Pain is a complicated sensation that depends not only on the severity of the actual injury, but on factors such as physical health and personal experiences and expectations. If you go to the dentist to have a filling, your fear of the drill and anticipation of the discomfort it will produce is likely to increase the level of pain you actually feel.
Your body contains nerve endings that are sensitive to painful stimuli such as crushing, extreme temperatures and irritating chemicals. When part of your body is injured, for example jamming your finger in a door, the nerve endings transmit pain signals to the brain via the spinal cord. Electrical signals and chemical messengers carry the information to various parts of the brain where they are interpreted as pain or not depending on the immediate requirements of the situation.
It is possible for you to be unaware of pain, as particular conditions need to be met before the pain signals affect your conscious mind. For example, a soldier in battle may not notice any pain from an injury until the immediate threat has vanished.
How do painkillers work?
There are two main classes of painkiller and they work via different mechanisms. The first class are aspirin drugs, such as paracetamol and ibuprofen. They work chiefly by blocking the body's production of prostaglandins, one of the main sets of chemicals that produce the sensation of swelling and pain.
They act at the site of the injury and as the level of prostaglandins is reduced, swelling is reduced and the intensity of the pain is reduced.
The second class of painkillers are the narcotic drugs, such as morphine and codeine. They work by blocking the path of the chemical messengers that signal pain in the spinal cord and brain.
The first class of painkillers are suitable for treating mild to moderate pain, while the second class can treat moderate to severe pain. The effectiveness of the first class eventually reaches a ceiling so that beyond a certain dose they cannot reduce the level of pain. Narcotics don't have a maximum dose – the amount of drug can continue to be increased to give relief whatever the level of pain. Because the two classes of drug work via different mechanisms, it's possible to combine the two to give better relief than either would alone.
Are there any alternatives to drugs for pain relief?
Besides drugs, there are a number of methods that can help to reduce pain. In cases of severe pain, many of these are best used in combination with traditional pharmaceuticals to obtain the maximum effect.
Because feelings of pain are not simply dependent on the severity of an injury, but are affected by a person's state of mind, there are a number of mind and body techniques that can reduce pain.
Relaxation involves reducing tension levels so that a person can gain rest and sleep. This is important because as fatigue levels rise, the ability to cope with pain decreases. Distraction relies on concentrating on something other than the pain, such as music or talking to friends, and can be useful in overcoming short periods of intense pain. Hypnotism can be used to alter the perception of pain and reduce feelings of distress..
Massage can provide relief not only by increasing relaxation, but by directly stimulating nerve endings in the vicinity of the pain. The nerves start to carry signals associated with other sensations. It also causes the release of naturally occurring pain relieving chemicals called endorphins. Direct electrical stimulation of nerve fibres works to relieve pain by utilising similar mechanisms. The electrodes can be placed on the surface of the skin or underneath it, depending on the location of the pain..
Do men and women feel pain differently?
although this area of study is rather new, there do appear to be differences in both how men and women respond to pain, and how effective certain drugs are at treating their pain.
Studies suggest that women have a lower threshold of pain than men and, for a given level of a disease, show greater levels of discomfort.
However, investigating the gender difference is complicated by hormonal and cultural factors. Hormone levels are known to play a role in pain perception, but these vary much more over the course of a woman's life than a man's. Additionally, the perception of pain is influenced by an individual's expectations and experiences, so the different genders may have been brought up to respond to pain differently.
Other studies suggest that women may actually be better able to cope with some forms of pain, so they may find a chronic illness such as arthritis less debilitating than a male. This may be because women have better coping strategies for dealing with the pain, such as talking about their problems with friends.
The effectiveness of some drugs in providing pain relief also seems to vary with gender. It has been shown that women experience greater pain relief from various types of narcotic drugs than men.
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