Pain: physiologic mechanisms used in physical therapy

 Skjoerboek, I. (1994). Torture Quarterly, Suppl. 1, 33-35.
 
This article was reviewed by Angela Pitar, doctoral physical therapy student at the University of Minnesota, 2014. 
 
The link to the article from the Dignity-Danish Institute Against Torture, is below.
 
Background - the definition of pain is an unpleasant sensory and emotional experience associated with the actual or potential tissue damage, or described by the patient in terms of such damage. Detailed descriptions of mechanisms of pain and treatment implications are made.
 
Physiology of pain - the perception of pain is either affected by the nociceptors situated in our tissues, through the A-delta or C fibers, respectfully, as a noxious signal extrinsic to the nervous tissue; or it can arise as the result of functional with/without structural disturbances inside the nervous tissue itself.
Pain modulation - the pain modulatory mechanisms are of interest to us and the limbic system plays an important role in this.
endogenous opioids-work by preventing the information of pain from getting to the limbic system and has a descending pain suppression mechanism
stimulation produced analgesia-electrical stimulation modalities work on the premise that they have to provoke some pain/discomfort to stimulate the production of endogenous opioids (so these modalities are sometimes avoided in victims of torture).
Three sequential types of pain -
  1. nociception- the acute pain, with/without tissue damage              
  2. inflammation-the vital response of tissues to an injury or infection
  3. chronic pain-persisting, ongoing pain.
2 important factors for the comprehension of pain arising from intrinsic factors -
  1. nourishment of the nerve cells and their tissues: the nervous tissue requires oxygen in order to send impulses
  2. denervation/disuse supersensitivity: when biological tissues are deprived of trophic factor, they atrophy and become hypersensitive
 

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