The Mystery of Pain: Acute vs Chronic Pain

Posted on Posted in Brain Science, Continuing Education, Pain, Psychology, Seminars, Webinars

By Michael Howard, Ph.D.

Early humans explained the mystery of pain by associating it with evil, magic, or demons. Relief was the responsibility of sorcerers, shamans, priests, and priestesses, who treated their clients with herbs and rituals.

Ancient civilizations recorded on stone tablets accounts of pain and the treatments used, including pressure, heat, water, and sun. The Greeks and Romans were the first to advance a theory of sensation, the idea that the brain and nervous system were involved in the perception of pain.pain

During the Middle Ages and into the Renaissance, evidence began to accumulate supporting these theories. Leonardo da Vinci and his contemporaries came to see the brain as the central organ responsible for sensation, with the spinal cord transmitting sensations to the brain.

In the 19th century, pain came to dwell under a new domain—science—which paved the way for advances in pain therapy. Physician-scientists discovered that opium, morphine, codeine, and cocaine could be used to treat pain. In the late 1800s, research led to the development of aspirin, to this day the most commonly-used pain reliever. Before long, anesthesia—both general and regional—was refined and applied during surgery.

Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. There are two basic categories of pain, acute and chronic, and they differ greatly.

Acute pain usually results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly—for example, after trauma or surgery—and may be accompanied by anxiety or emotional distress. The cause of acute pain can generally be diagnosed and treated, and the pain is self-limiting—confined to a given period of time and severity. In some instances, it can become chronic.

Chronic pain is widely believed to represent a disease in and of itself. It persists over a longer period of time than acute pain and is resistant to most medical treatments. Chronic pain often persists longer than three months, or longer than expected for normal healing. It can be made much worse by environmental and psychological factors. It can—and often does—cause severe problems for patients, as pain signals keep firing in the nervous system for weeks, months, or years. There may have been an initial mishap such as a sprained back or serious infection, or there may be an ongoing cause of pain such as arthritis, cancer, or infection. However, some people suffer chronic pain in the absence of any past injury or evidence of illness.

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Migraines In Women

Posted on Posted in Continuing Education, Homestudy, Pain, Seminars

woman-565132_640Migraine headaches are usually characterized by throbbing, severe pain (usually on one side of the head), an upset stomach, and — sometimes — disturbed vision.

Migraines were recognized as early as the 7th century BC—when the usual treatment involved trephining, or creating a hole in the skull to relieve the headache pressure, and release the “evil spirits or demons” thought to be causing the pain.

Women are three times more likely than men to suffer from migraine headache. Hormonal changes and the patient’s stage of life may play a role in women’s higher susceptibility to migraine. Even in ancient history, women with migraines probably greatly outnumbered men with the disorder.

Throughout history, a number of myths about migraine in women have flourished. Migraines in women were often attributed solely to PMS (pre-menstrual syndrome) or hormonal changes, such as those that occur during menopause. Another myth was that headaches in general — and headaches in women, in particular — were due to psychological problems, rather than being a biological condition. Consider some facts about migraines and women:

  • In the United States, almost nine million women suffer from migraines each year, and over three million have more than one migraine attack per month.
  • Sixteen out of every 100 women suffer from migraine headaches.
  • The highest prevalence for migraine in women occurs between the ages of 35 and 45, a time when many women are at the height of their professional careers and have the most family responsibilities and social obligations.
  • Half of all women with migraines report having 24 or more migraine attacks each year, and over 25 percent report having such headaches every week.
  • In women who have migraines, 60 percent experience headaches during menses as well as at other times of the month. Just 14 percent of women have migraine pain only during their menstrual period.

Headache is one of the most common conditions seen by clinicians today. Migraine headaches can be especially troublesome for patients and can cause symptoms that include significant pain as well as neurologic symptoms. Fortunately, there are now many effective treatments for migraine and other headaches, including medications and lifestyle changes.

In women with migraines, hormonal changes can play a significant role in the severity of symptoms. Thus, successful treatment of female migraineurs requires knowledge of neuro-endocrine changes from menarche to menopause. With such knowledge, clinicians can help female patients find relief from this challenging condition.

A thorough medical history and careful physical examination are essential to rule out less common but serious causes of headache. The best treatment always starts with the right diagnosis.

INR offers continuing education courses such as Women’s Health: Migraines and Headaches.  Click below for this and more from our library.

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