Pain Mechanisms
There is a need to think holistically in order to understand pain. It is complex and in this next section the aim is to give a brief over view and to enable the reader to reflect on some of the many facets of pain. Pain is a sensation that is real, and one that is felt and reported differently by each of us. It is influenced by our life experiences and our genetics. As health professionals we can contribute to alleviating a person’s concerns about their pain by listening and believing their story.
Please click on the podcast below to gain an over view of the physiological processes relating to pain.
Please click on the podcast below to gain an over view of the physiological processes relating to pain.
The following terms will be used
Nociceptors – nerve receptors that are sensitive to pain stimuli
Primary afferent fibres – The branch of the nerve which takes sensory information from the peripheral nervous system to the central nervous system. For example a pain stimulus from the hand to the spinal cord
Signalling up the spinal cord – The spinal cord consists of many neural pathways. The analogy is that of a telephone cable. A couple of cables (tracts) (i.e spinothalamic tract) transmit pain stimuli up the spinal cord to a part of the brain (i.e.thalamus)
Pain processing in the brain – A complex process which involves different parts of the brain
Inhibition of pain transmission – Pain signals may be inhibited by the activity of inhibitory interneurons.
Visceral pain – visceral tissues have two sets of afferents one set follows the sympathetic nerves and the parasympathetic sacral nerves and the other follows the parasympathetic vagus nerve to the brain stem.
Neuropathic pain – occurs as a result of an insult/injury/lesion in either the peripheral or central nervous system.
Nociceptors – nerve receptors that are sensitive to pain stimuli
Primary afferent fibres – The branch of the nerve which takes sensory information from the peripheral nervous system to the central nervous system. For example a pain stimulus from the hand to the spinal cord
Signalling up the spinal cord – The spinal cord consists of many neural pathways. The analogy is that of a telephone cable. A couple of cables (tracts) (i.e spinothalamic tract) transmit pain stimuli up the spinal cord to a part of the brain (i.e.thalamus)
Pain processing in the brain – A complex process which involves different parts of the brain
Inhibition of pain transmission – Pain signals may be inhibited by the activity of inhibitory interneurons.
Visceral pain – visceral tissues have two sets of afferents one set follows the sympathetic nerves and the parasympathetic sacral nerves and the other follows the parasympathetic vagus nerve to the brain stem.
Neuropathic pain – occurs as a result of an insult/injury/lesion in either the peripheral or central nervous system.
The following questions are designed to help you revise and understand the pain mechanisms discussed in the podcast - click on the links in bold – to refresh your memory.
· Where are nociceptors found?
· What are the three types of primary afferent fibres?
· Name the two pathways that are involved in pain signalling up the spinal cord?
· What might affect pain processing in the brain?
· Name two theories that relate to inhibition of pain transmission? How are these used in practice?
· Why might visceral pain be referred?
· What common condition might cause neuropathic pain?
· Where are nociceptors found?
· What are the three types of primary afferent fibres?
· Name the two pathways that are involved in pain signalling up the spinal cord?
· What might affect pain processing in the brain?
· Name two theories that relate to inhibition of pain transmission? How are these used in practice?
· Why might visceral pain be referred?
· What common condition might cause neuropathic pain?
