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Pain and Culture
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
Nuwan Jayawickreme, Eva Pugliese
The physical experience of pain is universal and is the most common reason why people around the world seek medical attention (Todd & Incayawar, 2014). In general terms, pain receptors in the human body respond to damaging or potentially damaging stimuli by sending threat signals through the spinal cord to the brain. The brain creates the sensation of pain in order to direct conscious attention and physiological responses such as inflammation to the part(s) of the body in need of attention. In this way, the basic physiological underpinnings of the pain experience are universal to all humans independent of culture, geographical location, ethnicity, gender, or age. Although the physical experience of pain is universal, the threshold (i.e., the point at which someone perceives a stimulation to be painful), tolerance of, and response to pain and pain treatments varies from person to person, depending in part on how the individual’s cultural background impacts the meaning he/she makes of that experience (Bates, 1987). Thus, it is vital that medical and psychosocial providers working with chronic pain patients understand the role of culture in the experience of pain in order to inform effective assessment and intervention approaches.
Nerve
Published in Manoj Ramachandran, Tom Nunn, Basic Orthopaedic Sciences, 2018
Mike Fox, Caroline Hing, Sam Heaton, Rolfe Birch
Nociceptors (pain receptors) are found in virtually every organ (except the brain). Their activity leads to the perception of pain and tissue injury. They have a high threshold for activation and often respond to more than one energy form (e.g. mechanical, thermal, mechanothermal) so are termed polymodal receptors. Myelinated fast Aδ and unmyelinated slow C fibres innervate these receptors.
Pain control in palliative care
Published in Rodger Charlton, Primary Palliative Care, 2018
Pain receptors are free nerve endings which are activated by noxious stimuli such as pressure (mechanoreceptors), extremes of temperature (thermoreceptors) and chemical substances such as histamine and prostaglandins (chemoreceptors) to produce so-called nociceptive pain. Pain receptors are also called nociceptors. Unlike other sensory receptors, they do not adapt to sustained stimulation but keep on firing signals. This is the reason why pain can become chronic, and it has evolved because of the continued need for the person to remember to protect that area of damage as well as to continue stimulating the endogenous pain control mechanisms.
Multimodal analgesia in neurosurgery: a narrative review
Published in Postgraduate Medicine, 2022
Caterina Aurilio, Maria Caterina Pace, Pasquale Sansone, Luca Gregorio Giaccari, Francesco Coppolino, Vincenzo Pota, Manlio Barbarisi
It is now understood that there are two forms of cyclooxygenase, termed cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). COX-1 is a constitutive isoform found in normal tissues, while COX-2 is induced in settings of inflammation and is constitutively expressed in certain areas of brain. NSAIDs are usually classified as mild analgesics, but it is important to consider the type of pain and its intensity in the assessment of analgesic efficacy. In postoperative pain, the NSAIDs may be superior to the opioids because they are particularly effective in different contests in which inflammation has caused sensitization of pain receptors [16]. The inhibition of COX-1 correlates with the inhibition of endogenous prostaglandins that impairs platelet function and promotes the ability of these drugs to increase the perioperative bleeding time. Probably for this reason, there are few clinical studies on the use of NSAIDs in brain surgery. In a Cochrane review, six studies were included in a meta-analysis on 742 patients to assess acute postoperative intensity of pain in brain surgery [10,17,18].
Dexmedetomidine vs hyaluronidase addition to fluoroscopy-guided caudal analgesia with steroid in lumbosacral spine surgery. A comparative double blinded study
Published in Egyptian Journal of Anaesthesia, 2021
Sanaa F. Wasfy, Waleed H. Nofal, Mona A. Ammar
Patients undergoing spine surgeries experience moderate to severe postoperative pain. Preventive analgesia is a recent concept, which includes preemptive, intraoperative and postoperative pain control [4]. Preventive analgesia can be achieved by combining regional anaesthesia with other analgesic modalities. Preemptive analgesia decreases the incidence of development of central sensitization due to prolonged triggering of peripheral pain receptors. Central sensitization leads to permanent pain perception, even after cessation of the painful stimulus [4].
Oral pharmacotherapeutics for the management of peripheral neuropathic pain conditions – a review of clinical trials
Published in Expert Opinion on Pharmacotherapy, 2020
Nebojsa Nick Knezevic, Filip Jovanovic, Kenneth D. Candido, Ivana Knezevic
Regardless of the increased use of multiple medications for the treatment of peripheral neuropathic pain, the results of clinical trials in patients with such conditions are mostly equivocal in terms of defining efficacy and in providing reassurance in reasonable numbers needed to treat. In order for clinicians to address the complexities of neuropathic pain, multiple oral medication therapy is encouraged with special care assessing drug–drug interactions in an ongoing search for advanced molecules targeting central and peripheral pain receptors.