The Place to Manage Your Pain

 

The field of Pain Medicine has evolved over the last 20 years to include an increasing array of sophisticated and technologically complex diagnostic and therapeutic procedures. Concurrent to this advancement has been the development of a battery of pharmacological options to treat pain, from extended-release formulations of analgesics to antidepressants and anticonvulsants designed to treat specific types of pain syndromes. Despite (and perhaps because of) this phenomenal growth, it is not uncommon for patients with persistent pain to find themselves having gone through a number of procedures and taking a growing list of medications without ever experiencing true resolution of the condition or a return to a normal lifestyle and function. Inherent in this approach is the viewpoint that the clinician’s role is to do something to the patient that will reduce symptoms rather than to work in concert with the patient to either resolve the root causes or ameliorate the functional consequences of their pain condition. Although motivated by the desire to help, this model of pain management neglects individual choice and personal responsibility. There are also lifestyle changes that may be necessary such as proper nutrition and physical therapy.

As new treatments are attempted to relieve painful symptoms without improvement, patients may become increasingly passive and can develop a sense of hopelessness and despair. Fortunately there are now quite effective and proven FDA cleared Electrotherapy pain control devices such as those sold on this web site.

Physical Pain is normally a sensory experience that can be described as the unpleasant awareness of a noxious stimulus or bodily harm. Individuals may experience pain by various daily hurts and aches and at times through more serious injuries or illnesses. For scientific and clinical purposes, pain is defined by the International Association for the Study of Pain (IASP) as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage".

In medicine pain is considered highly subjective. A definition that is widely used in medical practice was first given as early as 1968 by Margo McCaffery: "Pain is whatever the experiencing person says it is, existing whenever they say it does". All types of pain are the most common reason for consulting a physician in the United States, causing about half of all Americans to seek medical care annually. It usually is a major symptom in many medical conditions, and it can significantly interfere with a person's quality of life and general activities. Diagnosis is usually based on characterizing pain in various ways, according to duration, intensity, type (dull, burning, throbbing or stabbing), and source, or location in the body. Usually pain will stop without treatment or responds to simple measures such as resting or taking an analgesic, and it is then called ‘acute’ pain. But it may also become intractable and develop into a condition called chronic pain, in which pain is no longer considered a symptom but an illness by itself such as fibromyalgia. The study of pain has in recent years attracted many different fields such as pharmacology, neurobiology, electrotherapy, nursing, dentistry, physiotherapy, and psychology. Pain medicine is a separate subspecialty falling under medical specialties such as anesthesiology, neurology, and psychiatry.

Pain is a part of the body's built in defense system, triggering a reflex reaction to retract from a painful stimulus, and helps adjust behavior to increase avoidance of that particular harmful situation in the future. Given pains significance, physical pain can also be linked to various cultural, religious, philosophical, or social issues.

Mechanisms of Pain

Stimulation of a nociceptor, due to a chemical, thermal, or mechanical event that has the potential to damage body tissue, may cause nociceptive pain.
A nociceptor is a sensory receptor that reacts to potentially damaging stimuli by sending nerve signals to the spinal cord and to the brain. This process, called nociception, usually causes the perception of pain.

Damage to the nervous system itself, due to disease or trauma, may cause neuropathic (or neurogenic) pain. Neuropathic pain may refer to peripheral neuropathic pain, which is caused by damage to nerves, or to central neuropathic pain, which is caused by damage to the brain, brainstem, or spinal cord.

Nociceptive pain and neuropathic pain are the two main kinds of pain when the primary mechanism of production is considered. A third kind may be mentioned: see below psychogenic pain.

Nociceptive pain may be classified further in three types that have distinct organic origins and felt qualities.

Superficial somatic pain (or cutaneous pain) is caused by injury to the skin or superficial tissues. Cutaneous nociceptors terminate just below the skin, and due to the high concentration of nerve endings, produce a sharp, well-defined, localized pain of short duration. Examples of injuries that produce cutaneous pain include minor wounds, and minor (first degree) burns.

Deep somatic pain originates from ligaments, tendons, bones, blood vessels, fasciae, and muscles. It is detected with somatic nociceptors. The scarcity of pain receptors in these areas produces a dull, aching, poorly-localized pain of longer duration than cutaneous pain; examples include sprains, broken bones, and myofascial pain.

Visceral pain originates from body's viscera, or organs. Visceral nociceptors are located within body organs and internal cavities. The even greater scarcity of nociceptors in these areas produces pain that is usually more aching or cramping and of a longer duration than somatic pain. Visceral pain may be well-localized, but often it is extremely difficult to localize, and several injuries to visceral tissue exhibit "referred" pain, where the sensation is localized to an area completely unrelated to the site of injury.

Nociception is the unconscious afferent activity produced in the peripheral and central nervous system by stimuli that have the potential to damage tissue. It should not be confused with pain, which is a conscious experience. It is initiated by nociceptors that can detect mechanical, thermal or chemical changes above a certain threshold. All nociceptors are free nerve endings of fast-conducting myelinated A delta fibers or slow-conducting unmyelinated C fibers, respectively responsible for fast, localized, sharp pain and slow, poorly-localized, dull pain. Once stimulated, they transmit signals that travel along the spinal cord and within the brain. Nociception, even in the absence of pain, may trigger withdrawal reflexes and a variety of autonomic responses such as pallor, diaphoresis, bradycardia, hypotension, lightheadedness, nausea and fainting.

Brain areas that are particularly studied in relation with pain include the somatosensory cortex which mostly accounts for the sensory discriminative dimension of pain, and the limbic system, of which the thalamus and the anterior cingulate cortex are said to be especially involved in the affective dimension.

The gate control theory of pain describes how the perception of pain is not a direct result of activation of nociceptors, but instead is modulated by interaction between different neurons, both pain-transmitting and non-pain-transmitting. In other words, the theory asserts that activation, at the spine level or even by higher cognitive brain processes, of nerves or neurons that do not transmit pain signals can interfere with signals from pain fibers and inhibit or modulate an individual's experience of pain. These pain neurons through Electrotherapy and the gate control process can be interrupted and cause the pain to be greatly reduced and even eliminated in many cases.

Electrotherapy

Electrotherapy is the use of electrical energy as a medical treatment. In medicine, the term electrotherapy can apply to a variety of treatments, including the use of electrical devices such as deep brain stimulators for neurological disease. The term has also been applied specifically to the use of electrical current to speed wound healing. Additionally, the term "electrotherapy" or "electromagnetic therapy" has also been applied to a range of alternative medical devices and treatments such as the Wellnes Pro and Cold Lasers. These devices are FDA cleared and have been proven to be quite effective.



TerraQuant® Pro

Low-Level Laser Treatment LLLT

Low level laser therapy was first discovered in Eastern Europe in the 1960s. Lasers used in surgery, of course, literally burn through tissue—but the very low-intensity of the light beams used in LLLT have a constructive, rather than a destructive, effect. It turns out that LLLT probably has its most profound effects on the microscopic intracellular structures called mitochondria.17 When the gentle but penetrating beams of the LLLT laser illuminate cellular mitochondria, mitochondrial energy production is increased, which may help relieve local inflammation and pain. Low-level laser therapy may also assist in the process of wound and tissue healing through boosting microcirculation, promoting cellular proliferation, and reducing inflammatory activity that contributes to the cycle of chronic pain.

Most dramatically and recently, Australian researchers have identified a direct effect on the flow of cellular materials down the long axon that makes up the “wiring” of nerve cells. In essence, the low-level light basically “stuns” the nerve cells. In their own words these researchers have discovered that “laser-induced neural blockade is a consequence of such changes and provides a mechanism for… laser-induced pain relief. The repeated application of laser in a clinical setting modulates nociception [pain perception] and reduces pain. The application of laser therapy for chronic pain may provide a non-drug alternative for the management of chronic pain.”

It’s good to know how it works—but even better is knowing that it works. Fortunately for those who suffer from chronic pain, there’s a massive body of literature on LLLT’s effectiveness.

 


Wellness Pro Plus

The Wellness Pro Plus assists the body to achieve homeostasis, which is its natural state of well being, by correcting electrical abnormalities in areas of disease or injury.

However, in order to adequately explain how the Wellness Pro Plus work, it is appropriate to begin by considering certain fundamental aspects of living tissue.

The body is made up of a vast number of cells. In many ways these cells act like tiny batteries, storing and releasing energy, doing their work of taking in nutrients, releasing waste products, repairing and reproducing themselves, etc. Each cell, like any battery, has a measurable electrical charge, which must be maintained in order to function properly.

Energy flows constantly between all cells throughout the electrical circuitry of the body. When various forms of damage or trauma occurs to living tissue, there is a disruption in the electrical capacity of the involved cells and after an initial surge, there occurs, a measurable decrease in the production and flow of energy through the electrical network of the involved tissues. This condition is generally accompanied by pain in the area and often results in the body's inability to completely repair itself.

Therefore, lengthy rest periods and inactivity are often prescribed in order to attain eventual restoration of normal function. The Wellness Pro Plus treatments have been likened to putting a "jump start" on the dead battery of a car.
(Also known as The Gate Control Theory).

The gate control theory of pain, put forward by Ronald Melzack and Patrick Wall in 1962, and again in 1965, is the idea that the perception of physical pain is not a direct result of activation of pain receptor neurons, but instead is modulated by interaction between different neurons, both pain-transmitting and non-pain-transmitting. The theory asserts that activation of nerves that do not transmit pain signals can interfere with signals from pain fibers and inhibit an individual's perception of pain.

Evolutionary and behavioral role

Pain is part of the body's defense system, triggering mental and physical behavior to end the painful experience. It promotes learning so that repetition of the painful situation will be less likely.

Despite its unpleasantness, pain is an important part of the existence of humans and other animals; in fact, it is vital to healthy survival (see below Insensitivity to pain). Pain encourages an organism to disengage from the noxious stimulus associated with the pain. Preliminary pain can serve to indicate that an injury is imminent, such as the ache from a soon-to-be-broken bone. Pain may also promote the healing process, since most organisms will protect an injured region in order to avoid further pain.

Interestingly, the brain itself has no nociceptive tissue, and hence cannot sense pain inside itself. Thus, a headache is not due to stimulation of pain fibers in the brain itself. Rather, the membrane surrounding the brain and spinal cord, called the dura mater, is innervated with pain receptors, and stimulation of these dural nociceptors is thought to be involved to some extent in producing headache pain. The vasoconstriction of pain-innervated blood vessels in the head is another common cause. Some evolutionary biologists[who?] have speculated that this lack of nociceptive tissue in the brain might be because any injury of sufficient magnitude to cause pain in the brain has a sufficiently high probability of being fatal that development of nociceptive tissue therein would have little to no survival benefit.

Chronic pain, in which the pain becomes pathological rather than beneficial, may be an exception to the idea that pain is helpful to survival, although some specialists believe that psychogenic chronic pain exists as a protective distraction to keep dangerous repressed emotions such as anger or rage unconscious. It is not clear what the survival benefit of some extreme forms of pain (e.g. toothache) might be, and the intensity of some forms of pain (for example as a result of injury to fingernails or toenails) seem to be out of all proportion to any survival benefits. However, it is likely that the significant pain levels experienced in these situations are related to the high sensitivity of nerves in these parts of the body. For instance, the nerves in the roots of teeth need to be particularly sensitive in order for the subject to be aware of the sensation of eating, since teeth move very little during this process.

Diagnosis and assessment of Pain

To establish an understanding of an individual's pain, health-care practitioners will typically try to establish certain characteristics of the pain such as the site (localization), onset and offset, character, radiation, associated symptoms, time pattern, exacerbating and ameliorating factors, and the severity. According to its duration, pain may be categorized as acute (short term), subacute (medium term), or chronic (long term).

By using the gestalt of these characteristics, the source or cause of the pain can often be established. A complete diagnosis of pain will require also to look at the patient's general condition, symptoms, and history of illness or surgery. The physician may order blood tests, X-rays, scans, EMG, etc. Pain clinics may investigate the person's psychosocial history and situation.

Pain assessment may also draw upon the concepts of pain threshold, the least experience of pain which a subject can recognize, and pain tolerance, the greatest level of pain which a subject is prepared to tolerate.

Among the most frequent technical terms for referring to abnormal perturbations in pain experience, there are allodynia, pain due to a stimulus which does not normally provoke pain, hyperalgesia, an increased response to a stimulus which is normally painful, hypoalgesia and diminished pain in response to a normally painful stimulus.

Verbal characterization of Pain

A key characteristic of pain is its quality. Typical descriptions of pain quality include sharp, stabbing, tearing, squeezing, cramping, burning, lancinating (electric-shock like), or heaviness. It may be experienced as throbbing, dull, nauseating, shooting or a combination of these. Indeed, individuals who are clearly in extreme distress such as from a myocardial infarction may not describe the sensation as pain, but instead as an extreme heaviness on the chest. Another individual with pain in the same region and with the same intensity may describe the pain as tearing which would lead the practitioner to consider aortic dissection. Inflammatory pain is commonly associated with some degree of itch sensation, leading to a chronic urge to rub or otherwise stimulate the affected area. The difference between these diagnoses and many others rests on the quality of the pain. The McGill Pain Questionnaire is an instrument often used for verbal assessment of pain.

Intensity of Pain

Pain may range in intensity from slight through severe to agonizing and can appear as constant or intermittent. The threshold of pain varies widely between individuals. Many attempts have been made to create a pain scale that can be used to quantify pain, for instance on a numeric scale that ranges from 0 to 10 points. In this scale, zero would be no pain at all and ten would be the worst pain imaginable. The purpose of these scales is to monitor an individual's pain over time, allowing care-givers to see how a patient responds to therapy for example. Accurate quantification can also allow researchers to compare results between groups of patients.

Localization of Pain

Pains are usually called according to their subjective localization in a specific area or region of the body: headache, toothache, shoulder pain, abdominal pain, back pain, joint pain, myalgia, etc. Localization is not always accurate in defining the problematic area, although it will often help narrow the diagnostic possibilities. Some pain sensations may be diffuse (radiating) or referred. Radiation of pain occurs in neuralgia when stimulus of a nerve at one site is perceived as pain in the sensory distribution of that nerve. Sciatica, for instance, involves pain running down the back of the buttock, leg and bottom of foot that results from compression of a nerve root in the lumbar spine. Referred pain usually happens when sensory fibers from the viscera enter the same segment of the spinal cord as somatic nerves, i.e., those from superficial tissues. The sensory nerve from the viscera stimulates the nearby somatic nerve so that the pain localization in the brain is confused. A well-known example is when the pain of a heart attack is felt in the left arm rather than in the chest.

Management of Pain

Medical management of pain has given rise to a distinction between acute pain and chronic pain. Acute pain is 'normal' pain, it is felt when hurting a toe, breaking a bone, having a toothache, or walking after an extensive surgical operation. Chronic pain is a 'pain illness', it is felt day after day, month after month, and seems impossible to heal.

In general, physicians are more comfortable treating acute pain, which usually is caused by soft tissue damage, infection and/or inflammation among other causes. It is usually treated simultaneously with pharmaceuticals, commonly analgesics, or appropriate techniques for removing the cause and for controlling the pain sensation. The failure to treat acute pain properly may lead to chronic pain in some cases.

General physicians have only elementary training in chronic pain management. Often, patients suffering from it are referred to various medical specialists. Though usually caused by an injury, an operation, or an obvious illness, chronic pain may as well have no apparent cause. This disorder can trigger multiple psychological problems that confound both patient and health care providers, leading to various differential diagnoses and to patients' feelings of helplessness and hopelessness. Multidisciplinary pain clinics have been growing in number over the last few decades.

Anesthesia

Anesthesia is the condition of having the feeling of pain and other sensations blocked by drugs that induces a lack of awareness. It may be a total or a minimal lack of awareness throughout the body (i.e., general anesthesia), or a lack of awareness in a part of the body (i.e., regional or local anesthesia).

Analgesia

Analgesia is an alteration of the sense of pain without loss of consciousness. The body possesses an endogenous analgesia system, which can be supplemented with painkillers or analgesic drugs to regulate nociception and pain. Analgesia may occur in the central nervous system or in peripheral nerves and nociceptors. The perception of pain can also be modified by the body according to the gate control theory of pain.

The endogenous central analgesia system is mediated by three major components : the periaqueductal grey matter, the nucleus raphe magnus and the nociception-inhibitory neurons within the dorsal horns of the spinal cord, which act to inhibit nociception-transmitting neurons also located in the spinal dorsal horn. The peripheral regulation consists of several different types of opioid receptors that are activated in response to the binding of the body's endorphins. These receptors, which exist in a variety of areas in the body, inhibit firing of neurons that would otherwise be stimulated to do so by nociceptors.

The gate control theory of pain postulates that nociception is "gated" by non-noxious stimuli such as vibration. Thus, rubbing a bumped knee seems to relieve pain by preventing its transmission to the brain. Pain is also "gated" by signals that descend from the brain to the spinal cord to suppress (and in other cases enhance) incoming nociceptive information. Electrotherapy can be quite effective at reducing and even eliminating pain completely by takin advantage of the gate theory and enhancing the production of ATP (the energy source of the cells).

Complementary and alternative medicine

A survey of American adults found pain was the most common reason that people use complementary and alternative medicine.

Traditional Chinese medicine views pain as a 'blocked' qi, akin to electrical resistance, with treatments such as acupuncture claimed as more effective for nontraumatic pain than traumatic pain. Although the mechanism is not fully understood, acupuncture may stimulate the release of large quantities of endogenous opioids.

Pain treatment may be sought through the use of nutritional supplements such as curcumin, glucosamine, chondroitin, bromelain and omega-3 fatty acids.

There is interest in the relationship between vitamin D and pain, but the evidence is unconvincing. Severe vitamin D deficiency causes pain due to osteomalacia, but there is no clear mechanism for its relationship to other pain. As reported by Straube et al., of five small double-blind randomized controlled trials of vitamin D, only one found a statistically significant reduction in pain; uncontrolled case-series have showed reductions in pain, but there is nevertheless no persuasive evidence of a relationship between vitamin D status in those suffering from pain compared to controls.

Hypnosis as well as diverse perceptional techniques provoking altered states of consciousness have proven to be of important help in the management of all types of pain.

Some kinds of physical manipulation or exercise are showing interesting results as well.

Special types of Pain

Phantom pain
Phantom pain is the sensation of pain from a limb or organ that has been lost or from which a person no longer receives physical signals. Phantom limb pain is an experience almost universally reported by amputees and quadriplegics. Phantom pain is a neuropathic pain.

Pain asymbolia
Pain science acknowledges, in a puzzling challenge to IASP definition,[3] that pain may be experienced as a sensation devoid of any unpleasantness: this happens in a syndrome called pain asymbolia or pain dissociation, caused by conditions like lobotomy, cingulotomy or morphine analgesia. Typically, such patients report that they have pain but are not bothered by it, they recognize the sensation of pain but are mostly or completely immune to suffering from it.

Insensitivity to pain
The ability to experience pain is essential for protection from injury, and recognition of the presence of injury. Insensitivity to pain may occur in special circumstances, such as for an athlete in the heat of the action, or for an injured soldier happy to leave the battleground. This phenomenon is now explained by the gate control theory. However, insensitivity to pain may also be an acquired impairment following conditions such as spinal cord injury, diabetes mellitus, or more rarely Hansen's Disease (leprosy). A few people can also suffer from congenital insensitivity to pain, or congenital analgesia, a rare genetic defect that puts these individuals at constant risk from the consequences of unrecognized injury or illness. Children with this condition suffer carelessly repeated damages to their tongue, eyes, bones, skin, muscles. They may attain adulthood, but they have a shortened life expectancy.

Psychogenic pain
Psychogenic pain, also called psychalgia or somatoform pain, is physical pain that is caused, increased, or prolonged by mental, emotional, or behavioral factors. Psychogenic pain commonly manifests as headache, back pain, or stomach pain. Sufferers are often stigmatized, because both medical professionals and the general public tend to think that pain from a psychological source is not "real". However, specialists consider that it is no less actual or hurtful than pain from other sources.

 

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