{"id":294,"date":"2021-03-22T16:14:07","date_gmt":"2021-03-22T16:14:07","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/suny-hvcc-healthpsychology\/?post_type=chapter&p=294"},"modified":"2021-03-22T16:14:07","modified_gmt":"2021-03-22T16:14:07","slug":"multidimensional-nature-of-pain","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/suny-hvcc-healthpsychology\/chapter\/multidimensional-nature-of-pain\/","title":{"raw":"Multidimensional Nature of Pain","rendered":"Multidimensional Nature of Pain"},"content":{"raw":"

Introduction<\/span><\/h2>A definition of pain is provided by the International association for the Study of Pain (IASP) as follows:[1]<\/a><\/sup>\n\n
An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage<\/b><\/blockquote>\n\nPain is always subjective<\/b> and everyone learns the use of this word through experiences related to injury in early life.\n\nPain is a sensation in a part or parts of the body.<\/b> It can vary in intensity, quality, duration and pain can refer to other parts of the body.<\/b> Pain is usually an unpleasant sensation and therefore it also has an emotional aspect<\/b>. It is strongly linked to suffering.[2]<\/a><\/sup>\n\nEven in the absence of tissue damage or any likely pathophysiological cause, people still report pain. This could happen for psychological reasons. In these cases, it is challenging to distinguish whether someone's experience of pain arises from damaged tissue or not, as it can only be based upon the subjective report of such experience.[3]<\/a><\/sup>\n\nIn the following video, Karen D. Davis tries to explain why some people react to the same painful stimulus in different ways.\n\n
[embed]https:\/\/www.youtube.com\/embed\/I7wfDenj6CQ?[\/embed]\n\n<\/div><\/div><\/div>[4]<\/a><\/sup>\n\n

The Process of Feeling Pain<\/span><\/h2>Pain is a physiological protective system. It is essential to warn, detect, and minimize contact with damaging stimuli.[5]<\/a><\/sup> Nerve endings and sensory receptors in the skin and tissues detect sensory stimuli. This can be thermal, mechanical or chemical stimuli (heat, cold, pressure, etc.). Nociceptors<\/a> (from the Latin word nocere<\/i> that means \"<\/i>to hurt\") are sensory receptors that respond to damaging or potentially damaging stimuli. With the stimulation of a nociceptor, a noxious stimulus is converted into electrical activity in the peripheral terminals of nociceptor sensory fibres. This is called transduction. The stimulus is carried to the spinal cord (central nervous system) through a process called conduction. The nociceptive nerve fibres terminate and the synaptic transfer and modulation of input from one neuron to another take place. This is called transmission. The neurons in the dorsal horn of the spinal cord transfer nociceptive input to the brainstem, hypothalamus, thalamus and brain cortex. In the brain perception of the experience occurs. This is a subjective process. Only then does the brain create pain as output after processing the stimuli. It is important to underline that activity induced in the nociceptive pathways by a noxious stimulus does not always lead to pain. Nociceptors can be stimulated by potentially damaging stimuli as well as actual damaging stimuli. Only when the brain has processed the stimulus, will it lead to a response of pain or not. Pain is always the output of a widely distributed neural network in the brain rather than one coming directly by sensory input evoked by injury, inflammation or other pathology[6]<\/a><\/sup>.\n\n
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Nociception<\/a><\/div><\/div><\/div><\/div>

Pain Classification<\/span><\/h2>Based on the works of Woolf[5]<\/a><\/sup>, this is a useful way of classifying pain:\n\n