Upcoming SlideShare. Like this presentation? Why not share! Embed Size px. Start on. Show related SlideShares at end. WordPress Shortcode. Full Name Comment goes here. Are you sure you want to Yes No. What if I told you, you've been lied to for nearly all of your life? Ehsan Ahmed. Show More. No Downloads. Views Total views. Actions Shares. Embeds 0 No embeds. No notes for slide. BY: Mr. Shiva Nandha Reddy 2. Types of pain Pain is classified Based on duration based on location Based on intensity Based on etiology 7.
Acute pain Examples: arthritic pain, head ache, peripheral neuropathy. Chronic pain Examples are migraine headaches. Based on intensity: pain Mild pain Moderate pain Severe pain Based on intensity Pain scale Classification of pain based on etiology: pain Nociceptive pain Somatic pain Visceral pain Neuropathic pain Peripheral neuropathic pain Central neuropathic pain Based on etiology Central Neuropathic Pain.
Factors Influencing Pain 1. Developmental factors 2. Physiological factors- fatigue, genes, neurological functioning 3. Social factors- attention, previous experience, family and social support, spiritual factors. Gibson J. Updated January 6, Surgical intervention for lumbar disc prolapse. Koes, B. An updated overview of clinical guidelines for the management of non-specific back pain in primary care.
European Spine Journal, 19 12 , Leclaire, R. Radiofrequency facet joint denervation in the treatment of low back pain: A placebo-controlled clinical trial to assess efficacy. Spine, 26 , Martin, B. Trends in health care expenditures, utilization, health status among US adults with spine problems, Spine, 34 19 , Melzack, R. From the gate to the neuromatrix. Pain, S6 , SS Phantom limbs and the concept of a neuromatrix.
Trends in Neurosciences, 13 3 , Phantom limbs, the self, and the brain The D. Hebb Memorial Lecture. Canadian Psychologist, 30 , Pain, 4 , Mirza, S. Systematic review of randomized trials comparing lumbar fusion surgery to nonoperative care for treatment of chronic back pain.
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Spine, 32 , Nguyen, T. Long-term outcomes of lumbar fusion among worker's compensation subjects: A historical survey. Spine 36 4 , Pinto, R. Maher, C. Epidural steroid injections in the management of sciatica: A systematic review and meta-analysis. Annals of Internal Medicine, 12 , Outcomes of invasive treatment strategies in low back pain and sciatica: An evidence based review. European Spine Journal, 15 , SS Videman, T.
Associations between back pain history and lumbar MRI findings. Spine, 28 6 , Weinstein, J. Surgical vs. On a clinical level, I have evaluated more than 5, chronic pain patients who were being considered for a spinal cord stimulator SCS. My experience and outcome data on the effectiveness of SCS is mixed, which suggests that our current understanding of selective spinal modulation is far from complete. Pain is further modulated in an apparent coordinated fashion, including a number of areas within the brain that involves multiple descending mechanisms.
The work of Fields and Basbaum has demonstrated that the rostioventral medulla toward the front of the lower half of the brainstem plays an important role in pain modulation. Further, specific areas involved in descending inhibition include the periaqueductal gray matter, which is a cluster of neurons located in the pons and nucleus raphe magnus.
The pons is the main structure that receives and transmits information from the forebrain to the spinal cord and PNS. Marchand points out that the two regions contain origins of the descending serotonergic and noradrenergic tracts, which contribute to the inhibition of the pain signal. Finally, we need to include the role that the higher centers in the CNS play in pain modulation. Our knowledge has recently improved with the advancement of imaging technology, especially when considering the roles sensory and emotional components play in the higher cortical regions.
The interaction between higher centers and the limbic structures play a role in the motivational-affective component of the theory. Both of these influences contribute to pain modulation. Our knowledge of the pain experience has moved forward from a simple linear, dualistic model to a more global, intricate model that includes the importance of affective or emotional influences. Advances in neurophysiology and neuroanatomy have improved our knowledge with regard to the role modulation plays in the pain experience.
Improvements in imaging have provided valuable information that has resulted in improved care for the pain patient.
Nature and Nurture of Human Pain
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The Nature and Management of Labor Pain: Part I. Nonpharmacologic Pain Relief
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Letters to The Editor. Olson KA.
History of pain: a brief overview of the 17th and 18th centuries. Pract Pain Manage. History of pain: a brief overview of the 19th and 20th centuries. Livingston WK. Pain and Suffering. Melzack R, Wall PD. Pain mechanisms: a new theory. Melzack R, Casey KL.
History of Pain: The Nature of Pain
Sensory, motivational, and central control determinants of pain: a new conceptual model. Kenshalo ed. Charles C. Thomas; Springfield, IL: Chronic Pain. Behavioral Science in the Practice of Medicine. New York: Elsevier Biomedical Internation Association for the Study of Pain.
Multidimensional Nature of Pain
The Phenomenon of Pain. Sherrington CS.
The Integrative Action of the Nervous System. Head HH. Sensory disturbances from sensory cerebral lesions. Widespread pain in fibromyalgia is associated to a deficit of endogenous pain inhibition. Le Bars O. The whole body receptive field of dorsal horn multireceptive neurons. Brain Res Brain Rev. Willis WD. Nociceptive pathways anatomy and physiology of nociceptive ascending pathways.
Identifying psychological factors that influence surgical outcomes. Cortical representation of pain: Functional characterization of nociceptive areas near the lateral sulcus.