liveonearth (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
liveonearth) wrote2008-04-25 08:47 pm
liveonearth) wrote2008-04-25 08:47 pm
Entry tags:
Pain
Pain = pain (pān) a feeling of distress, suffering, or agony, caused by stimulation of specialized nerve endings. Its purpose is chiefly protective; it acts as a warning that tissues are being damaged and induces the sufferer to remove or withdraw from the source. The receptors for pain stimuli (nociceptors) are free nerve endings that are abundantly distributed in superficial layers of the skin and mucous membranes, as well as in deeper tissues such as the periosteum, surfaces of the joints, arterial walls, and the falx and tentorium of the cranial cavity. (Dorlands)
The posterior root fibers conducting impulses of pain and temperature probably terminate in the posterior column or the intermediate region of the gray matter soon after they enter the spinal cord. The neurons of the second order are supposed to pass through the anterior commissure to the superficial antero-lateral fasciculus (tract of Gowers) and pass upward in that portion of it known as the lateral spinothalamic fasciculus. This fasciculus lies along the medial side of the ventral spinocerebellar fasciculus. It is stated by some authors that the pain fibers pass upward in the antero-lateral ground bundles. In some of the lower mammals this pathway carries the pain fibers upward by a series of neurons some of which cross to the opposite side, so that in part there is a double path. In man, however, the lateral spinothalamic fasciculus is probably the most important pathway. On reaching the medulla these fibers continue upward through the formatio reticularis in the neighborhood of the median fillet to the thalamus, probably its ventro-lateral region. Whether higher neurons convey the pain impulses to the cortex through the internal capsule is uncertain. The pathway is probably more complex and Head is of the opinion that our sensations of pain are essentially thalamic. The pain and temperature pathways in the lateral spinothalamic fasciculus are not so closely intermingled but that one can be destroyed without injury to the other.
(Gray's Anatomy 1918)
Pain = An unpleasant sensation associated with actual or potential tissue damage and mediated by specific nerve fibers to the brain where its conscious appreciation may be modified by various factors.
Term used to denote a painful uterine contraction occurring in childbirth.
Algophobia.
(Stegmans)
Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia. Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors.
--Pain is also a term specifically used to denote a painful uterine contraction occurring in childbirth.
--The word "pain" comes from the Latin "poena" meaning a fine, a penalty.
(Medicine.net)
Fibromyalgia is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. Fibromyalgia is also characterized by restless sleep, awakening feeling tired, fatigue, anxiety, depression, and disturbances in bowel function. Fibromyalgia was formerly known as fibrositis.
--While fibromyalgia is one of the most common diseases affecting the muscles, its cause is currently unknown. The painful tissues involved are not accompanied by tissue inflammation. Therefore, despite potentially disabling body pain, patients with fibromyalgia do not develop body damage or deformity. Fibromyalgia also does not cause damage to internal body organs. Therefore, fibromyalgia is different from many other rheumatic conditions (such as rheumatoid arthritis, systemic lupus, and polymyositis). In those diseases, tissue inflammation is the major cause of pain, stiffness and tenderness of the joints, tendons and muscles, and it can lead to joint deformity and damage to the internal organs or muscles.
(Medicine.net)
Neuralgia (ndbobr-ral´jә) pain in a nerve or along the course of one or more nerves, usually consisting of a sharp, spasmlike pain that may recur at intervals. It is caused by inflammation of or injury to a nerve or group of nerves. Inflammation of a nerve, or neuritis, may affect different parts of the body, depending upon the location of the nerve. Two common types of neuralgia are that of the trigeminal nerve (see tic douloureux) and that of the sciatic nerve (see sciatica). adj., neural´gic., adj.
(Dorlands)
neuralgia (noo-ralj-)
Pain of a severe, throbbing, or stabbing character in the course or distribution of a nerve. Syn: neurodynia
[neur- + G. algos, pain]
neuralgia
Paroxysmal pain which extends along the course of one or more nerves.
Many varieties of neuralgia are distinguished according to the part affected or to the cause, as brachial, facial, occipital, supraorbital, etc. Or anaemic, diabetic, gouty, malarial, syphilitic, etc.
below from: http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/neuralgia.jsp
Description
Different types of neuralgia occur depending on the reason the nerve has been irritated. Neuralgia can be triggered by a variety of causes, including tooth decay, eye strain, or shingles (an infection caused by the herpes zoster virus). Pain is usually felt in the part of the body that is supplied by the irritated nerve.
Causes and symptoms
Neuralgia is caused by irritation or nerve damage from systemic disease, inflammation, infection, and compression or physical irritation of a nerve. The location of the pain depends on the underlying condition that is irritating the nerve or the location of the particular nerve that is being irritated.
Neuralgia can result from tooth decay, poor diet, eye strain, nose infections, or exposure to damp and cold. Postherpetic neuralgia is an intense debilitating pain felt at the site of a previous attack of shingles. Trigeminal neuralgia (also called tic douloureux, the most common type of neuralgia), causes a brief, searing pain along the trigeminal nerve, which supplies sensation to the face. The facial pain of migraine neuralgia lasts between 30 minutes and an hour and occurs at the same time on successive days. The cause is not known.
Glossopharyngeal neuralgia is an intense pain felt at the back of the tongue, in the throat, and in the ear-all areas served by the glossopharyngeal nerve. The pain may occur spontaneously, or it can be triggered by talking, eating, or swallowing (especially cold foods such as ice cream). Its cause is not known.
Occipital neuralgia is caused by a pinched occipital nerve. There are two occipital nerves, each located at the back of the neck, each supplying feeling to the skin over half of the back of the head. These nerves can be pinched due to factors ranging from arthritis to injury, but the result is the same: numbness, pain, or tingling over half the base of the skull.
Diagnosis
Neuralgia is a symptom of an underlying disorder; its diagnosis depends on finding the cause of the condition creating the pain.
To diagnose occipital neuralgia, a doctor can inject a small amount of anesthetic into the region of the occipital nerve. If the pain temporarily disappears, and there are no other physical reasons for the pain, the doctor may recommend surgery to deal with the pinched nerve.
Treatment
Glossopharyngeal, trigeminal, and postherpetic neuralgias sometimes respond to anticonvulsant drugs, such as carbamazepine or phenytoin, or to painkillers, such as acetaminophen. Trigeminal neuralgia may also be relieved by surgery in which the nerve is cut or decompressed. In some cases, compression neuralgia (including occipital neuralgia) can be relieved by surgery.
People with shingles should see a doctor within three days of developing the rash, since aggressive treatment of the blisters that appear with the rash can ease the severity of the infection and minimize the risk of developing postherpetic neuralgia. However, it is not clear whether the treatment can prevent postherpetic neuralgia.
If postherpetic neuralgia develops, a variety of treatments can be tried, since their effectiveness varies from person-to-person.
antidepressants such as amitriptyline (Elavil)
anticonvulsants (phenytoin, valproate, or carbamazepine)
capsaicin (Xostrix), the only medication approved by the FDA for treatment of postherpetic neuralgia
topical painkillers
desensitization
TENS (transcutaneous electrical nerve stimulation)
dorsal root zone (DREZ) surgery (a treatment of last resort)
Alternative treatment
B-complex vitamins, primarily given by intramuscular injection, can be an effective treatment. A whole foods diet with adequate protein, carbohydrates, and fats that also includes yeast, liver, wheat germ, and foods that are high in B vitamins may be helpful. Acupuncture is a very effective treatment, especially for postherpetic neuralgia. Homeopathic treatment can also be very effective when the correct remedy is used. Some botanical medicines may also be useful. For example, black cohosh (Cimicifuga racemosa) appears to have anti-inflammatory properties based on recent research.
Prognosis
The effectiveness of the treatment depends on the cause of the neuralgia, but many cases respond to pain relief.
Trigeminal neuralgia tends to come and go, but successive attacks may be disabling. Although neuralgia is not fatal, the patient's fear of being in pain can seriously interfere with daily life.
Some people with postherpetic neuralgia respond completely to treatment. Most people, however, experience some pain after treatment, and a few receive no relief at all. Some people live with this type of neuralgia for the rest of their lives, but for most, the condition gradually fades away within five years.
Key Terms
Desensitization
A technique of pain reduction in which the painful area is stimulated with whatever is causing the pain.
Dorsal root entry zone (DREZ)
A type of nerve surgery for postherpetic neuralgia that is occasionally used when the patient can get no other pain relief. The surgery destroys the area where damaged nerves join the central nervous system, thereby interfering with inappropriate pain messages from nerves to the brain.
Glossopharyngeal neuralgia
Sharp recurrent pain deep in the throat that extends to the area around the tonsils and possibly the ear. It is triggered by swallowing or chewing.
Migraine neuralgia
A variant of migraine pain, also called cluster headache, in which severe attacks of pain affect the eye and forehead on one side of the face.
Occipital neuralgia
Pain on one side of the back of the head caused by entrapment or pinching of an occipital nerve.
Postherpetic neuralgia
Persistent pain that occurs as a complication of a herpes zoster infection. Although the pain can be treated, the response is variable.
Shingles
A painful rash with blisters that appears along the course of a nerve. It is caused by infection with herpes zoster virus.
TENS
The abbreviation for transcutaneous electrical nerve stimulation, a technique used to control chronic pain. Electrodes placed over the painful area deliver a mild electrical impulse to nearby nerve pathways, thereby easing pain.
Trigeminal neuralgia
Brief episodes of severe shooting pain on one side of the face caused by inflammation of the root of the trigeminal nerve. Also referred to as tic douloureux.
The posterior root fibers conducting impulses of pain and temperature probably terminate in the posterior column or the intermediate region of the gray matter soon after they enter the spinal cord. The neurons of the second order are supposed to pass through the anterior commissure to the superficial antero-lateral fasciculus (tract of Gowers) and pass upward in that portion of it known as the lateral spinothalamic fasciculus. This fasciculus lies along the medial side of the ventral spinocerebellar fasciculus. It is stated by some authors that the pain fibers pass upward in the antero-lateral ground bundles. In some of the lower mammals this pathway carries the pain fibers upward by a series of neurons some of which cross to the opposite side, so that in part there is a double path. In man, however, the lateral spinothalamic fasciculus is probably the most important pathway. On reaching the medulla these fibers continue upward through the formatio reticularis in the neighborhood of the median fillet to the thalamus, probably its ventro-lateral region. Whether higher neurons convey the pain impulses to the cortex through the internal capsule is uncertain. The pathway is probably more complex and Head is of the opinion that our sensations of pain are essentially thalamic. The pain and temperature pathways in the lateral spinothalamic fasciculus are not so closely intermingled but that one can be destroyed without injury to the other.
(Gray's Anatomy 1918)
Pain = An unpleasant sensation associated with actual or potential tissue damage and mediated by specific nerve fibers to the brain where its conscious appreciation may be modified by various factors.
Term used to denote a painful uterine contraction occurring in childbirth.
Algophobia.
(Stegmans)
Pain: An unpleasant sensation that can range from mild, localized discomfort to agony. Pain has both physical and emotional components. The physical part of pain results from nerve stimulation. Pain may be contained to a discrete area, as in an injury, or it can be more diffuse, as in disorders like fibromyalgia. Pain is mediated by specific nerve fibers that carry the pain impulses to the brain where their conscious appreciation may be modified by many factors.
--Pain is also a term specifically used to denote a painful uterine contraction occurring in childbirth.
--The word "pain" comes from the Latin "poena" meaning a fine, a penalty.
(Medicine.net)
Fibromyalgia is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. Fibromyalgia is also characterized by restless sleep, awakening feeling tired, fatigue, anxiety, depression, and disturbances in bowel function. Fibromyalgia was formerly known as fibrositis.
--While fibromyalgia is one of the most common diseases affecting the muscles, its cause is currently unknown. The painful tissues involved are not accompanied by tissue inflammation. Therefore, despite potentially disabling body pain, patients with fibromyalgia do not develop body damage or deformity. Fibromyalgia also does not cause damage to internal body organs. Therefore, fibromyalgia is different from many other rheumatic conditions (such as rheumatoid arthritis, systemic lupus, and polymyositis). In those diseases, tissue inflammation is the major cause of pain, stiffness and tenderness of the joints, tendons and muscles, and it can lead to joint deformity and damage to the internal organs or muscles.
(Medicine.net)
Neuralgia (ndbobr-ral´jә) pain in a nerve or along the course of one or more nerves, usually consisting of a sharp, spasmlike pain that may recur at intervals. It is caused by inflammation of or injury to a nerve or group of nerves. Inflammation of a nerve, or neuritis, may affect different parts of the body, depending upon the location of the nerve. Two common types of neuralgia are that of the trigeminal nerve (see tic douloureux) and that of the sciatic nerve (see sciatica). adj., neural´gic., adj.
(Dorlands)
neuralgia (noo-ralj-)
Pain of a severe, throbbing, or stabbing character in the course or distribution of a nerve. Syn: neurodynia
[neur- + G. algos, pain]
neuralgia
Many varieties of neuralgia are distinguished according to the part affected or to the cause, as brachial, facial, occipital, supraorbital, etc. Or anaemic, diabetic, gouty, malarial, syphilitic, etc.
below from: http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/neuralgia.jsp
Description
Different types of neuralgia occur depending on the reason the nerve has been irritated. Neuralgia can be triggered by a variety of causes, including tooth decay, eye strain, or shingles (an infection caused by the herpes zoster virus). Pain is usually felt in the part of the body that is supplied by the irritated nerve.
Causes and symptoms
Neuralgia is caused by irritation or nerve damage from systemic disease, inflammation, infection, and compression or physical irritation of a nerve. The location of the pain depends on the underlying condition that is irritating the nerve or the location of the particular nerve that is being irritated.
Neuralgia can result from tooth decay, poor diet, eye strain, nose infections, or exposure to damp and cold. Postherpetic neuralgia is an intense debilitating pain felt at the site of a previous attack of shingles. Trigeminal neuralgia (also called tic douloureux, the most common type of neuralgia), causes a brief, searing pain along the trigeminal nerve, which supplies sensation to the face. The facial pain of migraine neuralgia lasts between 30 minutes and an hour and occurs at the same time on successive days. The cause is not known.
Glossopharyngeal neuralgia is an intense pain felt at the back of the tongue, in the throat, and in the ear-all areas served by the glossopharyngeal nerve. The pain may occur spontaneously, or it can be triggered by talking, eating, or swallowing (especially cold foods such as ice cream). Its cause is not known.
Occipital neuralgia is caused by a pinched occipital nerve. There are two occipital nerves, each located at the back of the neck, each supplying feeling to the skin over half of the back of the head. These nerves can be pinched due to factors ranging from arthritis to injury, but the result is the same: numbness, pain, or tingling over half the base of the skull.
Diagnosis
Neuralgia is a symptom of an underlying disorder; its diagnosis depends on finding the cause of the condition creating the pain.
To diagnose occipital neuralgia, a doctor can inject a small amount of anesthetic into the region of the occipital nerve. If the pain temporarily disappears, and there are no other physical reasons for the pain, the doctor may recommend surgery to deal with the pinched nerve.
Treatment
Glossopharyngeal, trigeminal, and postherpetic neuralgias sometimes respond to anticonvulsant drugs, such as carbamazepine or phenytoin, or to painkillers, such as acetaminophen. Trigeminal neuralgia may also be relieved by surgery in which the nerve is cut or decompressed. In some cases, compression neuralgia (including occipital neuralgia) can be relieved by surgery.
People with shingles should see a doctor within three days of developing the rash, since aggressive treatment of the blisters that appear with the rash can ease the severity of the infection and minimize the risk of developing postherpetic neuralgia. However, it is not clear whether the treatment can prevent postherpetic neuralgia.
If postherpetic neuralgia develops, a variety of treatments can be tried, since their effectiveness varies from person-to-person.
antidepressants such as amitriptyline (Elavil)
anticonvulsants (phenytoin, valproate, or carbamazepine)
capsaicin (Xostrix), the only medication approved by the FDA for treatment of postherpetic neuralgia
topical painkillers
desensitization
TENS (transcutaneous electrical nerve stimulation)
dorsal root zone (DREZ) surgery (a treatment of last resort)
Alternative treatment
B-complex vitamins, primarily given by intramuscular injection, can be an effective treatment. A whole foods diet with adequate protein, carbohydrates, and fats that also includes yeast, liver, wheat germ, and foods that are high in B vitamins may be helpful. Acupuncture is a very effective treatment, especially for postherpetic neuralgia. Homeopathic treatment can also be very effective when the correct remedy is used. Some botanical medicines may also be useful. For example, black cohosh (Cimicifuga racemosa) appears to have anti-inflammatory properties based on recent research.
Prognosis
The effectiveness of the treatment depends on the cause of the neuralgia, but many cases respond to pain relief.
Trigeminal neuralgia tends to come and go, but successive attacks may be disabling. Although neuralgia is not fatal, the patient's fear of being in pain can seriously interfere with daily life.
Some people with postherpetic neuralgia respond completely to treatment. Most people, however, experience some pain after treatment, and a few receive no relief at all. Some people live with this type of neuralgia for the rest of their lives, but for most, the condition gradually fades away within five years.
Key Terms
Desensitization
A technique of pain reduction in which the painful area is stimulated with whatever is causing the pain.
Dorsal root entry zone (DREZ)
A type of nerve surgery for postherpetic neuralgia that is occasionally used when the patient can get no other pain relief. The surgery destroys the area where damaged nerves join the central nervous system, thereby interfering with inappropriate pain messages from nerves to the brain.
Glossopharyngeal neuralgia
Sharp recurrent pain deep in the throat that extends to the area around the tonsils and possibly the ear. It is triggered by swallowing or chewing.
Migraine neuralgia
A variant of migraine pain, also called cluster headache, in which severe attacks of pain affect the eye and forehead on one side of the face.
Occipital neuralgia
Pain on one side of the back of the head caused by entrapment or pinching of an occipital nerve.
Postherpetic neuralgia
Persistent pain that occurs as a complication of a herpes zoster infection. Although the pain can be treated, the response is variable.
Shingles
A painful rash with blisters that appears along the course of a nerve. It is caused by infection with herpes zoster virus.
TENS
The abbreviation for transcutaneous electrical nerve stimulation, a technique used to control chronic pain. Electrodes placed over the painful area deliver a mild electrical impulse to nearby nerve pathways, thereby easing pain.
Trigeminal neuralgia
Brief episodes of severe shooting pain on one side of the face caused by inflammation of the root of the trigeminal nerve. Also referred to as tic douloureux.