Pain Syndrome

Causes of Appearance

The main causes of pain include injuries, spasms, circulatory disorders, infections, poisoning, excessive burning and freezing, deformities, and destruction of various parts of the musculoskeletal system (spine, joints).
Based on the characteristics of onset, pain patients can be divided into two major groups – nociceptive pain and neuropathic pain.

Nociceptive Pain (Painful Pain)

Occurs when stimuli directly affect pain receptors, located in tissues throughout the body. It can be mild or unbearable, but it can be easily relieved with analgesics and quickly disappears when the cause is removed. Depending on the type and location of these receptors, they can be divided into two types:

• Physical pain – appears superficially with clear localization; its nature is evident in inflammatory processes, tumors, and tissue-related injuries (bruises, fractures, tears, extensions, etc.), as well as some metabolic and circulatory disorders.
• Visceral pain – occurs when internal organs are damaged; it has a deep, poorly defined positional character; Cardiomyalgia, kidney pain, and ulcer disease can be cited as examples.
  The mechanism of nociceptive syndrome is associated with the production of two specific pain mediators – acetylcholine and histamine, bradykinin, and prostaglandins. By accumulating in the damaged area, these chemicals stimulate tissues, causing discomfort. An additional effect of inflammatory factors produced by white blood cells.
  Neuropathic Pain
  Occurs when directly affecting the functional structures of the peripheral and central nervous system – nerve branches, sections of the brain and spinal cord. Sometimes accompanied by pathological nerve stimulation with the formation of an abnormal reaction to non-painful stimuli (such as a light touch). It often appears as chronic pain, making it difficult to alleviate.
  

It can be divided into two types:

• Peripheral neuropathic – when nerves are injured in the form of neuritis, neuropathy, nerve inflammation, and tunnel nerve diseases.
• Central neuropathic – develops as a result of a sharp drop in blood flow to the brain, spinal cord injuries, spinal cord diseases, and multiple sclerosis.
• Functional neuropathic – manifests as a mismatch between the stimulus strength and the body’s physical response; it is considered a result of a disorder in the central nervous system.

Note: A separate group called psychogenic pain syndrome is distinguished. In this case, there are no physical injuries, but the chronic pain that appears is considered a result of the patient’s imagination and fear. It can develop as a type of neuropathic pain or as a result of long-term nociceptive pain syndrome accompanied by acute pain.

Diagnosis of Bodily Pain

The sequence of procedures in diagnosing the causes of bodily pain depends on its location, nature, and accompanying symptoms. In cases of unknown-site pain, the focus is first on instrumental methods such as ultrasound, X-rays, MRI, CT scans, electrocardiography, gastroscopy, and others. A list of surgical or general practitioner tests and analyses is provided by the general practitioner or another specialist.

The simplified system “Pain Tolerance Scale” includes 3 stages:

• Mild pain – does not impede movement and daily activities.
• Severe pain – affects normal lifestyle and prevents routine tasks.
• Unbearable pain – disrupts consciousness. Leads to loss of consciousness.
• The expanded classification assumes the use of a visual scale for personal assessment – from 0 to 10, where “ten” means severe pain shock. During examination, the patient is asked to self-assess the severity of the pain.

Warning! The severity of pain does not always indicate the seriousness of the pathological process, so it is wrong to give up on life due to severe pain, and the severity of mild pain should not be underestimated.

After determining the cause, severity, and nature of the pain, the doctor will prescribe appropriate pain relief medications. This is related to differences in the mechanism of action of different groups of analgesics – what may be effective in nociceptive pain may not be entirely effective in neuropathic pain.

Treatment of Bodily Pain
Treatment directly depends on the cause and nature of the pain (nociceptive or neuropathic). Treatment methods include both conservative measures using medications and physical therapy, as well as radical surgical approaches.

Medicinal Treatment:

• Analgesics – pain relievers and anesthetics.
• Anti-inflammatories – mainly nonsteroidal anti-inflammatory drugs (NSAIDs), and sometimes steroid injections.
• Muscle relaxants.
• Antispasmodics.
• Sedative medications.
  Warning! Self-administering pain-relieving medications without addressing the underlying cause may hinder diagnosis, complicate the situation, and make future treatment ineffective.

Improving drug absorption, reducing inflammation and swelling, relieving spasms, enhancing repair, muscle relaxation, and calming the nervous system are the goals of physical therapy.

Physical Therapy Practices:

• Far-infrared radiation.
• Electrical therapy.
• Therapeutic clay.
• Electric currents.
• Massage.
• Acupuncture.
• Cupping therapy.
  For musculoskeletal disorders, the method of immobilizing affected areas is widely used – splints, plaster casts, corsets, collars, bandages.

Surgical Intervention:

Used in cases where conservative methods are ineffective.
Please note! Pain is a common symptom of various diseases, so different doctors from different specialties such as general practitioners, neurologists, gastroenterologists, among others, may be involved in its treatment. In cases of emergencies and acute pain, urgent medical assistance from an intensive care physician, fracture specialists, or surgeons may be necessary.