Chronic Pain
From: Helen Dynda (olddad66@runestone.net)
Sat Mar 31 08:39:17 2001
Chronic Pain...March 31, 2001
Quick Reference
Pain of incredible proportions overwhelms all other symptoms and becomes the
problem. People so afflicted often cannot work. Their appetite falls off.
Physical activity of any kind is exhausting and may aggravate the pain.
Soon the person becomes the victim of a vicious circle in which total
preoccupation with pain leads to irritability and depression. The sufferer
can't sleep at night and the next day's weariness compounds the
problem-leading to more irritability, depression, and pain. Specialists
call that unhappy state the "terrible triad" of suffering, sleeplessness,
and sadness, a calamity that is as hard on the family as it is on the
victim. The urge to do something-anything-to stop the pain makes some
patients drug dependent and drives others to undergo repeated operations or
resort to questionable practitioners who promise quick and permanent
"cures."
Detailed Information
Many chronic pain conditions affect older adults. Arthritis, cancer,
angina-the chest-binding, breath-catching spasms of pain associated with
coronary artery disease-commonly take their greatest toll among the
middle-aged and elderly. Trigeminal neuralgia (tic douloureux) is a
recurrent, stabbing facial pain that is rare among young adults. But ask
anyone living in a community for retired persons if there are any trigeminal
neuralgia sufferers around and you are sure to hear of cases. So the fact
that Americans are living longer contributes to a widespread and growing
concern about pain.
Neuroscientists share that concern. At a time when people are living longer
and painful conditions abound, the scientists who study the brain have made
landmark discoveries that are leading to a better understanding of pain and
more effective treatments.
Treatment/Prevention
In the past several decades, important discoveries about pain-suppressing
chemicals came about because scientists were curious about how morphine and
other opium-derived painkillers, or analgesics, work. For some time
neuroscientists had known that chemicals were important in conducting nerve
signals (small bursts of electric current) from cell to cell. In order for
the signal from one cell to reach the next in line, the first cell secretes
a chemical, called a "neurotransmitter," from the tip of a long fiber that
extends from the cell body. The transmitter molecules cross the gap
separating the two cells and attach to special receptor sites on the
neighboring cell surface. Some neurotransmitters excite the second
cell-allowing it to generate an electrical signal. Others inhibit the
second cell-preventing it from generating a signal.
Numerous studies around the world led to the discovery of not just one
pain-suppressing chemical in the brain, but a whole family of such proteins.
The term endorphins is now often used to describe the group as a whole. The
discovery of the endorphins lent weight to an overarching theory of pain:
endorphins released from brain nerve cells might inhibit spinal cord pain
cells through pathways descending from the brain to the spinal cord. Further
evidence that endorphins figure importantly in pain control came from
studies of some of the oldest and newest pain treatments. These studies
involved the use of a drug called naloxone that prevents endorphins and
morphine from working.
Injections of naloxone resulted in a return of pain which had been relieved
by morphine and certain other treatments. But, interestingly, some pain
treatments are not affected by naloxone: their success in controlling pain
apparently does not depend on endorphins. Thus nature has provided us with
more than one means of achieving pain relief.
-Acupuncture
-Local electrical stimulation
-Brain stimulation
-Placebo effects
For more information, see:
American Pain Foundation
http://www.pain.com/
Chronic Pain from InfoMin
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