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

In most cases, pain anywhere in the body can be explained as a symptom of some other problem, but sometimes, there is no reason for abdominal pain. This type of pain is known as chronic functional abdominal pain. This is a gastrointestinal disorder that cannot be explained through X-ray or laboratory findings. It can be triggered by altered sensitivity to nerve impulses in the brain and gut. People suffering from this condition are often so debilitated by the pain that it becomes the central focus of their life.

This condition cannot be cured, but with proper treatment, it can be managed so that it does not affect the quality of your life. The aim of treatment for this condition is to control the symptoms and improve functioning. When it comes to treating this condition, the patient s relationship with his or her doctor plays an important role as the condition cannot be proven through any form of testing and it has a great psychological effect on the person. Regular checkups are also a key to managing this condition effectively.

The first step towards achieving this is to identify possible emotional and situational triggers. Maintaining a journal that records these experiences can help with this. Further treatment is usually either through psychological treatment or antidepressants.

Psychological treatment is based on the understanding that the brain can block pain by diverting attention elsewhere. Nerve impulses that travel from the abdomen to the brain must pass through a type of  gate  that is controlled by nerve impulses generated by the brain. When these impulses close the gates, pain is blocked while when these gates are open, the pain can be magnified. Psychological treatment for chronic functional abdominal pain can be in the form of relaxation techniques, imagery, hypnosis and cognitive behavioral therapy. While relaxation techniques such as meditation and hypnosis help a person shift focus from the pain, cognitive behavioral therapy teaches a person how to change thoughts and perceptions in order to control the pain.

Antidepressants can also act as pain relievers. This form of medication stimulates the production of brain signals that close the  gates  of nerve transmissions. This blocks the pain but can take several weeks to be effective. Some people may experience side effects such as drowsiness and nausea and hence should never be taken without a doctor s supervision. In some cases, antidepressants may also be combined with cognitive behavioral therapy or medication to regulate bowels.

Ways to Treat Chronic Functional Abdominal Pain!

Stomach problems are one of the most common issues you face. Irrespective of what your age is, it is highly likely that you have an upset stomach once in while. A stomach upset has a distinguishable characteristic -  that stomach linings as well as the small and large intestines tend to swell. This is called inflammation. The following are the most common causes of an upset stomach.

1. Viruses
Viruses are the most common causes of an upset stomach. It is highly likely that your stomach upset is because of a virus since there are so many types of them.

2. Parasites or bacteria like Salmonella and Escherichia coli
This is also a very common cause of stomach upset. Salmonella infections are usually caused by eating raw eggs, meat and meat products whereas Escherichia coli infections come from raw vegetables as well as milk and dairy products.

3. Allergic reactions
These happen very specifically to people who have a reaction to a certain type of food.

4. Excess alcohol
Most people think that alcohol will only make you pass out or get liver cirrhosis. Many people do not know that alcohol can actually adversely affect your stomach as well.

5. Excess caffeine
Caffeine is also dangerous to your stomach as taking too much of it can cause a stomach upset.

6. Fatty foods
Fatty foods such as cheese, dark chocolates, whole eggs, fatty fish, etc. are dangerous because they are harder to digest than many other types of food. This means that eating even a small amount of fatty foods are enough to cause a stomach upset sometimes.

7. Eating too much
This is also a major cause of stomach upset simply because your stomach can only digest a certain amount of food.

You must also be able to distinguish when you have a stomach infection and when you have Chron's disease as it is basically a chronic stomach upset. Chron's disease causes the whole digestive tract to be inflamed.

Common Causes Of Stomach Problems

Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

Everyone can suffer from pain in the stomach, at one time or the other and we usually ignore it. But when the pain is sudden and severe abdominal pain then it is termed as acute pain and this should not be ignored.

Often the following can be expected with acute pain:

Acute abdomen pain is usually synonymous with rapid onset of the symptoms which might indicate life threatening intra-abdominal pathology.
Pain is just a feature and not necessary that it is present at all times. An acute abdomen which is pain free usually occurs in children and women who are in their third trimester of pregnancy.
The differential diagnosis is difficult and wide especially in primary care. This is because the different organs within their peritoneal cavity might have different areas of referred pains.
Abdominal pain usually happens to be in the top three symptoms when patients present their state in the emergency and accident departments. But only few of these have acute abdominal pain.
Management of the abdominal pain should be the primary focus and an assessment should be done to reach the differential diagnosis so that care can be given accordingly.
The clinical evaluation regarding abdomen pain can change quickly. Any diagnosis which had been made can change and both doctor and patient should not be hesitant and seek other treatment.
Conditions which might cause acute abdomen pain are:

Meckel's diverticulitis or Acute appendicitis
Acute cholecystitis
Ectopic pregnancy
Acute pancreatitis.
Peptic ulcer disease
Diverticulitis.
Intestinal obstruction, including paralytic ileus (adynamic obstruction)
Pelvic inflammatory disease.
Gastrointestinal (GI) haemorrhage
Gastroenteritis.
Acute intestinal ischaemia/infarction or vasculitis.
Acute urinary retention
Renal colic or renal tract pain
Testicular torsion
Abdominal aortic aneurysm
Non surgical diseases like pericarditis, sickle cell crisis, acute intermittent porphyria, HIV-associated lymphadenopathy, bowel disease, typhoid, opiate withdrawal, enteritis, pneumonia, myocardial infarction and hepatitis.
Rare causes might include thromboemboli, phytobezoar, and phytobezoar
Diagnosis of abdominal pains:

Patients can be ordered to get their blood tests done. Also if need be then imaging can also be referred to them.
Following tests can be done to rule out the condition causing the abdominal pain:
Blood Tests: these include FBC, LFTs, glucose, amylase, clotting, calcium and arterial blood gas for pancreatitis
Crossmatch or group and save
Pregnancy test in women of childbearing age
Blood cultures
Peritoneal lavage in case of an abdominal trauma
Urine analysis
X ray of the abdomen, ultrasound, CT scan
ECG and cardiac enzymes
Laparoscopy should be a routine procedure

Don't Ignore the Acute Abdominal Pain

Stomach aches or abdominal pains are one of the most frequently reported health complaints faced by children. Children below the age of twelve are known to suffer from recurrent stomach pain. While pains such as these lead to momentary discomfiture, they also lay the path for graver worries if neglected for too long. Your child may feel sick and bunk school for two days; rest and home care can restore his or her health, but that in no way, is the best suited way of dealing with the situation. If tummy aches resurface over a certain period of time, parents should be cautious enough to look for the root cause and should try to eliminate it accordingly.

Widely noticed causes of stomach aches in children:

Unhygienic food can affect the child s digestive system.
Intolerance to a certain food item should not be overlooked.
Perpetual anxiety can make the tummy twist and turn.
Urinary Tract Infections can also lead to acute abdominal pain.
Serious factors such as gallstones or appendicitis could also be present. Immediate expert consultation is advised in such a case.
Caffeine and packaged soft drinks can be harmful.
Butter, ghee and other greasy products can trigger tummy aches.
Ways to treat tummy aches in children:

Keep children away from gas producing food items: Food that is hard to digest should be avoided. Lentil soup or dal should only be consumed in limited amounts to prevent the formation of gas. Don t let your child have too many nuts regularly.
Keep them hydrated: Fluid intake should be monitored. A child should drink at least six to seven glasses of water per day. Fruit juices or soups can also be given to them alongside main meals. This helps digestion.
Do not stack up food in one go: Eating a lot in one meal is a bad way of satisfying hunger. Have smaller meals in more numbers. Six to eight meals will keep your child full and will also eliminate chances of acid reflux which happens either due to an empty stomach or too much piling up of greasy food.
Timely check - up with the doctor: If tummy aches refuse to go away, take your child to a doctor for a thorough check- up. Administer medicines as prescribed by the physician.

Stomach Ache in Kids - 7 Causes Behind It!

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