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

Pain related sleep disruption has affected a large number of people around the globe. Statistics has it that, in India, about 25% of the population suffers from pain-related sleep deprivation. Studies call it  the vicious cycle of pain and sleep  as pain affects your ability to sleep and lack of sleep makes the pain even worse.

Back pain and arthritis are examples of some common pain-related medical disorders. People with these types of chronic pains have reported persistent sleeplessness or have had immense trouble falling asleep.

The following are the primary sleep disorders associated with chronic pain:

Insomnia: It is a medical condition that is characterized by an inability to fall asleep no matter how physically exhausted you are. Insomnia can be acute (lasting for one night to a week) or chronic (that lasts for more than 3 weeks).
Hypersomnia: It is a condition wherein you tend to sleep excessively; in this condition, you will have trouble being awake throughout the day or can fall asleep at any point of time.
Sleep Apnoea: This is a sleep disorder wherein breathing pauses and resumes repeatedly. Risk factors include obesity, age and gender; it is more commonly observed in men. This condition can be chronic with symptoms such as snoring loudly or feeling very tired even after one has had a night s sleep.
Restless leg syndrome: It is a sleep disorder wherein you continuously move your legs while sleeping. However, this condition can also cause you to move your legs even if you aren t sleeping.
Some of the causes of sleep disorders due to chronic pain are:

Pain
Worry and anxiety
Sweating at night
Depression and other mental disorders
Treatment

A pain and sleep disorder should be simultaneous as both the components of it, pain and sleep, are interrelated. Some of the ways people with chronic pain can still have a good night s sleep are:

Limiting caffeine intake
Abstaining from alcohol and smoking, as these disrupt the sleep cycles, thus aggravating the existing pain.
Practicing meditation and other relaxation techniques
Pain killers or sleeping pills can be administered, but only with the doctor s advice.
Hot water fomentation over painful area during night, for better sleep.

Back Pain and Bad Sleep

Exercises to cure long hours of sitting
Most of us are used to sitting throughout the day, willingly or unwillingly due to work or otherwise. We spend more hours sitting, and most of our work is done in this position. The downsides of this are many, one of them being a stiff back which not only causes a lot of pain but also initiates many other health problems.
Train yourselves on these highly effective exercises which minimise the pain and keep your muscles active.

1. Back press: put towel on your back and press the towel with the back. Hold that position for 10 sec. Repeat 10 times. Do not hold your breath while applying pressure at the back.
2. Bridges: lie on the floor, bend your knees and secure your feet on the ground. Raise your hips upwards so that your body forms a straight line from your shoulders to your knees. Release and go back to previous position.
3. Knee to chest exercise: just lie down on an exercise mat, bend your one knee while lying and try to touch that knee to the stomach. Hold it for 10 seconds. Repeat this with the other leg. Alternate the legs each time.
4. Bilateral knee to chest: bend both the knees while lying on bed. With support of your hands try bringing both bent knees to touch the stomach. Hold that position for 10 seconds. Repeat 5 times.
5. Static abdominal exercise: lying on your back, try to contract your stomach without holding your breath. Hold it for 10 seconds. Repeat the exercise for 7 or 10 times.
6. Knee to opposite chest: lying on your back, bend your knees. Try bringing one knee to opposite side of the chest and hold that position for 7 sec. Do this for 7 times and repeat the same for the other leg too.
7: leg swings: these are easy and fun. Stand by the wall, hold on to a rod or something similar to keep balance. Now with the leg that is not towards the wall, swing. Swing your leg from front to back, left to right. Do not be too quick, do this at a mediocre pace. Repeat with the other leg.
8: static glutei: lying on the stomach, squeeze your buttock and hold it for 10 seconds. Repeat 10 times.

General precautions:
1. Avoid bending instantly after or during the exercises. Incase you have to bend, first bend your knee then bend your back to pick up anything from ground.
2. While getting up from bed first turn to one side while lying, sideways then get up from bed slowly.
3. Apply hot pack in back whenever there is pain.
4. Try to sleep in hard part of mattress not in soft mattress.



Long Hours Of Sitting? Try This Permanent Relief From Back Pain

Most of us suffer from lower back pain at some point in our lives; be it from a sedentary lifestyle, spending hours at the office desk or from strenuous physical exercises. In most cases, a little bit of rest does the trick. However, if the lower back pain persists for 3-6 weeks, physiotherapy is recommended.

How does physiotherapy help?

The main purpose behind physiotherapy is reducing lower back pain and increasing muscle and bone function, so that such instances are avoided in the future. Physiotherapy is the first line of defence against lower back pain. More drastic measures such as surgery are undertaken once physiotherapy fails to do is job.

Physiotherapy is often recommended when the back pain is caused due to lifestyle factors, a minor injury like a fall or other moderate factors. For more severe back injuries, doctors recommend surgery straight away when there is no scope of performing physiotherapy.

Low-intensity back pain can be cured using a combination of heat packs, ultrasound wave therapy and Iontophoresis (using a localized current source to introduce medical ionic compounds to the body).

A physical therapy program for back pain usually has two components:

Passive physical therapy to help reduce the patient's pain to a more manageable level

Active exercises

Passive Physical Therapy - Modalities

The physical therapist may focus on decreasing pain with passive physical therapy (modalities). These therapies are considered passive because they are done to the patient. Examples include:

Heat/ice packs

TENS units

Iontophoresis

Ultrasound

Active Physical Therapy - Back Pain Exercises

In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine. Here are some of the common exercises for back pain:

Back Stretch: Put your hands underneath your head while lying back. Bend your knees but put your feet on the ground. Roll your legs to one side and hold them there for 10 seconds. Repeat three times for each side.

Deep Lunge: For this, you need to kneel on one knee with the other foot pointed towards the front. Lift the back knee up and hold it there for five seconds and then bring it down. Repeat this exercise three times for each side.

One Leg Stand: This is the simplest of exercises. Hold on to a wall for support while standing and face towards it. Then slowly hold one leg and bend it behind you. Hold in the same position for five seconds before bringing it down. Repeat the process three times for each leg in five second gaps.

Physiotherapy for Back Pain

Whether you're old or young, male or female, having a backache can be a real pain! A number of factors ranging from osteoarthritis to muscle strains can be attributed to back pains. No matter what the cause of a backache, a combination of core strengthening exercises, activity, and physical therapy can help lessen the pain.

A backache can be caused by something as simple as bending the wrong way. Hence, the first step towards dealing with a backache is to pay attention to daily movements. If you have to lift something heavy off the floor, bend your knees and let the weight of your load fall on your legs instead of it falling on your back. Here is more on how you can fight back pain with a bit of effort:

Light exercises
Simple, light exercises are the most effective ways of dealing with back pain. The key to exercising your back is moderation and knowing your limits.

Brisk walk and yoga
Regular brisk walks and yoga exercises that strengthen and stretch back muscles are effective ways to reduce and prevent back pain.

Right posture
Exercise can also help reduce excess weight that in turn helps reduce back aches. Slouching not only causes a hunch back but also aggravates back aches. Hence, maintain a right posture to take the pressure off nerves and lower back pain.

Proper posture while sleeping
A good night's sleep can also help soothe inflamed back joints and repair strained muscles. Pay attention to your mattress and ensure that your back is flat when you lie on it. Sleeping on your side can also help deal with the back pain. Consider resting your neck on a pillow, to keep your spine aligned while you sleep.

Hot & cold therapy
Experiment with hot and cold therapy before picking one of them to deal with your back pain. While applying ice packs on your back can help reduce inflammations, hot packs work better to reduce cramps and muscle spasms. Whether you use a hot pack or a cold pack, do not leave it on for more than 20 minutes.

Natural supplements
Natural supplements such as flaxseed oil, calcium, magnesium and vitamin c are helpful when dealing with back pains.

For short-term relief, you could also try over the counter pain relievers. However, do not let this become a long-term habit, as your body could get dependent on it. Other potential side effects could include stomach and liver problems. Hence, if your back ache does not subside on its own, it is best to consult a doctor before treating it yourself.

How to Deal with Back Pain

Pain is unpleasant suffering caused by injury or illness. Back pain may be sudden/constant, dull, severe or not responding to short rest and medication. Constant pain in back in any region of spine for more than few days to weeks needs intervention.

Pain which is intense especially at night requires urgent visit to a specialist.

Sudden onset of pain in back with or without injury needs urgent attention.

Back pain with difficulty in walking, pain while getting up from position of comfort, pain during change of posture or pain after prolonged sitting (for work) can lead to serious permanent damage, if left untreated.

Pain which travels to one or both legs may be due to pressure on the nerve/s and if left untreated for long can lead to permanent weakness or damage.

Pain associated with numbness, tingling or weakness in legs, especially below the knees, commonly called Sciatica, needs to be investigated. Various spinal ailments can lead to weakness in one or two limbs or all four limbs. There may be associated or isolated numbness (loss of sensation to touch, pain or temperature) without back pain.

Numbness, tingling or weakness may be the only symptoms without any complaint or without history of back pain.

Problems related to bladder control which may be difficulty to control, hesitancy in passing or dribbling of urine. There may be associated constipation. Loss of bowel/bladder control is caused by pressure on spinal cord &/or nerves which may be due to injury, infection, disc prolapse or tumor.

Sudden swelling and redness in back usually happens after an injury or accident but sometimes are signs of underlying severe illness.

Loss of normal shape/curvatures of spine can present with or without pain. It can lead to forward, sideways or rarely backward bending.

Unintentional weight loss, loss of appetite, evening rise of fever or disturbed sleep with associated back pain/weakness/numbness needs visit to a specialist.

When Should You See Your Doctor in Back Pain?

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