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Revision as of 13:51, 13 May 2013

Pain

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Overview

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Risk Factors

Differentiating from other Symptoms

Natural History, Complications and Prognosis

Diagnosis

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Electrocardiogram

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Treatment

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Cost-Effectiveness of Therapy

Future or Investigational Therapies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pain, in the sense of physical pain,[1] is a typical sensory experience that may be described as the unpleasant awareness of a noxious stimulus or bodily harm. Individuals experience pain by various daily hurts and aches, and occasionally 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".[2][3]

Pain is highly subjective to the individual experiencing it. A definition that is widely used in nursing was first given as early as 1968 by Margo McCaffery: "'Pain is whatever the experiencing person says it is, existing whenever he says it does".[4][5]

Pain of any type is the most frequent reason for physician consultation in the United States, prompting half of all Americans to seek medical care annually.[6] It is a major symptom in many medical conditions, significantly interfering with a person's quality of life and general functioning. Diagnosis is based on characterizing pain in various ways, according to duration, intensity, type (dull, burning or stabbing), source, or location in body. Usually pain stops 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. The study of pain has in recent years attracted many different fields such as pharmacology, neurobiology, nursing sciences, dentistry, physiotherapy, and psychology. Pain medicine is a separate subspecialty[7] figuring under some medical specialties like anesthesiology, physiatry, neurology, psychiatry.

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


References

  1. See section Clarification on the use of certain pain-related terms.
  2. This often quoted definition was first published in 1979 by IASP in Pain journal, number 6, page 250. It is derived from a definition of pain given earlier by Harold Merskey: "An unpleasant experience that we primarily associate with tissue damage or describe in terms of tissue damage or both." Merskey, H. (1964), An Investigation of Pain in Psychological Illness, DM Thesis, Oxford.
  3. SeeIASP Pain Terminology.
  4. McCaffery M. Nursing practice theories related to cognition, bodily pain, and man-environment interactions. LosAngeles: UCLA Students Store. 1968.
  5. More recently, McCaffery defined pain as "whatever the experiencing person says it is, existing whenever the experiencing person says it does.” Pasero, Chris; McCaffery, Margo (1999). Pain: clinical manual. St. Louis: Mosby. ISBN 0-8151-5609-X..
  6. National Pain Education Council
  7. From theAmerican Board of Medical Specialties website: "Pain Medicine is the medical discipline concerned with the diagnosis and treatment of the entire range of painful disorders. (...) Due to the vast scope of the field, Pain Medicine is a multidisciplinary subspecialty (...)."

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