Pain & Analgesia: The importance of pain! (Includes Pain Medications)

Pain is a vital sense in our body, it's an obvious indicator that one person is alive, and it's a normal phenomenon when a person reacts to a stimulus that causes pain.

image source:(https://www.wired.com/2017/04/the-cure-for-pain/)

Now, I am going to discuss to you about the nature of pain, and how some pain medication works.

Pain actually is a response to a traumatizing stimuli that causes specific pain nerves that travel impulses to the spinal cord then to the brain, leading to the response of the brain to let the person withdraw from the cause of the stimuli.

Painlessness an advantage or a disadvantage?

Now there are abnormal cases where in some people do not experience pain at all, one example of that is congenital insensitivity, in which from birth the condition already is existent. This is caused by massive amount of ENDORPHINE(a natural analgesic within the body). It could also be caused by a damage to the pituitary gland that would lead to mass production of endorphine.

It's really comforting not feeling the pain, and you could say that all your life you can't feel any discomfort no matter what position you are in, or whatsoever. But having that kind of advantage is not enough when it is compared to the disadvantage brought by not feeling pain at all.

Why is not feeling pain dangerous?

As I have said earlier the response to pain actually is the withdrawal to the cause of the stimuli, then if the person is not feeling the sensation after all then a tissue damage may result. For example, if a person with such kind of condition touches a hot kettle then that person will assume that it's not hot after all, cause he is not feeling the sensation of heat which is producing the stimuli to cause pain, then that person will not withdraw his hands from touching the said object. But the problem does not end there, there are also cases where in burns, and lacerations are unnoticeable and because it cannot be noticed, so the person will not be able to treat it, the wound is basically neglected, and if not treated healing will be slow, and there is a huge possibility of having an infection.

Internal damages are also dangerous, in which if there are any internal tissue damage that happened then the normal response of the person is irritability to the presence of internal pain, but with the absence of pain, which happens to be an early sign to any internal tissue damage, then it would be difficult to track or diagnose certain diseases early, which would cause severity and complication of diseases.

So basically pain is essential, we have to be thankful for it.

Painfulness an advantage or disadvantage

Let's site first a disease where in extreme sensitivity to a specific stimulus cause extreme pain.
Trigeminal Neuralgia, a damage to the fifth cranial nerve which is the trigeminal nerve, responsible for sensory and motor function of the face. If damaged, it causes severe attacks of pain in the face and even inside the mouth, it's very painful that even a wind blow can cause massive amount of painfulness.

I can't really say that there is an advantage to it, because, even if an object is not pain producing, as long as part of your face is in contact to it, discomfort is really an expected outcome.

Why is hypersensitivity to pain dangerous?

It's dangerous because it makes a person become irritable, which excites the person leading to increase the pulse, and blood pressure of a person. People with heart diseases and hypertension, would surely suffer the effects of hypersensitivity to pain. leading to hypertensive crisis or heart attack.

it could also affect the social status of a person, in which, if not understood, would lead into conflicts. Because of the extreme pain felt by the person in response to any stimuli, then a person can become irritable, to the point that everyone surrounding him or her becomes a nuisance.

so don't ask for this one too, you can't get anything good from this.

Common Pain Medications and their Actions

Image Link/source(https://www.madamasr.com/en/2017/01/13/news/u/health-ministry-increases-price-of-over-3000-medicines/)

Analgesic
Acetaminophen or Paracetamol

Brand names: (Panadol, Tylenol, Biogesic)
Causes analgesia by inhibiting Central Nervous System PROSTAGLANDIN(a lipid compound that controls the inflammation of a damaged organ that would lead to the production of pain) synthesis, but due to less effect on Peripheral Nervous System PROSTAGLANDIN synthesis, then this drug has no anti-inflammatory effect.

Non-steroidal Anti-inflammatory Drugs or NSAIDs

The anti-inflammatory effect is likely due to inhibition of the enzyme cyclo-oxygenase (COX). There are two COX isoenzymes: COX-1 and COX-2. depending on the NSAID, either COX-1 or COX-2 or both enzymes maybe inhibited. Inhibition of COX results in decrease PROSTAGLANDIN synthesis.

Ibuprofen

(Advil, Advil Liqui-gels, Menadol)

Celecoxib

Brand names: (Celebrex)

Ketorolac

Brand names: (Acular, Toradol)

Indomethacin

Brand names: (Indochron, Indocin)

Other Examples:
Diclofenac potassium
Diclofenac sodium
Diflunisal
Etodolac
Feneprofen calcium
Flurbiprofen
Flurbiprofen sodium
Indomethacin sodium trihydrate
Ketoprofen
Ketorolac tromethamine
Meloxicam
Nabumetone
Naproxen
Naproxen sodium
Oxaprozin
Piroxicam
Sulindac
Tolmetin sodium

Narcotic Analgesic or Opioid Analgesic

Attaches to specific receptors located in the Central Nervous System (cortex, brain stem, and spinal cord) resulting to various CNS effects. The mechanism is believed to involve decreased permeability of the cell membrane to sodium, which results in diminished transmission of pain impulses.

Hydromorphone Hydrochloride

Brand names: (Dilaudid)

Codeine Sulfate

Brand names: (Codeine)

Morhpine Sulphate

Brand names: (Astamorph PF, Avinza, Depo-Dur, Duramorph, Oramorph, Roxanol)

Other examples:
Alfentanil hydrochloride
Buprenorphine hydrochloride
Butorphanol tartrate
Fentanyl Citrate
Fentanyl transdermal system
Hydrocodone bitartate with acetaminophen
Meperidine hydrochloride
Methadone hydrochloride
Oxycodone hydrochloride
Paregoric
Propoxyphene hydrochloride
Propoxyphene napsylate
Remifentanil hydrochloride
Sufentanil
Tramadol hydrochloride

Analgesics, NSAIDs, and Narcotics do give comfort to people who suffer from any kind of pain, but we also have to know the different side-effects and adverse-effects of these drugs. The use of these drugs varies from the origin, and severity of the pain. Analgesic is less potent good for mild pain, NSAID's are moderately potent good for mild to moderate pain, and lastly Narcotics are strongly potent good for sever pain. But before medication yourself, if you are suffering from any kind of pain, then I recommend you to see a Physician.

There are also Physical therapies, Image guiding therapies, and herbal medicines that are also capable of minimizing pain, but I won't discuss it here, but to the next "Pain and Analgesia" series which will have a sub-title of Alternative pain measures.

I hope I have given you some ideas on how important pain is.

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