Perception of Pain: Acupuncture and Acupressure - Essay Example

?Running head: Perception of Pain Perception of Pain s Perception of Pain Pain is the most universal experience; however, perception of pain is vastly subjective and its perception varies from individual to individual. This depends on the processing of pain and the variation in personality types that a particular individual may possess. Most people attach negative or unpleasant emotional response with pain; however, this may not be so in case of soldiers for whom pain on the battlefield signifies that they are still alive or may be sent back home. Pain causes suffering and renders an individual incapable of carrying out his or her daily activities. Pain may have several negative feelings attached with it, but the function of pain is to protect the individual from further or exacerbating an injury. For instance, when an individual’s hand touches a hot pan, the reflexive withdrawal is the best example to demonstrate this aspect of pain and how it protects the individual from skin burn. Similarly, the excruciating muscle pain during over-exertion clearly indicates that an individual needs to rest and shows that pain can have its benefits, despite the suffering and misery it puts one through. Pain also teaches people to avoid certain behaviors that can trigger the pain and acts as a reinforcer of safety behavior. (Gambert, 2010) Pain is classified into two forms that is acute and chronic pain by Turk, Meichenbaum and Genest. Acute pain is the onset of pain and last for only a few days and it occurs due to tissue damage and has a protective purpose. In other words the source of the acute pain can easily be seen. Certain examples of acute pain include heart attack pain, acute appendicitis, sprain, fractures or lacerations. Chronic pain is a type of pain that lasts for a period of six months or more than that. It is a slow, throbbing pain and usually and may persist for a very long time. Chronic pain is further divided into three categories that is chronic recurrent pain, which is experienced by people suffering from migraines; it is characterized by bouts of no pain in the middle. (Hartvigsen et.al, 2004) The second category is called chronic intractable; the pain experienced is benign but it persists throughout the individual’s life. An example of chronic intractable pain would be lower back pain. The third category is called chronic progressive, whereby the pain is experienced by the individual with increasing intensity. Cancer pain is one such example of chronic progressive whereby, the pain intensity increases as the condition of the patient exacerbates with time. The persistence and intensity of chronic depends on a number of factors such as social support and environmental variables that reinforce pain behavior; for instance, if the pain behavior is followed secondary benefits from the individual’s environment then the pain is likely to persist for a very long time. Also individual personality, resistance and resilience play a great role how the pain is perceived and managed by the individual. (Hartvigsen et.al, 2004) Pain may have several functions; however, researchers have often conducted detailed researches regarding how pain is transmitted from the region of injury and processed in the central control unit that is brain. The oldest theory regarding the transmission of pain is called the specificity theory developed by Renee Descartes. This model to explain pain transmission was based on the premise that there is a particular pain pathway that gets activated every time an individual sustains an injury. This theory was very short on detail and shed no light as to where this pathway was located in the body and did not answer the fundamental question that is how can the pain pathway gets activated regardless of where the injury is sustained and how different kinds of pain are transmitted through one pathway. (Sullivan et.al, 2001) The theory had many shortcomings but remained the most dominant angle on the subject till the mid 1960’s. William Erb challenged the specificity theory in 1864 and then his theory was further supported by Alfred Goldscheider, and this theory became known as ‘pattern theory’. This theory was based on the premise that there sensory located under an individual’s skin and according to the degree of pressure or injury sustained by the body, various fibers are activated that carry the signal to the brain, where the pain is perceived. This pattern of stimulation is the reason why the theory came to be known as ‘pattern theory’. However, the fundamental drawback of this theory was that the pathway was still not specified and still the path through which the pain was transmitted to the brain was not identified. (Sullivan et.al, 2001) The Pattern theory was then followed by the Gate Control theory proposed by Melzack and Wall. This theory was based on the premise that a hypothetical structure known as the “gate” and the opening and closing of this structure decided the intensity and type of pain that was experienced by the individual. The theory was in concurrence with certain aspect of the ‘Pattern theory’ that there were sensory fibers located all over the body that signaled the sustenance of an injury regardless of the location. Melzack and Wall argued that after the sensory fibers became activated, this caused the gate to open that transmits the pain to the brain which then carries out the bodily response to the behavior. (Sullivan et.al, 2001) The theory further stated that the opening and closing of the gate depends on the behavior, such as after hitting your elbow on a hard surface triggers a sharp pain, which is then followed by subsequent rubbing of the skin that closes the gate and as a result alleviates the pain. This gave a very plausible explanation of how pain is transmitted and perceived; however, the theory is based on a hypothetical structure and it does not specify exactly where the gate is located, from where the pain is transmitted and what factors controlled the opening and closing of the hypothetical gate. However, this theory paved way for further research in the matter and researchers proposed that the body possessed various nerve fibers that were responsible for carrying the pain. Researchers stated that there were two kinds of fiber A-Delta Fibers and C-Fibers that carried different kinds of pain. The A-Delta Fibers are myelinated; therefore, they transmit pain sensation faster and as a result the kind of pain transmitted by these fibers is sharp and acute. On the other hand, C-fibers are unmyelinated and therefore, pain transmission through them is very slow and usually they are responsible for the transmission of chronic pain. The premise of the theory was that A-Delta fibers open the gate greatly, which results in the experience of acute pain. Whereas the unmyelinated C-fibers do not open the gate that much, hence this results in the experience of chronic pain. This was largely based on the approach developed by Melzack and remained the dominant perspective till mid 20th century. Later on the gate control theory forms the basis of the present theories regarding pain and its perceptions. Researchers have actively worked to develop various methods to measure the intensity of pain. As mentioned earlier, pain is a subjective experience and everyone has a different experience of pain, which varies according to the personality, resistance and resilience of the individual. Therefore, the most effective way to measure pain would be questionnaires and hence, Melzack developed the McGill Pain Questionnaire or McGill Pain Index; its name signifies the place where the test was developed and it consists of 20 questions that contains a group of adjectives that described the pain and the individual was required to pick the most suitable group of words that best describe the pain they felt. However, the main drawback with this questionnaire was that it did not provide ample information into the nature of the pain and sometimes people may choose the wrong answer, if they did not know how to describe their pain or may mix up words. In order to cover shortcomings of the aforementioned test, researchers developed Multidimensional Pain Inventory (MPI). MPI consisted of a series of questions that were designed to check the psychosocial aspects of the pain and analyze the intensity of the chronic pain. The analysis of the results of the MPI by Turk, Rudy and Kerns show that people with behavioral dysfunctions were likely to overestimate the intensity of their pain and likely to give answers that magnified the intensity. People who had interpersonal problems also greatly distressed by the pain and were likely magnify their pain intensity. On the contrary, people with high level of social support were likely to have better coping abilities and were less likely to let the pain affect their daily activities unlike the other two aforementioned groups. However, the reliability of this questionnaire; individuals taking the questionnaire may speed through the test and not answer truthfully if the pain is excruciating and too much to cope with. (Taylor, 2009) In case of children, the faces scale is designed to assess the intensity of pain and children are unable to articulate and explain the source or nature of their pain; faces scale have been highly efficacious when dealing with young children. These questionnaires are highly important in dealing with problems triggering the pain, and also act as an aid to diagnosis and effective treatment. Measurement of pain is largely based on questionnaires that have its own pros and cons but fundamentally they are extremely useful for both clinicians and the individual suffering from the pain. Clinicians have also discovered a variety of methods to help the individual manage or alleviate the pain and the following substance of the prose will highlight the methods developed by clinicians. (Franck et.al, 2000 & Taylor, 2009) As pain is the result of social and psychological factors, the clinicians can either use surgical methods to alleviate the pain. This method involves severing the nerves that give rise to pain in the individual’s body; this method is efficacious and provides immediate relief from the pain as the affected area becomes completely numb. However, the drawbacks to this method is that the numbness caused by the surgery is sometimes more uncomfortable then the pain itself and in certain cases, the pain relapses as nerves from adjacent areas in the body may grow to play the role of the severed nerves and as a result the pain may spring back. Medications such as painkillers also help but they only provide short-term benefits and do not provide complete relief or do not target the source of the problem. Furthermore, the side effects as a result of the medication may exacerbate an individual’s condition as opposed to alleviating it, which may give rise to serious detrimental repercussions in future. (Taylor, 2009) Due to the psychological component involved in the experience of pain, researchers have also deemed cognitive behavioral therapy (CBT) as a plausible method of treatment for pain. This is largely in case of people, whose pain behavior is reinforced by the secondary benefits given to them by their social environment. They are given a placebo and the individual can effectively reduce the pain they are experiencing. CBT is effective in reducing the negative emotional state but is vastly unable to remove the main variable that triggers the pain. Alternative methods to the alleviation of pain involve hypnosis, visual imagery or distraction but the efficacy of these methods largely depends on the intensity of the pain and the aforementioned methods such as imagery and hypnosis requires a highly impressionable individual to work. Acupuncture and Acupressure are also effective in helping an individual deal with the pain. Pain is a very subjective experience and researchers have conducted several researches to define the nature of this pain. Pain is perceived and managed according to the personality of an individual and considering the environmental variables present in one’s environment the individual can effectively regulate the intensity of the pain that is experienced by him or her. Pain can either have a mental or physiological source but either way, the intensity of the pain largely depends on an individual’s appraisal and his or her self-efficacy that determines how effectively an individual may get rid of the source of the problem. Reference Hartvigsen, J et.al. 2004. Psychosocial factors at work in relation to low back pain and consequences of low back pain; a systematic, critical review of prospective cohort studies. Occupational and Environmental Medicine. Franck, L.S. et.al. 2000. Pain assessments in infants and children, Volume 47, Issue 3. Elsevier: Pediatric clinics of North America. Gambert, S.R. 2010. Pain Perception: A complex issue in Geriatric Medicine. Journal of the American Geriatrics Society Sullivan, M.J.L et.al. 2001. Theoretical perspectives on the relation between catastrophizing and pain. Lippincott Williams and Wilkins Journals. Taylor, S.E. 2009. Health Psychology. McGraw-Hill Companies. Read More

 

Read More