pain

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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).

The Columbia Electronic Encyclopedia™ Copyright © 2013, Columbia University Press. Licensed from Columbia University Press. All rights reserved. www.cc.columbia.edu/cu/cup/
The following article is from The Great Soviet Encyclopedia (1979). It might be outdated or ideologically biased.

Pain

 

a disagreeable, oppressive, sometimes unbearable sensation arising in animals and man, chiefly in response to exceedingly strong or destructive factors.

In the course of the evolution of the organic world, pain was transformed into a danger signal; it became an important biological means for saving the life of an individual and, consequently, of a species. Pain mobilizes the body’s defenses to eliminate the painful stimuli and restore the normal functioning of organs and physiological systems. According to one concept (the theory of specificity), the sensation of pain occurs when particular structures are stimulated, the so-called pain receptors (free nerve endings), which have their own system of transmitting impulses to the central nervous system. According to another belief (the theory of intensity), strong stimulation of any receptors (touch, heat, cold) may cause pain.

Information about pain is transmitted through the dorsal (sensory) roots to the spinal cord and by way of the spinothalamic tract to the optic thalamus. After this information reaches the cerebral cortex it is perceived by the mind as pain. Other divisions of the brain are also involved in the process, including the reticular formation, limbic system, and hypothalamus. These determine the nature (modality) of pain and the resulting emotional manifestations (facial expressions, crying, and groaning) and autonomic manifestations (changes in blood pressure, heartbeat, respiration, and pupil dilation). The cerebral cortex can translate impulses that do not cause pain into painful impulses and under certain circumstances (emotional excitement and volitional stress) can mitigate and even completely abolish the sensation of pain. Strictly controlled mechanical, electrical, temperature, chemical, and other stimuli are used in laboratory experiments and clinical studies to determine the threshold and intensity of pain.

Pain is one of the earliest symptoms of many disturbances of the life processes. It is therefore a particularly important factor in the diagnosis and treatment of a number of diseases. A distinction is made between true pain, which is felt in the diseased organ (for example, in the heart, liver, and stomach), and referred, or reflex, pain in certain parts of the skin, the so-called Zakhar’in-Head zones (for example, in the left arm or shoulder blade in heart diseases). Stubborn and persistent pain often disturbs the functioning of individual organs, physiological systems, or the entire body and causes pathological phenomena (such as impairment of the central nervous system, gastrointestinal tract, or endocrine glands) which disappear when the pain ceases. The exhaustion of the nerve centers, chiefly the cerebral cortex, that results from prolonged and severe pain may produce shock, collapse, and sometimes even death.

Sensitivity to pain varies from individual to individual. It may be high (hyperalgesia), low (hypalgesia), and in some extremely rare cases absent altogether (analgesia). The perception of pain is quite subjective and dependent on many factors related to individual traits, type of higher nervous activity, impression of one’s own condition, mood, and physical and mental state. Adaptation to pain is much less common than to other kinds of sensations, and in cases where it is not noticed, this is usually due to distraction and the switching of attention.

According to data from modern psychology, the emotional reaction to pain, although determined by inborn nervous and physiological mechanisms, is nevertheless dependent in large measure on developmental conditions and upbringing. The conditioned activity of the brain plays an important role in the perception of pain. A conditioned stimulus may elicit a strong reaction of pain even in the absence of a strong painful stimulus. For example, if the eyes of a patient with causalgia are covered, he will react calmly to light pressure on the affected limb, but such pressure will produce severe pain if his eyes are open. Lesions of the nerve trunks, vascular disorders, metabolic disturbances, and so on may produce various kinds of pain (for example, causalgia, phantom pain, headache, and muscular pain), the genesis of which has to be specifically analyzed in each particular case. Modern medicine has at its disposal a wide array of pharmacological agents to mitigate or relieve pain. Physical agents and surgical methods are used for the same purpose.

The concept of pain is sometimes used in a figurative sense, as when speaking of spiritual pain to describe a special psychic state caused by various external or internal factors and associated with distressing sensations. These sensations are physiologically caused by the action of the higher nerve centers on certain internal organs.

REFERENCES

Dionesov, S. M. Bol’ i ee vliianie na organizm cheloveka i zhivotnogo, 2nd ed. Moscow, 1963.
Kassil’, G. N. Nauka o boli. Moscow, 1969.
Keele, C. A., and D. Armstrong. Substances Producing Pain and Itch. London, 1964.
Pain. Edited by A. Soulairac, J. Cahn, and J. Charpentier. London-New York, 1968.

G. N. KASSIL’

The Great Soviet Encyclopedia, 3rd Edition (1970-1979). © 2010 The Gale Group, Inc. All rights reserved.

What does it mean when you dream about pain?

Experiencing pain in one’s dream may be a reflection of real pain that exists somewhere in the dreamer’s body. Alternatively, the dreamer may consider someone or something to be a “pain.” The suppression of painful memories may also be an issue.

The Dream Encyclopedia, Second Edition © 2009 Visible Ink Press®. All rights reserved.

pain

[pān]
(physiology)
Patterns of somesthetic sensation, generally unpleasant, or causing suffering or distress.
McGraw-Hill Dictionary of Scientific & Technical Terms, 6E, Copyright © 2003 by The McGraw-Hill Companies, Inc.

Pain

(dreams)
When considering the interpretation of feeling pain in your dream, first look at you physical health. If you are feeling pain in your daily life, it may carry over into your dream state. Additionally, if the pain is emotional in nature, question the painful feelings and attempt to identify their source. The dream state is usually a safe way to experience negative feelings with which you may not want to deal.
Bedside Dream Dictionary by Silvana Amar Copyright © 2007 by Skyhorse Publishing, Inc.
References in periodicals archive ?
showed that several studies have used cell therapy for no-option CLI patients and, despite some failures due to factors that invalidated the functionality of stem cells (i.e., diabetes), the results obtained have confirmed the beneficial effects of cell therapy in reducing the major amputation rate, improving distal perfusion, reducing rest pain and claudication pain, improving ABI, TcP[O.sub.2], and walking distance, and overall improvement in the ischemic symptoms of CLI patients and their quality of life [40].
Patients including in the study were those with rest pain with ischemia features, trophic lesions, extensive gangrene and ulcers and those demonstrating presence of occlusive arterial disease.Moribund patients and those with extensive cardio-pulmonary disease or advanced malignancy were not included in the study.
Results showed that iguratimod obviously improved ACR20 and ACR70 at 24 weeks, and patients' health assessment questionnaire (HAQ) score showed reduced rest pain, tender joint count, and swollen joint count; lowered CRP level and ESR; and lowered physician and patient global assessment level of disease activity, but ACR50 at 24 weeks has no significant difference.
Rest pain which was present in15 patients (50%) before the procedure was relieved in all the patients at the end of 3 months (100%).
Patients aged 50 years and older with atherosclerosis risk factors and all persons over 70 years should be assessed for history of walking impairment, claudication, nonhealing lower extremity wounds, and ischemic rest pain. The presence of any of these features suggests the presence of PAD.
Clinical evaluation of PAD should begin with a thorough medical history (including walking) and physical exam to identity patients with risk factors, symptoms of claudication, rest pain, and/or functional impairment.
Clinical evaluation of PAD should begin with a thorough medical history (including walking) and physical exam to identify patients with risk factors, symptoms of claudication, rest pain, and/or functional impairment.
The ArtAssist[R] therapeutic device is helping patients who suffer from ischemic disease of the lower limbs; including non-surgical candidates suffering from diabetic foot ulcers, intermittent claudication, or rest pain. While patients are in a sitting position, the ArtAssist device applies a unique form of pneumatic compression to the foot, ankle, and calf to increase arterial blood flow.
My rest pain started getting better and better, which they told me would be the first thing to improve.
On the other hand, if an ESRD patient has limb-threatening ischemia, defined as rest pain or progressive ulceration or gangrene, then it's important to urge surgical intervention using techniques designed to minimize the extent of the harvest-site wound.
The court noted that the patient could submit evidence that he had a chance - even if it was a small chance - of being cured of the presenting problem of the "rest pain" and possible impending gangrene.