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Pain management - Essay Example

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It is the result of certain forms of stimulation and involves complex, multidimensional processes. The word pain has been utilized to explain many conditions. There are two types of pain: acute pain is generally any relatively…
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Pain management

is the key catalytic protein in the synthesis of prostaglandins from arachidonic acid, resulting in pain and inflammation, and is subject to inhibition by non­steroidal anti-inflammatory drugs (NSAIDS). In 1991, several laboratories identified a second gene product with COX activity, now termed COX-2. It is clear now that both isoforms, COX-l and COX-2 are expressed in both peripheral tissues and several areas of the CNS (Prochazkova et al., 2006).
Gatchel, Polatin, and Kinney (1995) state that there are two prominent theories of pain: the traditional specificity theory of pain and the gate control theory of pain. The former, still widely taught, proposes that pain is a specific sensation and that the intensity of pain is proportional to the extent of tissue damage. This theory implies a fixed, straight-through transmission system from somatic pain receptors to a pain center in the brain (p.416).
In 1965, Melzack and Wall proposed the gate control theory. This theory suggests that there are physiological and neural mechanisms in the body that can have an effect on the perception of the painful stimulus (Hawthorn & Redmond 2001). The theory postulates that there are two controls that affect the gate. One originates in the cortex and other brain locations and descends to the gate, while the other is peripherally located and ascends to the gate. In the former, inhibition is accomplished through central summation and input control. In the later, pain information conducting over C-fibers is modulated through pre-synaptic inhibition from incoming beta fibers in the substancia gelantosa. This gating mechanism depends on the relative quantity of information being received over the larger fibers versus the smaller fibers. In essence, the two peripheral impulses interfere with each other to alter pain perception. The gate control theory has received the most recognition in the field of pain research (Gatchel, Polatin, and Kinney 416).
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