feel any pain until after he had had surgery to repair everything that was broken.
Saladin, K.S., (2018). Chapter 16: Sense Organs. In Anatomy & Physiology, the unity of form and function (9th ed) (pp 563-611). McGraw Hill.