Pain Klasifikasi

8/11/2019 Pain Klasifikasi

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About Pain Pain Types

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lassifying the type of pain you have in the pain clinic is an essential first step to make, allowingou to choose the correct pain killer / reliever, and achieving better pain management. anyhronic pain syndromes are made up of different types of pain, and therefore combining medicinesom different appropriate groups can help improve pain relief. To find out how to use over theounter pain relieving medicines more effectively, please look at Analgesic !low Chart .

ain Classification

Nocice ti!e Pain arises from the stimulation of specific pain receptors. These receptors canrespond to heat, cold, vibration, stretch and chemical stimuli released from damaged cells.

Non Nocice ti!e Pain arises from within the peripheral and central nervous system."pecific receptors do not e#ist here, with pain being generated by nerve cell dysfunction.

omatic Pain "ource $ tissues such as skin, muscle, %oints, bones, and ligaments $ often known as

musculo$skeletal pain. Rece tors acti!ated $ specific receptors &nociceptors' for heat, cold, vibration, stretch

&muscles', inflammation &e.g. cuts and sprains which cause tissue disruption', and o#ygenstarvation &ischaemic muscle cramps'.

C#aracteristics $ often sharp and well localised, and can often be reproduced by touchingor moving the area or tissue involved.

$seful Medications $ may respond to combinations of Paracetamol , (eak Opioids O)"trong Opioids , and *"A+ s &see Analgesic !low Chart '.

sceral Pain "ource $ internal organs of the main body cavities. There are three main cavities $ thora#

&heart and lungs', abdomen &liver, kidneys, spleen and bowels', pelvis &bladder, womb, andovaries'.

Rece tors acti!ated $ specific receptors &nociceptors' for stretch, inflammation, and o#ygenstarvation &ischaemia'.

C#aracteristics $ often poorly localised, and may feel like a vague deep ache, sometimes being cramping or colicky in nature. +t fre uently produces referred pain to the back, with

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pelvic pain referring pain to the lower back, abdominal pain referring pain to the mid$back,and thoracic pain referring pain to the upper back.

$seful medications $ usually very responsive to (eak Opioids and "trong Opioids .

erve Pain

"ource $ from within the nervous system itself $ also known as pinched nerve, trappednerve. The pain may originate from the peripheral nervous system &the nerves between thetissues and the spinal cord', or from the central nervous system &the nerves between thespinal cord and the brain' $ see *erve Pain .

Causes $ may be due to any one of the following processeso *erve egeneration $ multiple sclerosis, stroke, brain haemorrhage, o#ygen

starvationo *erve Pressure $ trapped nerveo *erve +nflammation $ torn or slipped disco *erve +nfection $ shingles and other viral infections

Rece tors acti!ated $ the nervous system does not have specific receptors for pain &non

nocicpetive'. +nstead, when a nerve becomes in%ured by one of the processes namedabove, it becomes electrically unstable, firing off signals in a completely inappropriate,random, and disordered fashion.

C#aracteristics $ These signals are then interpreted by the brain as pain, and can beassociated with signs of nerve malfunction such as hypersensitivity &touch, vibration, hotand cold', tingling, numbness, and weakness. There is often referred pain to an area wherethat nerve would normally supply e.g. sciatica from a slipped disc irritating the >2 spinalnerve produces pain down the leg to the outside shin and big toe i.e. the normal territory inthe leg supplied by the >2 spinal nerve. "pinal nerve root pain is also often associated withintense itching in the distribution of a particular dermatome. People often describe nerve

pain is often described as lancinating, shooting, burning, and hypersensitive.

$seful Medications $ only partially sensitive to paracetamol, *"A+ s, Opioids. oresensitive to Anti$depressants , Anti$convulsants , Anti$arrhythmics , and * A Antagonists .Topical Capsaicin , may be helpful.

%o& do ' find out if my ain is neuro at#ic( $ try using the following "creening Tests .

ym at#etic Pain "ource $ due to possible over$activity sympathetic nervous system, and central / peripheral

nervous system mechanisms. The sympathetic nervous system controls blood flow to tissuessuch as skin and muscle, sweating by the skin, and the speed and responsiveness of the

peripheral nervous system. $ see "ympathetic Pain . Causes $ occurs more commonly after fractures and soft tissue in%uries of the arms and legs,

and these in%uries may lead to Comple# )egional Pain "yndrome &C)P"'. C)P" was previously known as )efle# "ympathetic ystrophy &)" '. Rece tors acti!ated $ like nerve pain there are no specific pain receptors &non nociceptive'.

The same processes as mentioned above in *erve Pain may operate in C)P". C#aracteristics $ presents as e#treme hypersensitivity in the skin around the in%ury and also

peripherally in the limb & allodynia ', and is associated with abnormalities of sweating andtemperature control in the area. The limb is usually so painful, that the sufferer refuses to useit, causing secondary problems after a period of time with muscle wasting, %oint
http://www.painclinic.org/aboutpain-medicationtypes.htm#WeakOpioidshttp://www.painclinic.org/aboutpain-medicationtypes.htm#StrongOpioidshttp://www.painclinic.org/aboutpain-medicationtypes.htm#StrongOpioidshttp://www.painclinic.org/aboutpain-paintypes.htm#tophttp://www.painclinic.org/nervepain-introduction.htmhttp://www.painclinic.org/aboutpain-medicationtypes.htm#Anti-depressantshttp://www.painclinic.org/aboutpain-medicationtypes.htm#Anti-convulsantshttp://www.painclinic.org/aboutpain-medicationtypes.htm#Anti-convulsantshttp://www.painclinic.org/aboutpain-medicationtypes.htm#Anti-arrhythmicshttp://www.painclinic.org/aboutpain-medicationtypes.htm#Anti-arrhythmicshttp://www.painclinic.org/aboutpain-medicationtypes.htm#NMDAAntagonistshttp://www.painclinic.org/aboutpain-medicationtypes.htm#TopicalAgentshttp://www.painclinic.org/nervepain-introduction.htm#ScreeningTestshttp://www.painclinic.org/nervepain-introduction.htm#ScreeningTestshttp://www.painclinic.org/nervepain-sympatheticpain.htmhttp://www.painclinic.org/aboutpain-paintypes.htm#NervePainhttp://www.painclinic.org/aboutpain-introduction.htmhttp://www.painclinic.org/aboutpain-paintypes.htm#tophttp://www.painclinic.org/i-cache/nerve-neuroma.JPGhttp://www.painclinic.org/aboutpain-paintypes.htm#tophttp://www.painclinic.org/aboutpain-medicationtypes.htm#WeakOpioidshttp://www.painclinic.org/aboutpain-medicationtypes.htm#StrongOpioidshttp://www.painclinic.org/aboutpain-medicationtypes.htm#StrongOpioidshttp://www.painclinic.org/nervepain-introduction.htmhttp://www.painclinic.org/aboutpain-medicationtypes.htm#Anti-depressantshttp://www.painclinic.org/aboutpain-medicationtypes.htm#Anti-convulsantshttp://www.painclinic.org/aboutpain-medicationtypes.htm#Anti-arrhythmicshttp://www.painclinic.org/aboutpain-medicationtypes.htm#NMDAAntagonistshttp://www.painclinic.org/aboutpain-medicationtypes.htm#TopicalAgentshttp://www.painclinic.org/nervepain-introduction.htm#ScreeningTestshttp://www.painclinic.org/nervepain-sympatheticpain.htmhttp://www.painclinic.org/aboutpain-paintypes.htm#NervePainhttp://www.painclinic.org/aboutpain-introduction.htm


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contractures, and osteoporosis of the bones. +t is possible that the syndrome is initiated bytrauma to small peripheral nerves close to the in%ury.

$seful medications $ many of the features of sympathetic pain are similar to those of nerve pain, and therefore nerve pain medications may be useful & Anti$depressants , Anti$

convulsants , and Anti$arrhythmics '. rugs which lower blood pressure by causingvasodilatation &nifedipine' may also be useful when used in combination. Treatment shouldinclude appropriate multi$modal medications, sympathetic nerve blocks, and intensiverehabilitation combining occupational and physiotherapy.

Co yrig#t )c* +,, &&&.PainClinic.orgome ?About Pain ?Pain iagnosis ? "pinal Pain ? *erve Pain ?@oint Pain ? uscle Pain ?Treatment ? +nformation

>eaflets ? Presentations and Articles ? Pay Online ? omain *ames
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Pain Klasifikasi