Physiology of Pain

[Genevieve]

Can anyone recommend any good books for the physiology of pain?

Our uni library is horrendous at the minute as most of the books are in storage for library refurbishment (:@ ) so pondering through them isn't an option (plus I'm short on time).

I'm doing an essay and the question is:

Identify the key differences between acute and chronic pain. Include a demonstration of your knowledge and understanding of the different physiological and psychological aspects of both pain types.

(This is actually a nursing module for honours, so a bit out of my midwifery comfort zone)

[Leo2004]

I disagree, this is not immunology, but physiology of pain as your question states.

You could look in a physiology book like guyton or something more detailed for the overview and/or a neurology book for some of the pain pathways location in the spinal cord/brain and/or an anaesthetics book like gwinnutt or something more detailed for the more receptor level details. Guyton is probably enough; the others for interest.

Don't forget the psychological component, tho. All the above are simply concerned with nociception i.e. the physiological mechanics of the stimulus. What we perceive as pain is much more complex and bound up with other psychological and social factors.

Good luck with the assignment, hth.

[Future Medic???]

I disagree, this is not immunology, but physiology of pain as your question states.

You could look in a physiology book like guyton or something more detailed for the overview and/or a neurology book for some of the pain pathways location in the spinal cord/brain and/or an anaesthetics book like gwinnutt or something more detailed for the more receptor level details. Guyton is probably enough; the others for interest.

Don't forget the psychological component, tho. All the above are simply concerned with nociception i.e. the physiological mechanics of the stimulus. What we perceive as pain is much more complex and bound up with other psychological and social factors.

Good luck with the assignment, hth.

Sorry I deleted my previous post because I didn't have enough time to explain the logic behind it. My thinking process is that body systems are not completely independent of one another, although the question as you so rightly elucidate, does state physiology of pain, I personally believe that it will be wrong to only focus on the nuerobiology. Physiology includes a comprehensive look at all the mechanisms of the human body, immunology included.

The stimuli (enzymatic and/or hormonal) and other signals that are sent as a result of the perception of pain are not able to completely dissociate from affecting the immune system, hence inflammation and tissue damage etc occurs. For example histamines are immune signals, serotonin will affect blood vessels and ultimately blood flow, hormones such as prostaglandins will regulate the inflammatory processes. I am not going to discuss in great detail but I think you appreciate my views.

I think you are quite right to point out the psychological and social factors, it is all as much a part of physiology as is immunology, you cannot eliminate any of the immunological effects, they are even more important as their signs and symptoms are usually overt.

My advice to the OP is to have a wholly view of the human body simply because all body systems and mechanisms are NOT independent of each other, whatever happens will/might have an effect on target systems but also on the rest of the body hence IMHO all mechanisms should be included in your report.

I realize that my thinking could possibly be flawed and please do correct me if you find this to be the case, I am always earger to learn and improve/correct my own knowledge and thinking process.

I hope this helps a bit and best wishes to the OP.

[Leo2004]

Hey There Futuremedic?,

You are quite right to say that acute inflammation, which is a complex immune-mediated phenomenon as you state, may occur at the same time as nociception and indeed prostaglandin sensitises the nerve endings of afferent nerve fibres.

However, nociception occurs due to a nerve stimulus which is processed higher up to lead to the subjective awareness of pain, whereas acute inflammation occurs as a result of and in reaction to tissue damage (which inevitably invokes pain).

I totally agree that everything in medicine needs to be looked at in a holistic way.

Good luck at med school and kudos to you for the impressive knowledge of inflammation!

[Genevieve]

Thanks Guys!!

Totally agree re: psychosocial aspects, I will be focusing a large part of the assignment on those issues, biopsychosocial model etc, I have found a great book for that already.
Thanks for the recommendation for the physiology book

So far I have written about the processes involved in nociception (transduction, transmission, perception and modulation) and went into detail on each part, which also did include bits about the 'chemical cascade' which I think is what you where talking about FutureMedic as it's about the inflammatory response and the sensitized areas surrounding inflamed tissue, due to the release of prostaglandins ?

I still have about 2000 words left to write and a large part of that is on chronic pain so again will have a lot to do with psychosocial side of things.


Thanks again

G x

[Leo2004]

Hey Genevieve,

There's some really good anaesthetics as well as neuropsychiatry stuff on chronic pain...

Sounds like a good essay so far...