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Related Concept Videos

Nociception01:44

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Nociception—the ability to feel pain—is essential for an organism’s survival and overall well-being. Noxious stimuli such as piercing pain from a sharp object, heat from an open flame, or contact with corrosive chemicals are first detected by sensory receptors, called nociceptors, located on nerve endings. Nociceptors express ion channels that convert noxious stimuli into electrical signals. When these signals reach the brain via sensory neurons, they are perceived as pain.
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Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
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Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Blood and Nerve Supply to the Bones01:29

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Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
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Sensory impulses related to touch, pressure, vibration, and proprioception from various body parts, such as the limbs, trunk, neck, and posterior head, travel to the cerebral cortex through the posterior column-medial lemniscus pathway. The pathway’s name derives from the two white-matter tracts that convey the impulses: the spinal cord's posterior column and the brainstem's medial lemniscus. First-order sensory neurons extend their axons into the spinal cord, forming the...
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Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management
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Neuropathic Pain.

Janne Gierthmühlen1, Ralf Baron1

  • 1Division of Neurological Pain Research and Therapy, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany.

Seminars in Neurology
|October 6, 2016
PubMed
Summary
This summary is machine-generated.

Accurate diagnosis of neuropathic pain is crucial for effective treatment. While clinical findings guide diagnosis, further tests and individualized, mechanism-based treatments are needed, alongside more research on neurostimulation for chronic pain.

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Area of Science:

  • Neurology
  • Pain Medicine

Background:

  • Distinguishing neuropathic pain from nociceptive pain is clinically challenging but essential for appropriate treatment.
  • Neuropathic pain diagnosis relies heavily on clinical assessment, including patient history and characteristic signs.

Purpose of the Study:

  • To highlight the importance of accurate neuropathic pain diagnosis and discuss current diagnostic and therapeutic strategies.
  • To emphasize the need for individualized, mechanism-based treatment approaches for neuropathic pain.

Main Methods:

  • Clinical history taking and physical examination focusing on neuropathic pain signs.
  • Review of supportive diagnostic tools such as imaging, electrophysiological tests, and skin biopsy.
  • Analysis of current first-line pharmacological treatments and emerging neurostimulation techniques.

Main Results:

  • Clinical findings are primary for diagnosing neuropathic pain; supportive tests can aid confirmation.
  • First-line treatments include calcium-channel modulators (pregabalin, gabapentin) and certain antidepressants (TCAs, SNRIs like duloxetine, venlafaxine).
  • Evidence for long-term effectiveness and safety of neurostimulation for chronic pain is limited, necessitating further randomized controlled trials.

Conclusions:

  • Accurate clinical diagnosis is paramount for effective neuropathic pain management.
  • Current treatments, while established, are often not precisely individualized.
  • Further research, particularly large randomized controlled trials, is required to validate advanced treatments like neurostimulation for chronic neuropathic pain.