What is pain?
Pain is defined as abnormal unpleasant feeling or sensation over physical (with usually organic pathology) or psychological level (with usually no pathophysiological cause) involving nervous system. The IASP (International Association for the Study of Pain) defines pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. We can not define pain as a disease but it’s a most common condition of the various medical conditions.
It’s a subjective symptom of many medical conditions which causes discomfort or unease by affecting general condition of a person. In other words we can say that pain is an indication of various medical conditions, which makes the person realize that something abnormal is going on that, requires treatment.
There are few specific causes of pain like Nocieptive pain in which there is stimulation of nerve endings known as nociceptors, which are present on the skin, internal organs, joints and muscles following an injury, burn, effect of cold, pressure, blow, or any type of stimulation causes tissue damage. On the other hand pain can occour due to malfunctioning or damage to the nervous system, which is usually associated with conditions like diabetes, spinal cord injury etc. one more cause of pain is there in which pain occurs due to abnormal psychological derangements in which usually no organic or pathophysiological cause is found. Often associated with psychic disorders like depression or any other psychic conflict, it includes psychogenic pain syndrome commonly presenting as chronic headache, chronic backache or general myalgia. To understand pain, it is very essential to understand the exact physiology behind it, Nociceptors (specific pain receptors) which are present in the skin, muscles joints and internal organs when they get activate with the effect of stimulus electrical impulses with pain message passes via peripheral nerve fibers and reaches to dorsal horn in spinal cord. After processing from spinal cord, impulses reaches to brain to Thalamus, from Thalamus it reaches to the somatosensory cortex (limbic system, the frontal cortex), where interpretation of physical sensation occurs.
Causes of pain
- Nocieptive – Stimulation of nerve endings known as nociceptors which are present on the skin, internal organs, joints and muscles following an injury, burn, effect of cold, pressure, blow, or any type of stimulation causes tissue damage.
- Neuropathic – Caused due to malfunctioning or damage to the nervous system which is usually associated with conditions like diabetes, spinal cord injury etc.
- Psychological cause – Usually no organic or pathophysiological cause is found in such cases. Often associated with psychic disorder like depression or any other psychic conflict. It includes psychogenic pain syndrome commonly featured with chronic headache, chronic backache etc.
Causes of pain can also be classified as:
- Physiological causes of pain – an acute response to an injury.
- Inflammatory causes of pain – when the pain is generated and maintained mainly by inflammatory mediators.
- Cancer related causes of pain – causes are usually multiple. It may be predominantly physiological, inflammatory neuropathic or ischemic.
- Neuropathic causes of pain – pain arising from injury or dysfunction of the central or peripheral nervous system.
- Central causes of pain – pain caused by a lesion or dysfunction of the central nervous system
- Ischaemic causes of pain – related to reduction in blood supply.
- Psychogenic causes of pain – pain, especially chronic pain, has almost invariably a strong emotional and behavioural component.
Classification of pain
Pain is mainly classified in to acute pain and chronic pain
- Acute pain – It is a sudden severe pain often caused due to tissue damage and often subsides after healing. Intensity and duration of pain mainly depends upon location of injury, stimulus, age of person and sex of person.
- Chronic pain – It remains for more than a month, following the healing of a tissue. It usually persists for three months or more and is often associated with functional disturbances like insomnia, fatigue. Sometimes chronic pain may result from long continued activation of pain receptors.
Pain can also be classified according to its sensation too like burning pain, stitching pain, throbbing pain, sticking pain, shooting pain, radiating pain, wandering pain etc.
Pain can also be classified by its origin and location for example headache (pain in head), abdominal colic (pain in abdomen), renal colic (pain arising from kidney stones), biliary colic (pain arising from gall stones), angina (heart), neuralgia, trigeminal neuralgia, post-herpetic neuralgia, Sciatica, dysmenorrhoea (painful menses), myalgia (pain in muscles) etc.
- Diagnosis includes – History of – Trauma or injury, medication or drug abuse, emotional distress condition etc.
- General examination – Posture, mobility, weight, color of skin.
- Physical examination includes- Examination of location affected by pain and examination of relevant system.
- X-ray, MRI – To detect the structural and tissue abnormalities.
- Neurological examination – Including gait, balance coordination and sensation.
- EMG, Nerve conduction studies- To detect the affected nerve or muscle
Pain Relief and Treatment of Pain
Homeopathic treatment of Pain
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which a patient is suffering.
The aim of homeopathy is not only to treat pain, but to address its underlying cause and individual susceptibility of the patient. For this patient’s current symptoms, past medical history and family history are taken into account. There are many homeopathic remedies which cover the symptoms of pain and can be selected on the basis of cause, location, sensation, modalities and extension of the pain. For individualized remedy selection and treatment of pain, the patient should consult a qualified homeopathic doctor in person. Some important homeopathic remedies for the treatment of pain are given below:
- Kreosote -Toothache, pain due to decayed teeth.
- Chamomilla – Pain: seems unendurable, drives to despair; worse by heat; evening before midnight; with heat, thirst and fainting; with numbness of affected part; eructation ameliorate. Toothache if anything warm is taken into the mouth; on entering a warm room; in bed; from coffee; during menses or pregnancy. Labor pains; spasmodic, distressing, wants to get away from them; tearing down the legs; press upward.
- Arnica Mont. – Acute pain after an injury along with sore bruised feeling. Pain caused by blunt trauma, acute sensitivity to touch.
- Ledum Pal. – For pain after punctured wounds or injury after sharp pointed instruments. Pain moving in limbs from below upwards.
- Colocynth – Abdominal colic which is better by bending double and makes patient restless. Sciatica pain which extends down the legs with numbness.
- Caulophyllum – Pains are intermittent, paroxysmal, and spasmodic. Labor pains short, irregular, spasmodic; tormenting, useless pains in beginning of labor. Pain in small joints.
- Brynoia Alba. – Pains: stitching, tearing, worse at night; worse by motion, inspiration, coughing; better by absolute rest, and lying on painful side.
- Rhus tox – Pain in muscles and joints, which is worse on initial motion but improves with continuous motion. Muscle stiffness is often present and warmth ameliorates.
- Belladonna – Pain in head with throbbing and congestion, often worse by heat.
- Hypericum – Excellent remedy for nerve pain especially after surgery or injury.
- Aconite. – Excellent remedy for acute pain with marked anxiety, fear and restlessness.
- Magnesia phos – Pains: sharp, cutting, stabbing; shooting, stitching; lightning-like in coming and going (Belladonna); intermittent, paroxysm becoming almost unbearable, driving patient to frenzy; rapidly changing place (Lac caninum , Pulsatilla), with a constricting sensation (Cactus grandiflorus , Iodium , Sulphur); cramping, in neuralgic affections of stomach, abdomen and pelvis. Better by Bending double; heat; warmth; pressure.