Nociceptive pain is caused by stimulation of sensory nerve fibers that respond to stimuli approaching or exceeding harmful intensity nociceptors , and may be classified according to the mode of noxious stimulation. The most common categories are "thermal" e. Some nociceptors respond to more than one of these modalities and are consequently designated polymodal. Nociceptive pain may also be classed according to the site of origin and divided into "visceral", "deep somatic" and "superficial somatic" pain.
Visceral structures e. Visceral pain is diffuse, difficult to locate and often referred to a distant, usually superficial, structure.
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It may be accompanied by nausea and vomiting and may be described as sickening, deep, squeezing, and dull. Examples include sprains and broken bones. Superficial pain is initiated by activation of nociceptors in the skin or other superficial tissue, and is sharp, well-defined and clearly located. Examples of injuries that produce superficial somatic pain include minor wounds and minor first degree burns.
Neuropathic pain is caused by damage or disease affecting any part of the nervous system involved in bodily feelings the somatosensory system. Peripheral neuropathic pain is often described as "burning", "tingling", "electrical", "stabbing", or "pins and needles". Nociplastic pain is pain characterized by a changed nociception but without evidence of real or threatened tissue damage, or without disease or damage in the somatosensory system.
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This applies, for example, to fibromyalgia patients. Psychogenic pain, also called psychalgia or somatoform pain , is pain caused, increased, or prolonged by mental, emotional, or behavioral factors. However, specialists consider that it is no less actual or hurtful than pain from any other source. People with long-term pain frequently display psychological disturbance, with elevated scores on the Minnesota Multiphasic Personality Inventory scales of hysteria , depression and hypochondriasis the " neurotic triad ".
Some investigators have argued that it is this neuroticism that causes acute pain to turn chronic, but clinical evidence points the other direction, to chronic pain causing neuroticism. When long-term pain is relieved by therapeutic intervention, scores on the neurotic triad and anxiety fall, often to normal levels. Self-esteem , often low in chronic pain patients, also shows improvement once pain has resolved. Inadequate treatment of pain is widespread throughout surgical wards, intensive care units , and accident and emergency departments , in general practice , in the management of all forms of chronic pain including cancer pain, and in end of life care.
The International Association for the Study of Pain advocates that the relief of pain should be recognized as a human right , that chronic pain should be considered a disease in its own right, and that pain medicine should have the full status of a medical specialty. Acute pain is usually managed with medications such as analgesics and anesthetics. Sugar sucrose when taken by mouth reduces pain in newborn babies undergoing some medical procedures a lancing of the heel, venipuncture , and intramuscular injections. Sugar does not remove pain from circumcision , and it is unknown if sugar reduces pain for other procedures.
Individuals with more social support experience less cancer pain, take less pain medication, report less labor pain and are less likely to use epidural anesthesia during childbirth, or suffer from chest pain after coronary artery bypass surgery. Suggestion can significantly affect pain intensity. This placebo effect is more pronounced in people who are prone to anxiety, and so anxiety reduction may account for some of the effect, but it does not account for all of it. Placebos are more effective for intense pain than mild pain; and they produce progressively weaker effects with repeated administration.
Cognitive behavioral therapy CBT has been shown effective for improving quality of life in those with chronic pain but the reduction in suffering is modest, and the CBT method was not shown to have any effect on outcome. A number of meta-analyses have found clinical hypnosis to be effective in controlling pain associated with diagnostic and surgical procedures in both adults and children, as well as pain associated with cancer and childbirth.
The authors concluded that "although the findings provide support for the general applicability of hypnosis in the treatment of chronic pain, considerably more research will be needed to fully determine the effects of hypnosis for different chronic-pain conditions. Pain is the most common reason for people to use complementary and alternative medicine. A meta-analysis of randomized clinical trials found that spinal manipulation was "more effective than sham therapy but was no more or less effective than general practitioner care, analgesics, physical therapy, exercise, or back school" in the treatment of lower back pain.
A quarter reported having experienced recurrent or continuous pain for three months or more, and a third of these reported frequent and intense pain.
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The intensity of chronic pain was higher for girls, and girls' reports of chronic pain increased markedly between ages 12 and In , responding to the need for a more useful system for describing chronic pain , the International Association for the Study of Pain IASP classified pain according to specific characteristics:. However, this system has been criticized by Clifford J.
Woolf and others as inadequate for guiding research and treatment. The nature or meaning of physical pain has been diversely understood by religious or secular traditions from antiquity to modern times. Physical pain is an important political topic in relation to various issues, including pain management policy, drug control , animal rights or animal welfare , torture , and pain compliance. In various contexts, the deliberate infliction of pain in the form of corporal punishment is used as retribution for an offence, or for the purpose of disciplining or reforming a wrongdoer, or to deter attitudes or behaviour deemed unacceptable.
The slow slicing , or death by a thousand cuts, was a form of execution in China reserved for crimes viewed as especially severe, such as high treason or patricide. In some cultures, extreme practices such as mortification of the flesh or painful rites of passage are highly regarded. The most reliable method for assessing pain in most humans is by asking a question: a person may report pain that cannot be detected by any known physiological measure.
However, like infants, animals cannot answer questions about whether they feel pain; thus the defining criterion for pain in humans cannot be applied to them. Philosophers and scientists have responded to this difficulty in a variety of ways. The presence of pain in an animal cannot be known for certain, but it can be inferred through physical and behavioral reactions. In particular, there are no known nociceptors in groups such as plants, fungi, and most insects,  except for instance in fruit flies.
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In vertebrates, endogenous opioids are neuromodulators that moderate pain by interacting with opioid receptors. First attested in English in , the word peyn comes from the Old French peine , in turn from Latin poena meaning "punishment, penalty"  in L. From Wikipedia, the free encyclopedia. This article is about physical pain.
For mental or emotional pain, see Psychological pain. For other uses, see Pain disambiguation. Main article: Chronic pain. Main article: Phantom pain. Main articles: Pain asymbolia and Congenital insensitivity to pain. For other uses, see Painless disambiguation. Play media. See also: History of pain theory. See also: Pain assessment , Pain scales , and Pain ladder. Main article: Visual analogue scale. See also: Pain and dementia and Pain in babies. Main article: Nociception.
Main article: Neuropathic pain. Main article: Psychogenic pain. Main article: Pain management.
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Further information: Pain management in children and Pain management during childbirth. Main articles: Pain in animals and Pain in invertebrates. Archived from the original on 13 January Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage Derived from Bonica JJ June Cambridge, Mass.
Chapter 1. In: The Handbook of Chronic Pain. Nova Biomedical Books. The Journal of the American Osteopathic Association. British Journal of Anaesthesia. The Cochrane Database of Systematic Reviews. In Williams KD ed. East Sussex: Psychology Press. Bonica's management of pain. Pain management: an interdisciplinary approach. Edinburgh: Churchill Livingstone. In Weiner R ed.
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Pain management: a practical guide for clinicians. The Lancet. The challenge of pain 2nd ed. New York: Penguin Books. Biological Sciences. Indian Journal of Palliative Care.
Archived from the original PDF on 19 October Measurement of subjective responses. New York: Oxford University Press. London: Penguin. Retrieved 12 October Grand Rapids, Mich: Zondervan Publ. Clinical Infectious Diseases.