Someone wise once said that everything that happens to you
throughout your life represents ten percent of your experience. The
remaining ninety percent is how you respond to those events. So, if you
are injured or suffer from a disease and the result is pain, you could
give in and be an invalid or you could respond positively. Just talking
about pain in terms of the central nervous system misses the point. You
cannot separate pain from the emotions. Some may react to pain with
despair and depression. Others may fight to make their lives better
despite the pain. All this requires an answer to the question, "What is
this thing called pain?" The first part of the answer distinguishes
between acute and chronic. When you are injured, have some type of
inflammation or a disease, the pain is said to be acute if the cause has
been diagnosed and treatment will produce a cure, i.e. the pain is not
going to last long. Chronic pain becomes a disease in its own right,
i.e. it comes to have a existence independent of the cause. The
psychological response to knowing the pain is going to persist often
makes it seem worse and can make it resistant to treatment.
Chronic pain can be caused directly by an injury or disease, or
it may be a side effect or complication following surgery, caused by
drug interactions, etc. Always liking to produce lists, doctors have
classified pain into the following categories:
Nociceptive where you feel a sensation in a specific location.
This may be somatic and so felt in the joints, bones, muscles and
ligaments, or visceral which is felt in the internal organs such as the
heart, lungs, liver and kidneys. The latter can be more difficult to
localize because the pain simply comes from inside the body.
Non-nociceptive may be neuropathic, i.e. pain generated by the
nervous system and not tied to a specific location in the body. When the
nervous system is damaged, the messages become more difficult to
interpret and the brain is often confused by random effects. The result
is unpredictable feelings of tingling, numbness, pins and needles and
other unpleasant symptoms. Alternatively, there may be sympathetic pain
where the skin and tissue around an injury become unusually sensitive
and restrict movement.
No matter which variety of pain you may have, there are a range
of analgesics or painkillers available to relieve any suffering. The
less powerful drugs are the nonsteroidal anti-inflammatory drugs
(NSAIDs) which reduce swelling and inflammation in the joints and
elsewhere. The more powerful deal with moderate to severe pain with
tramadol being the most commonly prescribed because it is less likely to
cause dependence than the opiates. Tramadol works by changing the way
in which the neurotransmitters carry messages in the nervous system.
Because of this, it is equally effective no matter what the cause of the
pain, i.e. localized or arising from the nervous system itself. The
messages are not carried to the brain or not clearly interpreted as
being pain messages. Thus, you can have a reasonably good quality of
life even though the source of the pain remains active in your body.
