Why does PAIN occur? Understand the Mechanism of Pain

Pain is an unpleasant and distressing physical sensation caused by disease or injury, which induces hurt and anxiety in those suffering from it.
There are many different manifestations of pain, ranging from short term (acute pain) to long term (chronic pain). Other classifications include pain in the internal organs (visceral pain), injured tissue (inflammatory pain), nerves (neuropathic pain), etc.

The reason for the occurrence of pain depends on the cause and kind of pain being experienced. In most cases, pain acts as a warning sign that the body has been afflicted by a disorder of some sort, which may have arisen due to internal sickness or external wounding. Acute pains are generally cured on their own through rest or simple medication. Chronic pains, on the other hand, are more complicated in nature and the treatment requires more elaborate diagnosis.

The mechanism of pain

Pain is an extremely personal and subjective experience and affects each individual to varying degrees. The pain signals, which can arise in any part of the body, travel through the spinal cord to the brain along thousands of specialized nerves and nerve fibres. In the brain, it is processed in the centres associated with anxiety, emotions, memory, appetite, etc. Signals and pain inputs are then returned from the brain to the spinal cord, which may heighten or diminish pain.

In some cases, pain may also be induced by damage to the brain and spinal cord, which happens after a stroke.
A constant barrage of pain signals may cause the cells at the end of nerve fibres to become over-sensitized. This is known as 'wind-up' and is one of the most common causes of chronic pain that occurs even though the root of the problem has been identified and treated.

The causes and effects of pain differ from case to case depending on the signals received by the brain and its interpretation. It affects the individual's day to day activities and if persistent, can also have a harmful impact on mental health and psychosis. Pain is always handled, diagnosed and treated differently in all patients by drawing out the best possible solution to the problem.





Why does PAIN occur? Understand the Mechanism of Pain

A menstrual cramp is something which every woman complains of for a day or two every month. Menstrual cramps are usually the pains felt in the lower abdomen, which can occur both before and during a woman's menstrual period. These cramps are caused by a hormone called prostaglandin that causes the uterine muscles to contract during menstruation. When the uterus contracts to shed its natural lining during your period it releases a hormone called prostaglandins which causes pain and inflammation. So higher the level of prostaglandins more severe the menstrual cramps.

It might be just a minor discomfort for some, but for others it can be severe. The symptoms of menstrual cramps include pain in the abdomen, pressure in the abdomen and pain in the hips, lower back, and inner thighs as well. However, if the cramps are severe you might have an upset stomach, loose stools and vomiting too.

Three out of four women experience menstrual pains and every one out of 10 women experiences severe cramps. Here are few remedies that might help in relieving the pain:

Exercise, brisk walking or any type of physical activity can help to ease your belly pain as by being physically active your body pumps more blood, which helps in releasing endorphins to counteract the prostaglandins and reduce your cramps.
Apply heat on the lower abdomen or the area where you feel the pain as it helps to relax the contracting muscles in your uterus.
Improve your diet by reducing fat and increasing vegetables. However, avoid foods that contain caffeine and salt.
Take a warm bath as it may also provide some relief.
Add ginger in your food as it helps in lowering the levels of the pain-causing prostaglandins.
Drink chamomile tea at least three times a day.
Take fish oil supplements, vitamin B1 or both.
Make sure to get enough vitamin D.
Have an orgasm as it releases endorphins which has a pain-relieving effect and helps in boosting your mood as well.
Include more dietary magnesium such as dry almonds and boiled spinach as it helps to ease the pain of cramps.
Acupuncture also has an anti-inflammatory effect.
Take a safe painkiller to reduce pain.
Birth control pills may help relieve painful cramps, but they do come with side effects which may include spotting, breast tenderness, nausea and low sex drive.
Refrain yourself from smoking and drinking alcohol.
Finally, have appropriate rest.
Note: If you still do not get any relief despite trying some of these options then you must visit your doctor to rule out more serious health issues as the menstrual cramps are sometimes caused or worsened by other conditions and any sort of medications for such cramps are to be taken after consulting a Gynaecologist.

How to Get Relief From Severe Menstrual Cramps

The Anterior cruciate ligament (ACL) is an important ligament that gives stability to the knees. An injury to this ligament can result in a host of complications and discomfort. Children or adults who are into sports such as gymnastics, volleyball, tennis, basketball, soccer, football, often injure this ligament. As per various studies and surveys, ACL injury is more likely to affect female athletes as compared to their male counterparts.

Depending on the severity and extent of the damage, an Anterior Cruciate Ligament Injury may be ranked on a grade of 3.

Grade 1 sprains indicate a mild injury or stretching of the ligament, seldom affecting the stability of the knees.
Grade 2 sprains are indicative of a partial ligament tear (the ligament loosen up). The damage is still under control.
Grade 3 sprains are extensive and severe, indicating a complete ligament tear (the ligament often breaks in two pieces). With a complete ligament tear, the stability of the knee is also affected (the knee becomes highly unstable).
What causes Anterior Cruciate Ligament (ACL) Injury?
While a host of sports activities mentioned above increases the risk of the injury, a person may also suffer a partial or a complete anterior cruciate ligament tear under the following situations.

A jump down a ladder, a tree, or a wall. An incorrect jump or a landing may be equally responsible for the ligament tear.
A collision or a hit, especially on the knee (while playing football).
Slowing down suddenly while still in running motion. A person suddenly stopping or missing a step can also injure the ligament.
Symptoms associated with ACL injury

An excruciating pain (especially in the back and outside of the knee) is often seen in people with a complete ligament tear (the movement is yet not affected). However, within a few hours, there may a swelling around the knee, indicating the severity of the injury with internal bleeding within the knee joints.
There may be restricted knee movement. The knee also feels unstable, further limiting the movement.
Sometimes a pop in the knee can be heard just at the time of the ACL injury.
Prolonged ACL injury left unattended can result in a painful complication such as knee osteoarthritis.
Diagnosis
To diagnose the extent of the damage, the doctor may suggest

Physical examination, including a quick brief about the case history.
Imaging tests such as X-rays and MRI can go a long way to analyze the ligament injury.
In the case of extensive swelling of the knees, the doctor may carry out an arthroscopy to have a closer look inside of the knee.
An accurate and timely diagnosis is important to avoid the aggravation of the injury. In the case of swelling and knee pain, consult a doctor, and get yourself thoroughly examined.

Anterior Cruciate Ligament Injury- Causes, Symptoms, and Diagnosis

Hot and Cold therapy is one of the most popular home remedies for any kind of joint pain or muscle sprain. In some cases applying heat therapy and cold therapy alternatively, can help relieve the pain while for others only one form of therapy is necessary. To understand what to use when, one should first understand the effect of heat and cooling on the body.

Applying a heat pack or immersing the affected limb in hot water improves blood circulation and makes the muscles more flexible. Thus, it can help relax a muscle and fasten the healing of damaged tissues. On the other hand, cold therapy or cryotherapy reduces blood flow to the affected site. This helps relieve inflammation and pain caused by it. It can also make the area feel numb by reducing nerve activity temporarily.

Types of Heat Therapy
Heat therapy can be categorized as dry heat and moist heat. Dry heat involves using saunas or dry heating packs to relieve pain. This is also known as conducted heat therapy. As the name suggests, moist heat involves the use of steamed towels, hot baths and moist heating packs. This is also known as convection heat therapy. Moist heat is usually considered more effective than dry heat.

Types of Cold Therapy
Cold therapy may be applied to a part of the body or to the entire body. This includes ice packs, coolant sprays, ice baths, ice massages and whole body, cold therapy chambers.

How to use heat and cold therapy?
The sooner heat and cold therapy is given to a person, the faster they will recover from their pains. Heat therapy can be given to a person for extended periods of time but when giving cold therapy, a person should not be exposed to a cold pack or ice bath for more than 10-15 minutes. Care should also be taken no to apply ice or a frozen pack directly on the skin as it can damage the skin and nerves.

When not to use Heat Therapy?
If the injury site is swollen or bruised, cold therapy is better than heat therapy. Heat therapy should also not be applied to an open wound. People suffering from conditions such as diabetes, dermatitis, deep vein thrombosis, vascular diseases and multiple sclerosis should also avoid heat therapy as these conditions can increase the risk of burns and other such complications. Pregnant women should also consult a doctor before using a hot tub or sauna.

When not to use Cold Therapy?
Cold therapy is avoidable for treating stiff joints and muscles. People suffering from poor circulation and sensory disorders should also avoid using cold therapy without a doctor s supervision. 

Hot & Cold Therapy - How It Can Treat Pain?

Avascular Necrosis, also termed as Ischemic Bone Necrosis or Osteonecrosis is a medical condition characterized by the bone death on being deprived of blood. The condition is known to occur in the shoulder, ankles, and knees. However, the part of the body most affected by Avascular Necrosis is the hip. In this article, we will describe the conditions that contribute towards Avascular Necrosis of the hip along with the associated symptoms.

Factors that lead to Avascular Necrosis of the hip
The supply of blood to the bones may be interrupted by a myriad of factors some of which include

1. Certain medical conditions and health disorders such as

Gaucher's disease: A genetic disorder resulting from glucocerebrosidase enzyme deficiency. As a result, glucocerebroside gets deposited in the cells of the macrophage-monocyte system.
Sickle cell anemia: A genetic disorder which results in the RBC's appearing like a sickle cell instead of being round shaped.
Both of these conditions bring about a significant reduction in the supply of blood to the bones resulting in Avascular Necrosis.

Certain inflammatory conditions that may damage the arteries and trigger Avascular Necrosis of the hip include autoimmune diseases, pancreatitis or HIV infection.

2. Extensive and prolonged use of corticosteroids: Often used as non-inflammatory drugs, corticosteroids can play a contributing role, resulting in Avascular Necrosis (non-traumatic). The fatty substances are usually broken down by the body. However, the use of corticosteroids may affect this breakdown as a result of which the fatty substances start piling up in the blood vessels, constricting their size. The constricted blood vessels, in turn, reduces the supply of blood to the bones to a great extent.

3. An injury or a fracture affecting the femur: A hip fracture or a dislocation that affects the upper half of the thigh bone or the femur acts as a potential threat, triggering a traumatic Avascular Necrosis (AVN) of the hip.

In some case, radiation therapy or chemotherapy for cancer can go a long way in interfering with the ability of the bone (weakens the bone) to receive blood, causing bone death.

People who are into heavy drinking stand a greater risk of suffering from AVN. An increased consumption of alcohol causing constriction and narrowing of the blood vessels interfering with the flow of blood to the bones.

Symptoms characteristic of AVN of the hip

Unfortunately, the initial stages of AVN are asymptomatic. However, as the condition progresses into later stages, a person may experience pain and discomfort, particularly while exerting pressure on the bone affected by the condition.
As the bone and the adjacent joints deteriorate and collapse further, a person may experience great difficulty in using the joint altogether.
In some cases, the condition may progress and affect both the hips (Avascular Necrosis Bilateral).

Causes and Symptoms of Avascular Necrosis of the Hip

Hemorrhoids or piles are diagnosed by swelling of veins in the lower part of anus and rectum. Due to swelling, the walls of rectum and anus are stretched and thus become irritated. Hemorrhoids are of two types: Internal and External hemorrhoids.

Internal Haemorrhoids: As the name suggests, the piles are not visible from outside. These are present deep inside the rectum, located above the pectinate line and these are covered with the cells that are present through the rest of intestines. Internal hemorrhoids are normally painless. The first sign of internal hemorrhoids is rectal bleeding. However, straining can push internalhemorrhoid and it protrudes through the anus and this can be painful.

Causes of Haemorrhoids
The swelling of hemorrhoid occurs only when the pressure in the small vessels of rectum and anus is increased and is engorged with blood. The size of the hemorrhoids is also increased. The increased pressure may be due to various factors:

Consuming low fiber diet and pushing or straining while passing stools, thus blood vessel pressure is increased.
Pregnancy also is a cause of swelling as there is the increased pressure of the uterus on rectum and anus.
Sitting for long on toilet also increases pressure.
Obesity is also a cause of hemorrhoids.
People suffering from diarrhea, both acute and chronic.
A person having colon cancer might have hemorrhoids.
Signs and Symptoms of Haemorrhoids:

The most common symptoms of hemorrhoids are painless bleeding, itching in anal, swelling and feeling of the presence of lump at the anus.
All these symptoms are associated with inflamed hemorrhoid.
Inflamed internal hemorrhoid can cause swelling, but is painless as there are no fibers attached to veins above the pectinate line that cause pain. However, passing hard stools can scrape off the thin lining of hemorrhoid, which can cause the painless bleeding.
Spasms of the rectum and anal muscles caused by these swollen hemorrhoidscause pain, especially when they are protruded through the anus.
Internal hemorrhoids can form a clot or thrombose resulting in severe pain.
The presence of has inflammation, stool,and constant moisture and these can lead to itching and burning sensation in the anus among patient of internal hemorrhoid.
Treatment of Haemorrhoids

Diet: Haemorrhoids can be treated when individuals consume a fiber-rich diet in order to soften the stools and ease their bowel movements. Fiber-rich foods include fresh fruits, dry fruits, grains, vegetables, and cereals. About 20 to 30 grams per day of fibrous foods is recommended. Dietary fiber will help create bulk in the intestines which will help in softening of stools and ease bowel movement. Supplemental fiber available in the marketincludes psyllium husk, methylcellulose, and calcium polycarbophil. Other recommendations include increased intake of liquids and having stool softeners. Drinking enough water and liquids will prevent stool from hardening.
Over-the-counter topical treatment: There are various products available to treat hemorrhoids, such as gels, hydrocortisone creams, ointments, foams, pads, and suppositories.
Home remedies: Soaking anus in a warm sitz bath might also help in hemorrhoids for about 10 to 15 minutes per day. One should practice good hygiene and clean anus with warm water while showering. Avoid using soap and dry toilet paper. One can also use a cold compress on the anus.
Minimally Invasive Procedure for Hemorrhoids (MIPH)

Out of the various types of medical and surgical interventions available to treat Piles, Minimally Invasive Procedure for Hemorrhoids (MIPH) 0r painless stapler surgery is known to be very popular since it acts an alternative approach to surgical interventions made for piles.

MIPH is defined as a minimally invasive surgical technique in which a band of loose or prolapsed mucosa and sub mucosa in the rectum is excised, proximal to the piles and disrupted mucosa is fixed by  stapled end to end mucosal anastomosis.

This will ultimately occlude the blood supply to the superior hemorrhoidal artery above the hemorrhoidal tissue, resulting in the retraction of prolapsed mucosa back to its original anatomical position. A special circular stapler known as PPHO3 is used in the anastomosis and the whole maneuver will take around 30 45 minutes.

Internal Haemorrhoids - Best Ways They Can Be Treated!

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