What does Pain Medicine studies?
Nowadays, one of the most frequent reasons of applying for medical care is pain caused by locomotor apparatus disease. From 20 to 45 % of the world’s population suffers from pain connected with locomotor apparatus lesions (women and older adults are affected more often). Chronic pain is the reason for work capacity loss and social activity of person. It is connected with pathological conditions, such as: depression, sleep disorders, destabilization of the cardiovascular system.
In the structure of locomotor apparatus pathology, depending on the underlying pathogenetic mechanism, such things can be outlined: inflammatory diseases of the joints and surrounding tissue (arthritis, tenosynovitis, myositis), degenerative joints, trauma, tumors.
Pain as a disease
Pain is a positive feeling, because it is the first signal of danger. Since childhood we from our own experience, learn to get away from what hurts. Trauma pain forces us to restrict functioning of affected limb, and contribute to its healing. Such “positive” pain is called “acute”, which is based on the pathological process associated with trauma, inflammation or infection.
Chronic pain lasts for more than 3-6 months, which exceeds the period of tissue healing. This type of pain loses its useful signal value and it occurs for other pathological laws. Prominent role in the development of which is mental factor. If acute pain is considered as a symptom, chronic pain partakes features of the disease, which manifests itself in emotional and mental disorders with the development of pain behavior.
The perception of pain
Everyone has a different perception of pain, which may depend on upbringing and sex. For example, person used to suffer in silence usually says that it is not so painful, when something hurts. One who is accustomed to the express their feelings, will tell that something hurts a lot. It is proved that women are capable of easier response to pain than men.
Pain feels differently during the day and at night. The pain, which gives us no opportunity to sleep at night for a long time, during the day feels easier. It happens so, because at night pain captures our attention, and during the day we can be distracted from it when taking to a friend or watching movies, working. The fear that appears as a result of a misunderstanding of pain causes, leads to fixation of attention and increases suffering generally.
Causes of pain
In 90% of all cases pain is hidden in five biological structures: soft tissues (skin, muscles, ligaments, etc.), joints, bones, blood vessels and nerve fibers. Therefore, it is divided into tissue, joint, bone, vascular and neurogenic pain.
Tissue pain. Causes of pain are formed in the skin, muscles, ligaments, internal organs.
Kneecap pain. Reasons for this pain are: intra-articular and non- articular pathology. Intra-articular pain occurs during rheumatic diseases, infections, osteoarthritis, injuries. Often it is accompanied with inflammation and excessive production of intra-articular (synovial) fluid. It while movement stretches a joint cavity and causes pain. Non-articular lesions included: diseases and injuries of tendons, synovial bursas and ligaments.
Bone pain. Characterized by aching pain, which extends along the bone. Causes of bone pain are: osteoporosis, increased intraosseous pressure, tumors.
Vascular pain. Caused by blood supply disorders due to narrowing of the arteries or blood flow at the extended or thrombosed veins. Characterized by numbness, gait disturbance, edema and ulceration on the skin.
Neurogenic pain. Occurs due to irritation by pathological factors of pain conductors (nerves). In addition to pain, there are disorders of sensitivity (increase or decrease, up to the absolute loss) at certain parts of the body.
Diagnostics of pain
In order to find out causes of pain, it is necessary, to go through complex diagnostic path. Doctor finds out the information on development of disease, patient’s complaints and which system has disorders (cardiovascular, musculoskeletal, nervous, immune, etc.). This allows him/her to determine the location and character of pain, to ascertain musculoskeletal disorders and to identify the probable cause of pain.
When establishing the diagnosis, modern medicine bases on the data of additional methods of examination. For example, during the diagnostics some technical tools, such as: radiography, magnetic resonance imaging, computer tomography, ultrasound may be used This allows doctors to see how affected organ looks, to visualize what kind of tissue is a substrate of pain and state, whether the process spreads to nearby tissues or not.
Separate effective method of diagnostics is laboratory tests: based on changes of blood parameters, “invisible” causes of disease can be determined (infection, damages to the immune system, etc.). Therefore, if any patient has this or that disease, doctor chooses the most optimal method of diagnosis.
Final stage of the diagnostic process is the analysis of the examinations and establishment of definitive diagnosis, then treatment will be prescribed.
Pain at irregular sport
Physical activity is becoming an increasingly popular lifestyle choice. A lot of people for a whole week give themselves to work and at weekends they exercise. This phenomenon became so common, that the term “weekend sportsman’s” was coined. Often this type of physical activity is the cause of the pain itself. Due to irregular physical loads, patterns of locomotor system are overloaded, causing pain and violation of working activity.