The breakthrough experience

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History of pain theory Before the relatively recent discovery of neurons and their role in pain, various different body functions were proposed to account for pain.

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There were several competing early theories of pain among the ancient Greeks: Hippocrates believed that it was due to an imbalance in vital fluids.

Specificity theory saw pain as "a specific sensation, with its own sensory apparatus independent of touch and other senses". However, after a series of clinical observations by Henry Head and experiments by Max von Freythe psychologists migrated to specificity almost en masse, and by century's end, most textbooks on physiology and psychology were presenting pain specificity as fact.

They proposed that all skin fiber endings with the exception of those innervating hair cells are identical, and that pain is produced by intense stimulation of these fibers. Cognitive activities "may affect both sensory and affective experience or they may modify primarily the affective-motivational dimension.

Thus, excitement in games or war appears to block both dimensions of pain, while suggestion and placebos may modulate the affective-motivational dimension and leave the sensory-discriminative dimension relatively undisturbed.

Wilhelm Erb's "intensive" theory, that a pain signal can be generated by intense enough stimulation of any sensory receptor, has been soundly disproved. Some The breakthrough experience fibers do not differentiate between noxious and non-noxious stimuli, while others, nociceptorsrespond only to noxious, high intensity stimuli.

At the peripheral end of the nociceptor, noxious stimuli generate currents that, above a given threshold, send signals along the nerve fiber to the spinal cord. The "specificity" whether it responds to thermal, chemical or mechanical features of its environment of a nociceptor is determined by which ion channels it expresses at its peripheral end.

Dozens of different types of nociceptor ion channels have so far been identified, and their exact functions are still being determined. This is followed by a duller pain, often described as burning, carried by the C fibers.

These A-delta and C fibers connect with "second order" nerve fibers in the central gelatinous substance of the spinal cord laminae II and III of the dorsal horns. The second order fibers then cross the cord via the anterior white commissure and ascend in the spinothalamic tract.

Before reaching the brain, the spinothalamic tract splits into the lateralneospinothalamic tract and the medialpaleospinothalamic tract. Other spinal cord fibers, known as wide dynamic range neuronsrespond to A-delta and C fibers, but also to the large A-beta fibers that carry touch, pressure and vibration signals.

People with congenital insensitivity to pain have reduced life expectancy. The Evidence for Evolutionbiologist Richard Dawkins addresses the question of why pain should have the quality of being painful.

He describes the alternative as a mental raising of a "red flag". To argue why that red flag might be insufficient, Dawkins argues that drives must compete with one other within living beings.

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The most "fit" creature would be the one whose pains are well balanced. Those pains which mean certain death when ignored will become the most powerfully felt. The relative intensities of pain, then, may resemble the relative importance of that risk to our ancestors.

This may have maladaptive results such as supernormal stimuli. The pain perception threshold is the point at which the stimulus begins to hurt, and the pain tolerance threshold is reached when the subject acts to stop the pain.

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Differences in pain perception and tolerance thresholds are associated with, among other factors, ethnicity, genetics, and gender. People of Mediterranean origin report as painful some radiant heat intensities that northern Europeans describe as nonpainful.

And Italian women tolerate a lesser level of intense electric shock than Jewish or Native American women.

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Some individuals in all cultures have significantly higher than normal pain perception and tolerance thresholds. For instance, patients who experience painless heart attacks have higher pain thresholds for electric shock, muscle cramp and heat.

Pain assessmentPain scalesand Pain ladder A person's self-report is the most reliable measure of pain. Quality can be established by having the patient complete the McGill Pain Questionnaire indicating which words best describe their pain. Visual analogue scale The visual analogue scale is a common, reproducible tool in the assessment of pain and pain relief.

When applied as a pain descriptor, these anchors are often 'no pain' and 'worst imaginable pain". Cut-offs for pain classification have been recommended as no pain mmmild pain mmmoderate pain mm and severe pain mm. Pain and dementia and Pain in babies When a person is non-verbal and cannot self-report pain, observation becomes critical, and specific behaviors can be monitored as pain indicators.Cirque du Soleil Crystal A Breakthrough Ice Experience.

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Pain - Wikipedia