pain

pain, unpleasant or hurtful sensation resulting from stimulation of nerve endings. The stimulus is carried by nerve fibers to the spinal cord and then to the brain, where the nerve impulse is interpreted as pain. The excessive stimulation of nerve endings during pain is attributed to tissue damage, and in this sense pain has protective value, serving as a danger signal of disease and often facilitating diagnosis. Unlike other sensory experiences, e.g., response to touch or cold, pain may be modified by sedatives and nonsteroidal anti-inflammatory drugs or, if unusually severe, by opioid narcotics. Recently, patient-controlled analgesic techniques have been introduced, in which patients have the option of injecting small quantities of narcotic type analgesics to control their own pain. Microprocessor-controlled injections may be made through intravenous catheters, or through a catheter into the epidural (covering of the spinal cord) area. If such treatments do not suffice and if the cause of the pain cannot be removed or treated, severing a nerve in the pain pathway may bring relief.

Pain is occasionally felt not only at the site of stimulation but in other parts of the body supplied by nerves in the same sensory path; for example, the pain of angina pectoris or coronary thrombosis may extend to the left arm. This phenomenon is known as referred pain. Subjective or hysterical pain originates in the sensory centers of the brain without stimulation of the nerves at the site of the pain.

Progress has been made in the management of chronic pain and in the education of patients and physicians in such techniques as biofeedback, acupuncture, and meditation and the appropriate use of narcotics and other medications. Using advanced medical-imaging technology, researchers have now located multiple pain centers in the cerebral cortex of the brain, offering promise of possible improvements in measuring and managing pain.

Bibliography

See F. T. Vertosick, Jr., Why We Hurt: The Natural History of Pain (2000).

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pain

Physical suffering associated with a bodily disorder (such as a disease or injury) and accompanied by mental or emotional distress. Pain, in its simplest form, is a warning mechanism that helps protect an organism by influencing it to withdraw from harmful stimuli (such as a pinprick). In its more complex form, such as in the case of a chronic condition accompanied by depression or anxiety, it can be difficult to isolate and treat. Pain receptors, found in the skin and other tissues, are nerve fibres that react to mechanical, thermal, and chemical stimuli. Pain impulses enter the spinal cord and are transmitted to the brain stem and thalamus. The perception of pain is highly variable among individuals; it is influenced by previous experiences, cultural attitudes (including gender stereotypes), and genetic makeup. Medication, rest, and emotional support are the standard treatments. The most potent pain-relieving drugs are opium and morphine, followed by less-addictive substances and non-narcotic analgesics such as aspirin and ibuprofen.