Pain-Modulation: Difference between revisions

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== Pain Modulation  ==
== Pain Modulation  ==


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=== Levels of Pain Modulation  ===
=== Levels of Pain Modulation  ===


Pain modulation is easily classified into 5 discreet levels of interaction.&nbsp; These levels correspond to either important synaptic junctions, or significant chemical processes involved in the trasmission of pain.  
Pain modulation is easily classified into 5 discreet levels of interaction.&nbsp; These levels correspond to either important synaptic junctions, or significant chemical processes involved in the transmission of pain.  


===== Level 1:&nbsp; Periphery  =====
===== Level 1:&nbsp; Periphery  =====


Level 1 pain modulation refers to events acting in the periphery of the body, at the source of the pain source.&nbsp;
Level 1 pain modulation refers to events acting in the periphery of the body, at the source of the pain source. The [[somatosensation]] defined as the sensation from skin, mucus, limbs, and joints and classified into: thermoception, [[nociception]], equilibrioception  mechanoreception response to (vibration, touch, and pressure), and [[Proprioception|proprioception.]]
 
Nociceptors are peripheral cell nerve endings that initiate pain sensation, respond to noxious stimulus (thermal, mechanical, or chemical) which in turn trigger action potential to the spinal cord and to higher centers. It is divided into A delta and C fibers.
 
* A- delta fibers are large(larger than C- fiber) myelinated, fast conducting fibers, concerned with localized, sharp, and fast sensation of pain.
 
* C- fibers are small, unmyelinated, slow conducting nerve fibers, concerned with dull, and slow pain sensation.
 
Under normal conditions the nociceptors are inactive when there is a noxious stimulus (tissue damage) those pain receptors respond according to the stimulus type and cyclooxygenase-2 is activated to release more PG(prostaglandin), and signals transmitted to the dorsal horn of spinal cord ( first order neuron).
 
'''A- beta'''  are myelinated, large diameter, and have the fastest conduction velocity. These fibers respond to non painful stimulus such as touch sensation, mild pressure, and vibration.


===== Level 2:&nbsp; Dorsal Horn  =====
===== Level 2:&nbsp; Dorsal Horn  =====
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<references />
<references />
[[Category:Pain]]
[[Category:Pain]]
[[Category:Pharmacology]]
[[Category:Physiology]]
[[Category:Physiology]]
[[Category:Neurology]]

Revision as of 05:02, 10 December 2021

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Pain Modulation[edit | edit source]

Pain modulation the process of alterations in the pain signals along the transmission pathway of pain, it explains why individuals response to the same stimulus different, explains the mechanism of action when using clinical analgesic. Pain control and modulation is a complex chore that is often the primary reason patients seek the services of rehabilitation professionals.  Modulation of pain begins with an understanding of the various levels of pain modulation and extends to clinical interventions and protocols designed to reduce pain. For example, opiates they are capable of increasing and decreasing pain experience.

Levels of Pain Modulation[edit | edit source]

Pain modulation is easily classified into 5 discreet levels of interaction.  These levels correspond to either important synaptic junctions, or significant chemical processes involved in the transmission of pain.

Level 1:  Periphery[edit | edit source]

Level 1 pain modulation refers to events acting in the periphery of the body, at the source of the pain source. The somatosensation defined as the sensation from skin, mucus, limbs, and joints and classified into: thermoception, nociception, equilibrioception mechanoreception response to (vibration, touch, and pressure), and proprioception.

Nociceptors are peripheral cell nerve endings that initiate pain sensation, respond to noxious stimulus (thermal, mechanical, or chemical) which in turn trigger action potential to the spinal cord and to higher centers. It is divided into A delta and C fibers.

  • A- delta fibers are large(larger than C- fiber) myelinated, fast conducting fibers, concerned with localized, sharp, and fast sensation of pain.
  • C- fibers are small, unmyelinated, slow conducting nerve fibers, concerned with dull, and slow pain sensation.

Under normal conditions the nociceptors are inactive when there is a noxious stimulus (tissue damage) those pain receptors respond according to the stimulus type and cyclooxygenase-2 is activated to release more PG(prostaglandin), and signals transmitted to the dorsal horn of spinal cord ( first order neuron).

A- beta  are myelinated, large diameter, and have the fastest conduction velocity. These fibers respond to non painful stimulus such as touch sensation, mild pressure, and vibration.

Level 2:  Dorsal Horn[edit | edit source]

Level 2 pain modulation refers to events in the dorsal horn of the spinal cord.  It is here where the Gate Theory of Pain comes into play.

Level 3:  Fast Neuronal Descending Pathways[edit | edit source]
Level 4:  Hormonal[edit | edit source]
Level 5: Cortical[edit | edit source]

Pain Interventions[edit | edit source]

Modalities[edit | edit source]
Exercise[edit | edit source]
Manual Therapy[edit | edit source]

References[edit | edit source]