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Everyone experiences pain at one or the other time in life. Pain is a normal body response to an injury or physiological malfunction caused by an illness. Both acute and chronic pain can often be effectively treated with usual pain medications. But excruciating chronic pain that does not respond to pain killers tests the physical and mental limits of the sufferer. A patient who experiences such pain would be ready to undertake any available treatments to get a relief.
What is the difference between an acute pain and a chronic pain?
Any pain that originates suddenly is called an acute pain. It is usually caused by an injury and it does not last long. It subsides with time when the injury heals. All that is required is a pain medication if the pain is unbearable. But the case of a chronic pain, the one which lasts for more than 3-6 months, is different. It is usually connected to diseases and disorders like diabetes, cancer, arthritis, fibromyalgia etc. In a minority of cases, no definite cause can be figured out.
It can be challenging to treat pain that is refractory to the usual pain medications and that reappears after the medications are stopped.
A basic understanding of the mechanism of pain perception and the gate-control theory
The feeling of pain is originally generated in pain receptors, specific neural structures located everywhere in the body. To be felt as pain, the signals from these receptors has to be sent to the brain via special pain fibers. There are generally two types of pain fibers – A and C. A fiber, transmit fast and sharp pain signals while the C fibers conduct slow and diffuse pain signals. The A fibers also carry other non-noxious sensations like touch to the brain. All these sensory nerve fibers are connected to specific neurons in the spinal cord from where the signals are transmitted through neuronal pathways to the relevant parts of the brain and are thus perceived and interpreted.
This has a scientific background. The gate-control theory, developed by Ronald Melzack and Patrick Wall in 1960s, explains the mechanism by which emotions and thoughts affect pain perception. According to this theory, a neurological gate in the spinal cord operates to block the pain signals carried by some nerve fibers while allowing those carried by the others. When there is a large amount of pain stimuli, the gate opens for these signals and they reach the brain. The sensory fibers that carry sensations other than pain are faster than the pain fibers in signal transmission. When a large amount of these sensory stimuli reach the synaptic cells, the gate is closed for pain signal transmission and hence pain is not perceived.