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Pain

Definition: 
Acute pain may be defined as an unpleasant localized sensation in response to a noxious stimulus (trigger) that appears to be capable of producing tissue damage.

Acute Pain Physiology

acute pain produces an individually varied emotional response that depends on the:

  • physiologic 

  • psychologic

  • cultural

  • socioeconomic factors


Adverse psychologic or physiologic effects of pain

  • alter early response to treatment or rehabilitation

  • can impede or prevent recovery

Local factors influencing pain perception:

  • tissue damage directly stimulates peripheral nociceptors

  • electrochemical impulses carried by: 

    • small myelinated delta A fibres

    • unmyelinated C afferent fibres

  • release of substances which further stimulate and sensitize the nociceptors:

    • bradykinin

    • potassium

    • prostoglandins

    • H+ ions

    • serotonin

    • substance P

Central factors influencing pain perception:

  • noxious impulses via afferents stimulate midbrain & thalamus

  • Cortical contribution (frontal cortex)

  • emotional responses (anxiety)

  • measurable changes in circulating catecholamines, cortisol, clotting time, fibrinolysis and T & B lymphocyte function



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