What Is a Pain?

People experience pain when they are physically damaged, emotionally hurt, or as a result of a previous painful action. The sensory neurons send pain signals to the brain via the spinal cords, and the brain interprets the type of pain we experience.

Chronic pain is not caused solely by unpleasant stimuli.

People believe they are in pain even when it is not present, as in phantom pain.  Pain can originate from one place but be felt at a different place

 People interpret and experience pain differently, for instance some may experience more pain, while others experience less pain for the same injury

The extent of an injury does not determine the degree of pain felt

It is possible for neurons to block pain

Pain Perception

The art of life entails avoiding pain but there is no pleasure without pain. In medical language, Pain may be defined as unpleasant sensory and emotional experience resulting from an injury or bodily harm. It is one of the most common symptoms that always require intervention before discovering the main cause of the problem. Pain has both emotional and physical effects that are too difficult to control and cannot be compared from one patient to another.

As an example, Jordan injured his lower back after jumping from a high wall. The injury has caused him severe pain and the result is that he is mostly in very deep pain and unable to sleep and lead a normal life. Once severe pain has crept in, life becomes abnormal for just anyone. In Jordan’s case too, it is equally true. First of all, if the psychological impact of Jordan’s pain is analyzed some important facts would come to light. It has left him sleepless where he at an average sleeps for no more than 4 hours a day. The result is that of having mild depression. While mild depression cannot be very difficult to manage, if it persists it can transform from mild to severe. Moreover, the way pain has disrupted his normal life; it is quite natural that Jordan might start feeling helpless. Once normal life is disrupted, a person’s personal life also gets disrupted.

Another major problem that comes from experiencing chronic pain is that it can disrupt a person’s social life. Pain can bring the ability of a person to bear pressure low leading to a rise in stress level. In turn it can impact the person’s relationships since the person would not feel like socializing with people. Pain can give rise to intense pressure in personal and social lives of people. Jordan is experiencing the same psychosocial effects of pain where his personal and social lives have been disrupted due to growing pain (The Open University, 2016). Another important problem is that he is feeling irritated and stressed. In this regard while he would need physical interventions to cope with the effects of pain, simultaneously he would require psychological interventions to help him cope with the stress being caused by pain.

A number of psychological, physiological and behavioral approaches to pain management have been found to be effective. Stress can be a key factor that exacerbates pain. Stress can be psychological, physical or caused by environmental factors. Relaxation training has been found to be an effective method of pain management. Apart from it progressive muscle relaxation and autogenic training have also been found to be highly effective at managing the pain in the muscles. The cognitive behavioral approaches to pain management have also been found to be highly effective at managing pain in the patients experiencing muscular pain.

There is a significant amount of correlation evidence linking chronic stress to the development of chronic pain syndromes. Different groups have looked into various forms of stress, from depression and psychological stress to chronic suffering as a result of migraines and other physiological stressors, with the common finding that perceived stress, regardless of the form it takes, is associated with increased incidence of chronic pain syndromes. Second, chronic pain patients have been shown to have functional derangements in their HPA axis, leading to inappropriate responses to stress, altered levels of stress-hormones, and the induction of hyperalgesic states. Third, such hyperalgesic priming can cause downstream sensitization of CNS neurons, leading to somatization (The Open University, 2016).

Essentially, chronic stress leads to hormonal imbalances, which in turn leads to hyperalgesia and CNS sensitization. Based on the strong evidence for a psychological root to the physical manifestations of certain chronic pain syndromes, there is a very strong case to be made for the implementation of psychological screening as a part of the diagnostic criteria for such syndromes, thereby necessitating its role in treatment. Current evidence suggests that the most effective treatment of hyperalgesia combines medical interventions with psychotherapy that focuses on lowering stress reactions and increasing adaptive strategies. Despite the fact that research has shown psychotherapy to be vital to the treatment of chronic pain syndromes, it is still not part of the requisite treatment protocol.

Without addressing the psychological triggers that induce stress, the physiological deregulation will continue to activate the same neuronal pain loops. The current, predominantly pharmacotherapy-­‐based strategy for treating chronic pain is tantamount to palliative symptom relief. Without treating the underlying psychological mechanisms that support this disease, symptom palliation – whether it be through pharmaceutical, mechanical, nutritional or botanical interventions –at best provides-aid a solution, band leaving the root cause untouched (The Open University, 2016).

Subsequent studies have found that hyperalgesic priming enhances the reaction of the nociceptive nerve endings to cytokines that are inflammatory in nature. Besides, stress is known to induce a prolonged state of high sensitivity to pro-inflammatory cytokines that cannot be distinguished from occurrence of hyperralgesic priming which is initiated by the inflammation. In essence, the downstream effects of hyperalgesic priming of the primary afferent nociceptors trigger variations in the central nervous system, leading to central sensitization and somatization. This association is thought to be explained by an increased recruitment of CNS neurons that become activated by peripheral nociceptor stimulation.

Likewise, the HPA axis has been repeatedly demonstrated to be a major pathway through which the CNS exerts control over the immune system in conditions of stress. A central mechanism of action in this regard is the secretion of vasopressin and corticotrophin, which in turn ensure the release of the (CRH) hormone by the hypothalamus. As a result, the CRH triggers the pituitary glands to release the adrenocorticotropic hormone (ACTH), which in turn stimulates the secretion of glucocorticoids (including cortisol) by the adrenal glands. For this reason, The Open University (2016) notes that sensitivity to pain is greatly affected by the degree of activation of the HPA reaction to stress, and this exposes one to the occurrence of widespread chronic pain.

In Jordan’s case, it is important to note that pain has had a psychological impact on him too creating stress in his personal life. While he is experiencing sleeplessness, simultaneously he has also experienced mild depression that has caused him trouble in his personal life. This can impact his personal life and relationships and in case the emotional problems sustain for long, their impact can be deeper. Jordan’s injury has left him in severe pain and unless he is provided with the right interventions managing his pain and its psychological side effects may become difficult. If his pain is not managed well, the results can be devastating for the patient and may also have a long term psychological impact. In this regard it is important that the Patients like Jordan are provided training in relaxation techniques that can help them manage their pain themselves. However, prior to training the patient in pain management effective tools have to be used for pain assessment so that accordingly an intervention program can be administered.

Reflection

Writing this essay was quite simple and enjoyable since the topic was one of my favorites in the entire module. The scientific content and my essay plan had no significant differences. Actually, this made the writing of the final essay a simple task. It was especially easy to research and analyze available literature on pain perception and related issues. They were readily available on various libraries and websites, which gave me an easy time gathering the required materials. Last, putting down the findings from my research was made easier by the essay outline written while conducting the research. In future, I intend to research more widely and use different sources written by different scholars.

Bibliography

The Open University (2015) SDK100 Science and health: an evidence-based approach: Topic 3 Section 6, The Open University.

The Open University (2016) SDK100 Science and health: an evidence-based approach: Topic 3 Section 4, The Open University.

The Open University (2016) SDK100 Science and health: an evidence-based approach: Topic 3 Section 3, The Open University.

The Open University (2016) SDK100 Science and health: an evidence-based approach: Topic 3 Section 2, The Open University.

The Open University (2016) SDK100 Science and health: an evidence-based approach: Topic 3 Section 1, The Open University.