1. CLASSIFICATION OFPAIN By: Dr. Vahid Nikoui Email:

2. DEFINITIONS OF PAIN International Association for the Study of Pain (IASP)(WHO)An unpleasant emotional experience associate with actualor potential tissue damage or described in terms of suchdamage. BellThe subjects conscious perception of modulated nociceptive impulses that generate an unpleasant sensory and emotional experiences associated with actual or potential tissue damage or described in terms of such damage. MonheimAn unpleasant emotional experience usually initiated by noxious stimulus and transmitted over a specialized neural network to CNS where it is interpreted as such.2 Mac bryde 3. HISTORICAL NOTE Greek - Poin meaning penalty. Latin -Poena meaning punishment fromGod. Homer - Thought pain was due to arrowsshot by God. Aristotle - was the first to distinguish fivephysical senses, and considered pain to bepassion of the soul . Plato - pain and pleasure arose from withinthe body, an idea that perhaps gave birth to3the concept that pain is an emotionalexperience more than a localized body 4. Nociception Nociception (synonym: nocioception or nociperception) isdefined as "the neural processes of encoding andprocessing noxious stimuli. "Nociceptor A nociceptor is a sensory receptor that responds topotentially damaging stimuli by sending nerve signals tothe spinal cord and brain.Noxious Noxious stimulus, an actually or potentially tissuedamaging event, may be mechanical, chemical orthermal.Algesia Algesia, from the Greek word algesis, is the sensitivity topain. 5. TYPES OF PAIN 1. Based on speed of onset, quality & duration(1) Experimental(2) Transient (3) Acute(4) Chronic1. Experimental: noxious stimuli causes a mild uncomfortable orpainful sensation.2. Transient pain: Short duration Severe5 Self limiting 6. 3. Acute pathological pain: Sharp, fast, pricking Occurs very rapidly Carried by large diameter myelinated A fibers Usually alleviated with the help of professional4. Chronic pathological pain: Burning, aching Gradually increases Carried by small diameter non-myelinated Cfibers Experience of persistent pain that lasts manymonths to years Little apparent cause & not self limiting6 Pain often increases over time & is aggravated by 7. 2.Based on level of stimulation SOMATIC PAINVISCERAL PAINAssociated with skin andAssociate with viscera musculo-skeletal regionand internal organsSuperficial Deep7 8. Inflammatory Pain tissue injuryProstaglandins &Bradykinin Local vasodilatation & Capillary permeabilityNon Inflammatorypain poorly understood Receptor noxiouspsychicstimuli8chronic 9. Referred Pain Referredpain (sometimes referred to asreflective pain) is a term used to describe thephenomenon of pain perceived at a siteadjacent to or at a distance from the site of aninjurys origin. One of the best examples of this is duringischemia brought on by a myocardialinfarction (heart attack) where pain is often feltin the neck, shoulders, and back rather than inthe chest, the site of the injury. 10. SPECIFIC PAINS HeadacheA headache or cephalgia is pain anywhere in theregion of the head or neck. It can be a symptom of anumber of different conditions of the head and neck. 1- Headache of intracranial originMeningitis headache, Migraine, Alcoholicheadache, Headache due to low pressure ofCSF, Constipation headache 2- Headache of extracranial originHeadache due to muscular spasm, Headache due tonasal irritation, Headache due to eye disorders 11. Toothache A toothache, also known as odontalgia or, lessfrequently, as odontalgy, is a pain in or around a tooth.In most cases toothaches are caused by problems inthe tooth or jaw, such as cavities, gum disease, theemergence of wisdom teeth, infected dental pulp, jawdisease, or exposed tooth root. 12. Trigeminal neuralgia Trigeminal neuralgia (TN), Tic Douloureux (alsoknown as prosopalgia, the Suicide Disease orFothergills disease) is a neuropathic disordercharacterized by episodes of intense pain in theface, originating from one of the three trigeminalnerves. It is, "one of the most painful conditions known tohumans, yet remains an enigma to many healthprofessionals." This pain may be felt in the ear, eye, lips, nose,scalp, forehead, cheeks, teeth, and/or jaw; somepatients also experience pain in their left indexfinger. 13. ABNORMAL PAINS Hyperalgesia Hyperalgesia is an increased sensitivity to pain, which may becaused by damage to nociceptors or peripheral nerves. AllodyniaAllodynia, meaning "other pain", is a pain due to a stimuluswhich does not normally provoke pain and can be eitherthermal or mechanical. Hyperpathia Hyperpathia is a clinical symptom of certain neurologicaldisorders wherein nociceptive stimuli evoke exaggeratedlevels of pain. Phantom Limb PainA phantom limb is the sensation that an amputated or missinglimb is still attached to the body and is moving appropriatelywith other body parts. 14. Thanks for YourCompany