younger groups, although reported pain intensity scores remained similar (Glover et al., 2014). I wonder why in the older individual, their pain perception decreases or their pain threshold increases? Paladini, Fusco, Coaccioli, Skaper, and Varrassi (2015) report biochemical and structural changes with aging primarily involving A-delta fibers (Aδ). C fibers are the large myelinated nerve cells. Aδ fibers are the nerve cells which deliver fast, localized sharp pain messages to the somatosensory cortex (Huether, & McCance, 2017). The biochemical and structural changes is an explanation pain threshold increases with age while the threshold of pain tolerance remains unchanged or decreases. References Glover, T., Yao, Y., Ezenwa, M., Suarez, M., Wang, J., Molokie, R, Brown, J., Wilkie, D. (2014). Pain intensity, symptom distress, and number of comorbidities differ by age groups among hospice patients with cancer (s731). Journal of Pain and Symptom Management. 53 (02), 426 - 427 Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby. Paladini, A., Fusco, M., Coaccioli, S., Skaper, S. D., & Varrassi, G. (2015). Chronic pain in the elderly: The case for new therapeutic strategies. Pain Physician , 18 (5), E863-E876. Glenda Carter
WEEKLY DISCUSSIONS 9 Pathophysiology of Acute, Chronic and Referred Pain Pain is one of the body's most important adaptive and protective mechanisms, and all definitions suggest it is a complex's phenomenon and cannot be characterized as an only response to injury (Rodriguez, 2015). It is a sensation that alerts a person that tissue or a particular part of the human body has been injured or damaged (Huether & McCance, 2017). Acute pain Acute pain begins suddenly and is relieved after the chemical mediators that stimulate pain receptors are removed. The initiation of pain in the body system starts with stimulation of the peripheral nervous system. This leads into unpleasant sensations within the neurologic system. The nerves that constitute the peripheral nervous system – transmit these impulses to the central nervous system (the brain and spinal cord) so that these impulses are interpreted and perceived as sensations. The peripheral nerves send signals to the dorsal horn of the spinal cord, and from there the sensory signals are transmitted to the brain through the spinothalamic tract (Huether & McCance, 2017). Chronic Pain Chronic pain is pain that is ongoing and usually lasts longer than six months and lasting even after healing has taken place. Nociceptors not only signal acute pain but when sensitized, contribute to the pathophysiological framework of chronic pain. The nociceptive transmission occurs within the dorsal horn and causes the manifestation of pain within an individual's neurologic system (Huether & McCance, 2017). Under normal circumstances, the nociceptive sensory system returns to a normal functional state as soon as healing takes place. But many features of sensitization persist and are manifest as chronic pain and hyperalgesia, especially when the nervous system itself is injured leading to chronic pain (Huether & McCance, 2017).
- Fall '17
- keisha lovence