Its main manifestations are pain. Pain, pain syndrome: causes, types, diagnosis, treatment. Acute sore throat

Determining the types of pain is necessary to prescribe adequate treatment for the syndrome. The nature of the pain allows us to identify a possible pathology. Localization of pain allows us to determine the location of the pathological lesion. Potential causes of pain are the direction in which the main measures for treating the disease are carried out.

We offer you material that describes the main types of pain.

Pain is a psychophysiological reaction of the body that occurs when the sensitive nerve endings embedded in organs and tissues are severely irritated. This is the oldest defensive reaction in evolutionary terms. It signals trouble and causes the body to respond aimed at eliminating the cause of pain. Pain is one of the earliest symptoms of some diseases.

The following localization of pain in patients occurs:

• Somatic superficial (in case of damage to the skin);
• Somatic deep (with damage to the musculoskeletal system);
• Visceral (if internal organs are damaged).

If the localization of pain does not coincide with the site of injury, the following are distinguished:

• Projected pain (for example, when the spinal roots are compressed, the pain is projected into the areas of the body innervated by them - it “shoots” in the arm, leg, etc.);
• Referred pain (occurs due to damage to internal organs and is localized in distant superficial areas of the body).

For damage to nervous system structures:

Pain that occurs when peripheral nerves are damaged is called neuropathic, and when the structures of the central nervous system are damaged, it is called central.

Nature of pain

When making a diagnosis and choosing a treatment method, it is necessary to determine the nature of the pain.

Acute pain- this is a new, recent pain, inextricably linked with the damage that caused it, and, as a rule, is a symptom of some disease. It disappears when the damage is repaired.

Chronic pain often acquires the status of an independent disease and continues for a long period of time even after the cause of acute pain has been eliminated. The most acceptable period for assessing pain as chronic is its duration of more than 3 months.

Types of pain

Types of pain that pharmacists most often encounter in their practice:

Headache(migraine, cluster or cluster headaches, chronic paroxysmal hemicrania and muscle tension headaches; secondary or symptomatic - a consequence of a traumatic brain injury, vascular pathology of the brain, tumors, etc.);

• Pain associated with inflammation of the elements of the musculoskeletal system (joint pain, discogenic radiculitis, myofascial pain, myalgia);
• Abdominal pain (abdominal pain);
• Pain due to injury, dislocations);
• Pain from skin damage (abrasions, burns);
• Toothache and pain after dental procedures;
• Pain due to angina pectoris;
• Menstrual pain;
• Pain in cancer patients.

Causes of pain

Before deciding which pain medications will help and recommending an over-the-counter drug, the pharmacist should ask the following questions:

How long does the pain last and what is its nature (pain for more than 7 days indicates the need for medical intervention)?

What is the likely cause of the pain (for example, muscle and joint pain associated with exercise can be treated with over-the-counter analgesics)?

Can the patient clearly localize and describe the pain (if the pain is difficult to localize, it is more likely reflected in diseases of the internal organs, which requires medical consultation)?

Identifying possible causes of pain is sometimes not easy.

Has the patient been examined for joint diseases?

For pain in the joint: is there swelling, a local increase in temperature, or increased pain when touched? If so, it may be infectious arthritis or rheumatic disease. The use of analgesics in these cases may delay correct diagnosis.

Has the patient previously taken any prescription or over-the-counter medications? This is necessary to know to take into account possible drug interactions, complications of therapy and allergic reactions.

If the patient's condition is not severe and the pain is not a symptom of a more serious condition, over-the-counter medications should be recommended. However, your pharmacist/pharmacist should advise you to consult a doctor when pain lasts more than 7 days or symptoms return after a few days of temporary improvement.

Prescription of painkillers

The sequence of actions of the doctor when prescribing painkillers:

1. The doctor carefully interviews and carefully examines the patient. Determines the effectiveness and duration of previously taken medications, the presence of concomitant diseases and drug complications. The doctor must determine the leading peripheral component of pain (tendon-muscular, neurogenic, etc.), find out the presence of psychosocial and emotional stress precursors of chronic pain syndrome. Analysis of the data obtained will allow you to select the main, patient-specific drug group (non-steroidal anti-inflammatory drugs (NSAIDs), sodium or calcium channel blockers, monoamine reuptake inhibitors, etc.) and draw up a treatment regimen.

2. When prescribing painkillers, the doctor usually adheres to a rational sequence of prescribing painkillers, which means the following:

• Several drugs that support analgesia may be used;
• Using an adequate period of time to evaluate the effectiveness of the drug (possibly several weeks);
• Use of a combination of drugs;
• Prevention of their side effects.

3. Only a doctor can recommend the rational use of medications as a component of complex pain therapy, i.e. prescribe additional sessions of physiotherapy, blockade with local anesthetics, and possibly recommend the use of neurosurgical methods.

Attention: chronic pain! A very serious medical problem is chronic pain - an independent syndrome that develops with progressive diseases and persistent dysfunction of organs and systems, for which etiotropic therapy is insufficiently effective or impossible.

Acute pain

Acute pain plays a protective role and helps maintain vital functions. It signals damage, which helps the body protect itself from further injury. Acute pain optimizes behavior to promote wound healing (eg, restoring or immobilizing the injured limb). Thus, it has a protective value for the body. Special care is required for acute pain.

Chronic pain

Chronic pain (more than 6 months), unlike acute pain, lacks a signaling and protective function and does not contribute to optimizing the patient’s behavior aimed at healing the injury. Chronic pain becomes an independent painful condition, as it leads to mental exhaustion and social maladjustment. The patient may experience irritability, weakness, a narrowing of interests and decreased social activity. Treatment of chronic pain requires a preliminary examination of the patient and identification of the causes of this syndrome.

The significance of chronic pain is determined not only by the severe suffering of patients who experience this painful symptom for a long time, which inevitably leads to physical and social maladjustment. But - this is no longer in doubt - chronic pain is an independent factor that significantly worsens life prognosis.

Note to the pharmacist

Treatment of chronic pain is an extremely difficult challenge for a doctor. Physician-patient interactions must include many factors: pain management, stress reduction, resumption of normal activities, return to professional status. Often, chronic pain therapy requires the participation of several specialists, but for the result to be successful, it is necessary that the patient is also interested in success.

Counseling a visitor with chronic pain

Typically, customers with chronic pain are frequent visitors to the pharmacy. Unfortunately, counseling such visitors presents some difficulties, since long-term pain syndrome turns healthy and strong people into neurasthenics, distrustful, suspicious and very dependent on the doctor. Although a visitor with chronic pain typically fills a prescription, the involvement of a pharmacist certainly has a positive effect on the correct administration of medications. To do this, the patient and the pharmacist must establish friendly contact, i.e. the latter must have good communication skills, even despite the negative changes in the former's character caused by chronic pain.

Irritability with pain

Effective visitor-pharmacist relationships are possible if the latter is able to be a source of understandable information. It is necessary to understand that the patient may experience irritability during pain, which depletes his mental and adaptive strength.

The pharmacist must eliminate barriers in communication with the patient related to his educational, socioeconomic and cultural level, interests and habits. In addition, the patient must be assured of the strict confidentiality of all information discussed with the pharmacist.

The pharmacist should first determine the patient’s level of awareness. When communicating, you must use words that are easy to understand and avoid complex medical terms.

Effective communication occurs when the recipient of information hears and understands what is being communicated. This can be achieved through the method of “active listening”. Irritability during pain can be controlled with mild sedatives.

Do not forget that pain exhausts the patient not only physically, but also mentally. A patient with chronic pain is focused only on his own body, so you should not initiate a conflict with it yourself. Remember that according to the Code of Ethics, “the primary responsibility of a pharmacist is to look after the welfare of each patient and to place his interests above his own interests.”

The vast majority of diseases are accompanied by pain. Pain is an unpleasant painful feeling associated with one or another tissue damage. Pain is one of the main, most common and leading symptoms that force the patient to seek medical help from various medical specialists.

Pain is not just a symptom of a disease, it is a complex complex of pathological reactions and sensations of the patient.

Having arisen as a defensive reaction to pathological stimuli, pain is a signal of trouble and makes us understand that the body is in some kind of danger. When experiencing pain, a person immediately tries to find a way to overcome these negative sensations and stop the pain. Thus, pain as a symptom is always a marker of some health problem. Pain, even minor pain, cannot be ignored and its symptoms cannot be ignored. Unfortunately, there are diseases that do not always manifest as pain at an early stage. But in this case, you can almost always look for other, equally important signs of the disease and consult a doctor.

For an objective assessment of pain, specially developed scales are used, with the help of which, when interviewing a patient, the intensity and severity of the pain syndrome can be clarified. The degree of pain is not always directly proportional to the severity of the sufferer’s condition, although such a dependence certainly exists.

To assess the intensity of pain, there is a visual technique based on the patient’s assessment of the pain scale using a ten-point system. Numbers from 0 to 10 sequentially represent the transition from mild, to moderate, and finally to severe pain. Moreover, the number “10” on the scale means unbearable pain that is impossible to endure. The patient is asked to show on the scale the number that corresponds to his sensations of pain. The patient's assessment of pain intensity may vary depending on the effectiveness of treatment after taking an analgesic drug.

Another method for assessing pain uses the “pain tolerance” scale. Thus, “mild pain” is assessed as pain that can be ignored. “Severe pain” impairs a person’s basic needs, “unbearable pain” forces the patient to be on bed rest. Pain sensations may vary significantly among different patients.

Causes and types of pain syndrome

Throughout life, a person encounters pain. There are many reasons for the occurrence of pain, since the vast majority of ailments, among other symptoms, are accompanied by pain.

The pain can be acute or chronic. Acute pain is a pain syndrome that lasts less than three months. Accordingly, the pain syndrome becomes chronic if its duration extends beyond this time interval. Acute pain can be relieved after the cause of it is eliminated, or it can become chronic.

An acute, difficult situation is not always accompanied by acute, severe pain, so the manifestations of pain should always be assessed simultaneously with other complaints and symptoms of the disease.

Chronic pain is accompanied by anxiety, depressive symptoms, hypochondria, restlessness, indifference to other problems, and a person’s personality changes. Chronic pain syndrome often occurs with cancer (acute pain is also possible), chronic rheumatic processes in the joints and connective tissue, in the spine and other diseases. In patients with chronic pain, sleep and appetite are disturbed, the range of interests is narrowed, and everything becomes subordinate to pain. There is a dependence of a person with pain syndrome on others, on pain and taking medications.

Acute and chronic pain can vary in intensity (from mild pain to unbearable excruciating pain). Pain syndrome may differ in origin and have a different mechanism of development.

Acute and chronic pain can accompany and be a symptom of diseases of the joints and internal organs. Pain can occur with painful spasms and inflammatory processes of any localization, with increased pressure and spasm in a hollow organ, with tissue swelling, the impact of a pathological process directly on a sensitive nerve fiber, and so on. There are many causes of pain, but all types of pain can be divided into the following several types.

Nociceptive pain

Nociceptive pain is a pain syndrome that occurs when exposed to painful stimuli that affect pain receptors. For example, this type of pain is observed in various inflammatory processes, traumatic injuries, bruises, swelling of tissues and organs, sprains and tissue ruptures.

With decreased blood circulation in the organ, hypoxia, and dysmetabolic changes in surrounding tissues, nociceptive pain also occurs. As a rule, nociceptive pain can be clearly localized. The pain can radiate, that is, go to other places.

Nociceptive pain is observed in various inflammatory diseases of the joints (arthritis, arthrosis), muscles, ligaments, muscle spasms, and in the postoperative period. The listed types of pain are classified as somatic pain.

If pain impulses come from the internal organs (heart, gastrointestinal tract), then such pain is called visceral. In this case, the nerve fiber itself is not damaged, and pain is perceived by a sensitive neuron, which is affected by damaging factors. Examples of visceral nociceptive pain can be sore throat, pain during exacerbation of a peptic ulcer, pain during biliary and renal colic, pain due to insufficient blood circulation in the affected limb.

The mechanism of development of nociceptive pain is due to the fact that due to damage to cells and tissues, a large number of special substances (pain mediators) are formed, which cause a painful unpleasant sensation called pain. These biological substances include bradykinin, prostaglandins, histamine and acetylcholine. In addition, during inflammation, protective blood cells of the leukocyte series (leukocytes, lymphocytes) rush to the pathological focus, additionally releasing inflammatory factors into the surrounding tissues. This contributes to an even greater pain response and degree of pain.

Complaints of patients with nociceptive pain are of the nature of cutting, pressing, shooting pain. Often this pain is perceived as throbbing, squeezing, stabbing, aching, sawing. After the cessation of the pathological effect that led to pain, pain tends to quickly fade and stop. The intensity of pain may increase with movements, turns, and changes in body position. And vice versa, as a rule, the pain syndrome (with nociceptive pain) decreases somewhat at rest (not always).

Another type of pain syndrome is neuropathic pain.

Neuropathic pain

Neuropathic pain is mediated by the damaging effects of various factors directly on the functional units of the peripheral and central (spinal cord and brain) nervous systems. At the same time, the possibility of pathological excitation of nerve cells sharply increases, which can lead to the fact that various non-painful stimuli are perceived as pain. This type of pain is not protective, but at the same time, it brings numerous suffering to patients and sharply reduces the level of quality of life of the sick person. As a rule, this pain is long-lasting and chronic.

Neuropathic pain is perceived by patients as a feeling of painful tingling, burning unbearable pain, or a sensation of needles or injections, “as if struck by an electric shock.” In some patients, neuropathic pain is of a drilling, shooting, burning nature, and can disturb during the day and at night. Often the pain is accompanied by a crawling sensation, paresthesia, numbness, and burning. Often, neuropathic pain is accompanied by a feeling of cold or heat; there may be sensations like being struck by nettles. Neuropathic pain syndrome may occur after herpes zoster ( depriving), due to compression of an area of ​​the spinal cord, with neuropathy as a result of chronic hyperglycemia (diabetes mellitus of both types). Postherpetic neuropathic pain (after suffering from herpes zoster) can bother the patient for several months or more, when the blistering rash is no longer detectable.

Neuropathic pain is often combined with impaired sensory functions and an increased pain threshold.

Neuropathic pain is classified into two types.

Neuropathic pain of the peripheral type is formed with various neuralgia, polyneuropathies, neuritis, damage to nerve trunks due to tunnel syndromes (compression of the nerve trunk in natural anatomical formations), neuropathies of various origins, herpes zoster.

Neuropathic pain that develops after an acute cerebrovascular accident, with multiple sclerosis, myelopathy and traumatic lesions of the spinal cord, is called central.

Another type of pain is dysfunctional pain- pain symptoms associated with impaired sensitivity to pain due to an imbalance between the level of painful stimulus and response to it. In this case, control over pain by the nervous system is disrupted. With this type of pain, “dysfunction” of the central nervous system occurs.

Principles of treatment and diagnosis of pain syndrome

Often, a patient may have pain of both neuropathic and nociceptive origin, since the same person, especially in old age, may have several diseases. It can be quite difficult to understand what type of pain prevails in this case. Therefore, pain treatment should be carried out by a doctor or a team of doctors.

If pain occurs, you should not self-medicate; you must contact a specialist of the appropriate profile. There is no universal medicine that would have the same analgesic effect in all patients.

In addition, approaches to the treatment of acute and chronic pain, therapies and medications used can be completely different.

Both doctors providing emergency care (traumatologists, surgeons, resuscitators) and other specialists (therapists, neurologists, endocrinologists and others) can take part in the treatment of pain syndrome.

When treating pain, it is necessary to find the cause of the disease, and along with correcting the pain syndrome, treat the disease that caused the pain. By taking painkillers without a doctor’s prescription, without affecting the cause of the pain, the disease can progress to a stage that will be difficult, and sometimes impossible, to influence.

Diagnosis of the causes of pain syndrome includes the entire range of necessary tests and studies required in this case, which are prescribed only by a doctor.

Therefore, it is very important to seek the help of a doctor as soon as possible at the first manifestations of pain. Considering the nature and mechanism of development of pain in a given patient, the doctor may prescribe various drugs that have analgesic activity. Currently, painkillers are represented by several groups that affect various parts of the pathogenesis of pain. At the same time, analgesics, which are successfully used in the treatment of nociceptive pain, may be ineffective in neuropathic pain. In some cases, it is possible to use various drugs simultaneously, as prescribed by a doctor.

Thus, the treatment of pain and pain syndrome appears to be a complex task, in the treatment of which doctors of various profiles may be involved. It is important to prevent the transition of acute pain syndrome to chronic, when, despite the possibilities of pharmacotherapy, the patient must constantly take painkillers.

Pain is understood as an adaptive reaction of the body. If unpleasant sensations continue for a long time, then they can be characterized as a pathological process.

The function of pain is that it mobilizes the body’s forces to fight any illness. It is accompanied by the appearance of vegetosomatic reactions and an exacerbation of a person’s psycho-emotional states.

Designations

Pain has several definitions. Let's look at them.

1. Pain is a psychophysical state of a person, which is a reaction to stimuli associated with organic or functional disorders.
2. This word also refers to the unpleasant sensation that a person experiences when experiencing any dysfunction.
3. Pain also has a physical form. It manifests itself due to malfunctions in the body.

From all of the above, we can draw the following conclusion: pain is, on the one hand, the performance of a protective function, and, on the other, a phenomenon that is of a warning nature, namely, it signals an upcoming disorder in the functioning system of the human body.

What is pain? You should know that this is not only physical discomfort, but also emotional experiences. The psychological state may begin to deteriorate due to the presence of pain in the body. Against this background, problems appear in the functioning of other body systems. For example, gastrointestinal disorders, decreased immunity and loss of ability to work. A person’s sleep may also worsen and their appetite may disappear.

Emotional state and pain

In addition to physical manifestations, pain affects the emotional state. A person becomes irritable, apathetic, depressed, aggressive, etc. The patient may develop various mental disorders, sometimes expressed in the desire to die. Strength of spirit is of great importance here. Pain is a test. It happens that a person cannot assess his real condition. He either exaggerates the pain effect, or, conversely, tries to ignore it.

Moral support from relatives or other close people plays an important role in the patient’s condition. It is important how a person feels in society, whether he communicates. It's better if he doesn't withdraw into himself. It is also of great importance to inform the patient about the source of discomfort.

Medical professionals are constantly faced with such feelings in patients, as well as their emotional state. Therefore, the doctor is faced with the task of diagnosing the disease and prescribing a treatment regimen that will have a positive effect on the recovery of the body. The doctor must also see what psychological and emotional experiences the person may be experiencing. The patient needs to be given recommendations that will help him emotionally set himself in the right direction.

What species are known?

Pain is a scientific phenomenon. It has been studied for many centuries.

It is customary to divide pain into physiological and pathological. What does each of them mean?

1. Physiological pain is the body’s reaction, which is carried out through receptors at the site of the appearance of any illness.
2. Pathological pain has two manifestations. It can also be reflected in pain receptors, and can also be expressed in nerve fibers. These pain sensations require longer treatment. Since the psychological state of a person is involved here. The patient may experience depression, anxiety, sadness, and apathy. These conditions affect his communication with other people. The situation is aggravated by the fact that the patient withdraws into himself. This state of a person greatly slows down the healing process. It is important that during treatment the patient has a positive attitude and not a depressive state, which can lead to a deterioration in the person’s condition.

Types

Two types are defined. Namely: acute and chronic pain.

1. Acute refers to damage to body tissue. Then, as you recover, the pain goes away. This species appears abruptly, passes quickly and has a clear source. This pain occurs due to any injury, infection or surgery. With this type of pain, a person’s heart begins to beat quickly, pallor appears and sleep is disturbed. Acute pain occurs due to tissue damage. It goes away quickly after treatment and healing.
2. Chronic pain is a condition of the body in which, as a result of tissue damage or the appearance of a tumor, a pain syndrome appears that lasts for a long time. In this regard, the patient’s condition is aggravated, but the signs that a person suffers from acute pain are not here. This type negatively affects a person’s emotional and psychological state. When pain sensations are present in the body for a long time, the sensitivity of the receptors is dulled. Then the pain is not felt as pronounced as at first. Doctors say that such sensations are a consequence of improper treatment of acute pain.

You should know that untreated pain will have a negative impact on a person’s emotional state in the future. As a result, she will burden his family, relationships with loved ones, and so on. Also, the patient will have to undergo repeated therapy in a medical institution, wasting effort and money. In hospitals, doctors will need to re-treat such a patient. Also, chronic pain will not allow a person to work normally.

Classification

There is a certain classification of pain.

1. Somatic. This pain usually means damage to parts of the body such as skin, muscles, joints and bones. The causes of somatic pain include surgical intervention in the body and bone metastases. This species has permanent characteristics. Typically, the pain is described as gnawing and throbbing.
2. Visceral pain. This type is associated with damage to internal organs such as inflammation, compression and stretching. The pain is usually described as deep and squeezing. It is extremely difficult to accurately determine its source, although it is constant.
3. Neuropathic pain appears due to nerve irritation. It is constant, and it is difficult for the patient to determine the place of its origin. Usually this type of pain is described as sharp, burning, cutting, etc. It is believed that this type of pathology is very serious and the most difficult to cure.

Clinical classification

There are also several clinical categories of pain. These divisions are useful for initial therapy, since their symptoms are then mixed.

1. Nocigenic pain. There are cutaneous nociceptors. When they are damaged, a signal is transmitted to the nervous system. The result is pain. When internal organs are damaged, muscle spasms or strains occur. Then the pain arises. It can affect certain areas of the body, such as the right shoulder or the right side of the neck if the gallbladder is affected. If discomfort appears in the left hand, this indicates heart disease.
2. Neurogenic pain. This type is typical for damage to the central nervous system. It has a large number of clinical types, such as avulsion of branches of the brachial plexus, incomplete damage to the peripheral nerve and others.
3. There are many mixed types of pain. They are present in diabetes, hernia and other diseases.
4. Psychogenic pain. There is an opinion that the patient is formed by pain. Representatives of different ethnic groups have different pain thresholds. Among Europeans it is lower than among Latin Americans. You should know that if a person experiences any pain, it changes his personality. Anxiety may arise. Therefore, the attending physician needs to set the patient in the right mood. In some cases, hypnosis may be used.

Other classification

When the pain does not coincide with the site of injury, there are several types of it:

• Projected. For example, if you compress the spinal roots, pain is projected into the areas of the body innervated by them.
• Referred pain. It appears if internal organs are damaged, then it is localized in distant parts of the body.

What types of pain do babies have?

In a child, pain is most often associated with the ears, head and tummy. The latter hurts quite often in young children, as the digestive system is developing. Colic is common in infancy. Headaches and earaches are usually associated with colds and infections. If the child is healthy, then a pain in the head may indicate that he is hungry. If a child experiences headaches frequently and is accompanied by vomiting, then it is necessary to contact a pediatrician for examination and diagnosis. It is not recommended to delay visiting a doctor.

Pregnancy and pain

Pain during pregnancy in women is a fairly common occurrence. During the period of bearing a baby, the girl constantly experiences discomfort. She may experience pain in different parts of the body. Many people experience abdominal pain during pregnancy. During this period, a woman experiences hormonal changes. Therefore, she may experience feelings of anxiety and discomfort. If your stomach hurts, this may be caused by problems, the nature of which can be determined by a gynecologist. The presence of pain during pregnancy may be associated with fetal movement. When aching pain occurs in the lower abdomen, you need to consult a doctor.

Pain may also occur due to the digestive process. The fetus can put pressure on organs. This is why pain occurs. In any case, it is better to consult a doctor and describe all the symptoms. It should be remembered that pregnancy poses a risk for both the woman and the unborn child. Therefore, it is important to determine what pain is present in the body and describe its semantics to the attending physician.

Unpleasant sensations in the legs

As a rule, this phenomenon occurs with age. In fact, there can be many reasons for pain in the legs. It is better to find out them as early as possible and start treatment. The lower limb includes bones, joints, and muscles. Any ailments of these structures can cause pain in a person.

If a person is healthy, then pain in the legs can occur from heavy physical activity. As a rule, this is associated with playing sports, standing for long periods of time or walking for a long time. As for the fair sex, pain in the legs can accompany a woman during pregnancy. Also, unpleasant sensations may arise as a result of taking contraceptives of a certain group. The most common causes of leg pain are:

1. Various injuries.
2. Radiculitis, neuritis.
3. Inflammatory processes.
4. Flat feet and arthrosis.
5. Violation of water-salt metabolism in the body.

There are also vascular pathologies in the legs that cause pain. The person himself cannot discern what is causing the discomfort. He doesn't even know which specialist he needs to contact. The doctor’s task is to accurately diagnose and prescribe an effective treatment regimen.

How is a patient who complains of leg pain diagnosed?

Since there are a great many reasons for the occurrence of unpleasant sensations in the legs, it is necessary to identify the relevant one in each specific case. To do this, a series of examinations should be carried out.

1. Blood chemistry.
2. The patient is prescribed a general blood test.
3. An assessment of water and electrolyte disturbances is carried out.
4. X-ray.
5. The amount of glucose that is present in the blood is assessed.
6. Microbiological examination.
7. Examination of the patient with tumor markers if there is a suspicion of cancer.
8. Serological study.
9. Bone biopsy if there is a possibility that bone tuberculosis is present in the body.
10. Ultrasound scanning.
11. Vascular angiography is done to confirm venous insufficiency.
12. Tomography.
13. Rheovasography.
14. Scintigraphy.
15. Ankle pressure index.

It should be understood that a person who comes to the clinic with complaints of pain in the legs will not be prescribed all of the above types of examinations. First, the patient will be examined. Then, to confirm or refute this or that diagnosis, certain studies will be prescribed.

Women's pain

A woman may experience pain in the lower abdomen. If they occur during menstruation and are of a pulling nature, then there is no need to worry. This kind of phenomenon is the norm. But if the lower abdomen constantly pulls and there is discharge, you need to consult a doctor. The causes of these symptoms may be more serious than period pain. What can cause pain in the lower abdomen in women? Let's consider the main pathologies and causes of pain:

1. Ailments of female organs such as the uterus and ovaries.
2. Infections that are sexually transmitted.
3. Pain may occur due to the coil.
4. After surgery, scars may form in the female body, which cause pain.
5. Inflammatory processes associated with kidney and bladder diseases.
6. Pathological processes that may occur during pregnancy.
7. Some women experience pain during ovulation. This is due to the process of the follicle rupturing and leaving the egg.
8. Pain can also occur due to the bending of the uterus, resulting in stagnation of blood during menstruation.

In any case, if the pain is constant, then you need to visit a doctor. He will conduct an examination and prescribe the necessary examinations.

Side pain

Quite often people complain of pain in their side. In order to determine why exactly a person is bothered by such unpleasant sensations, it is necessary to accurately determine their source. If pain is present in the right or left hypochondrium, this indicates that the person has diseases of the stomach, duodenum, liver, pancreas or spleen. Also, pain in the upper lateral part may indicate a rib fracture or osteochondrosis of the spine.

If they occur in the middle part of the lateral regions of the body, this indicates that the large intestine is being damaged.

Pain in the lower sections, as a rule, occurs due to ailments of the final section of the small intestine, ureters and ovarian diseases in women.

What causes a sore throat?

There are several reasons for this phenomenon. A sore throat is present if a person has pharyngitis. What kind of illness is this? Inflammation of the back of the throat. A severe sore throat may be due to a sore throat or tonsillitis. These ailments are associated with inflammation of the tonsils, which are located on the sides. The disease is often observed in childhood. In addition to the above, the cause of such sensations can be laryngitis. With this disease, a person's voice becomes hoarse and hoarse.

Dental

A toothache can occur unexpectedly and take a person by surprise. The easiest way to get rid of it is to take a painkiller. But you should remember that taking the pill is a temporary measure. Therefore, you should not postpone your visit to the dentist. The doctor will examine the tooth. Then he will prescribe a photo and carry out the necessary treatment. There is no point in quenching dental pain with painkillers. If you experience any discomfort, you should immediately contact your dentist.

A tooth can begin to hurt for various reasons. For example, pulpitis can become a source of pain. It is important not to neglect the tooth, but to treat it in time, since if medical assistance is not provided in time, its condition will worsen and there is a possibility of tooth loss.

Unpleasant sensations in the back

Most often, back pain occurs due to problems with the muscles or spine. If the lower part hurts, then perhaps this is due to ailments of the bone tissue of the spine, ligaments of the spinal discs, spinal cord, muscles, etc. The upper part can be disturbing due to diseases of the aorta, tumors in the chest and inflammatory processes in the spine.

The most common cause of back pain is disorders of the muscles and skeleton. As a rule, this occurs after exposure to heavy loads on the back, when the ligaments are sprained or spasmed. Intervertebral hernias are less common. In third place in terms of frequency of diagnosis are inflammatory processes and tumors in the spine. Also, diseases of the internal organs can cause discomfort. The choice of treatment methods for back pain depends on the causes of its occurrence. Drugs are prescribed after examining the patient.

Heart

If a patient complains of pain in the heart, this does not mean that there is a heart pathology in the body. The reason may be completely different. The doctor needs to find out what the essence of the pain is.

If the cause is cardiac in nature, then most often they are associated with coronary heart disease. When a person has this disease, the coronary vessels are affected. In addition, the cause of pain can be inflammatory processes that occur in the heart.

This organ can also begin to hurt as a result of excessive physical exertion. This usually occurs after strenuous training. The fact is that the greater the load on the heart, the more rapidly its need for oxygen increases. If a person is actively involved in sports, he may experience pain that disappears after rest. If heart pain does not go away for a long time, then you need to reconsider the loads that the athlete puts on the body. Or it’s worth restructuring the training process plan. Signs that you need to do this include a rapid heartbeat, shortness of breath, and numbness in your left arm.

A little conclusion

Now you know what pain is, we have looked at its main types and types. The article also presents classifications of unpleasant sensations. We hope that the information presented here was interesting and useful to you.

Alexey Paramonov

Pain is an ancient mechanism that allows multicellular creatures to detect tissue damage and take measures to protect the body. Emotions play a big role in understanding pain. Even the intensity of ordinary physiological pain largely depends on a person’s emotional perception - some people can hardly bear the discomfort of minor scratches, while others can easily have their teeth treated without anesthesia. Despite the fact that thousands of studies have been devoted to the study of this phenomenon, there is no complete understanding of such a relationship yet. Traditionally, a neurologist determines the pain threshold using a blunt needle, but this method does not provide an objective picture.

The pain threshold - its “height” - depends on several factors:

• genetic factor - there are “hypersensitive” and “insensitive” families;
• psychological status - the presence of anxiety, depression and other mental disorders;
• previous experience - if the patient has already experienced pain in a similar situation, then next time he will perceive it more acutely;
• various diseases - if it increases the pain threshold, then some neurological diseases, on the contrary, lower it.

Important point: everything said above concerns only physiological pain. The complaint “it hurts everywhere” is an example of pathological pain. Such conditions can be either a manifestation of depression and chronic anxiety, or a consequence of problems indirectly related to them (the most suitable example is this).

One of the most important classifications of pain is by its type. The fact is that each type has specific signs and is characteristic of a certain group of pathological conditions. Having established the type of pain, the doctor can reject some of the possible diagnoses and formulate a reasonable examination plan.

This classification divides pain into nociceptive, neuropathic and psychogenic.

Nociceptive pain

Typically, nociceptive pain is an acute physiological pain that signals injury or illness. It has a warning function. As a rule, its source is clearly defined - pain in the muscles and bones during a bruise, pain during suppuration (abscess) of the subcutaneous tissue. There is also a visceral version of nociceptive pain, its source is the internal organs. Despite the fact that visceral pain is not so clearly localized, each organ has its own “pain profile.” Depending on the location and conditions of occurrence, the doctor determines the cause of the pain. Thus, heart pain can spread to half of the chest, radiating to the arm, shoulder blade and jaw. If such symptoms are present, the doctor will first rule out cardiac pathologies.

In addition, the conditions under which pain occurs are also important. If it occurs when walking and stops while stopping, this is a significant argument in favor of its cardiac origin. If similar pain occurs when a person is lying or sitting, but as soon as he gets up, it goes away - the doctor will think about the esophagus and its inflammation. In any case, nociceptive pain is an important clue when searching for an organic disease (inflammation, tumor, abscess, ulcer).

This type of pain can be described as “aching”, “pressing”, “bursting”, “wavy” or “cramping”.

Neuropathic pain

Neuropathic pain is associated with damage to the nervous system itself, and with damage at any level - from peripheral nerves to the brain. Such pain is characterized by the absence of obvious disease outside the nervous system - it is usually called “piercing”, “cutting”, “stabbing”, “burning”. Neuropathic pain is often combined with sensory, motor and autonomic disorders of the nervous system.

Depending on the damage to the nervous system, pain can manifest itself on the periphery in the form of a burning sensation and a feeling of cold in the legs (with diabetes, alcoholism) and at any level of the spinal column with spread to the chest, the anterior wall of the abdomen and limbs (with radiculitis). In addition, pain can be a sign of damage to one nerve (trigeminal neuralgia, postherpetic neuralgia) or create a complex palette of neurological symptoms if the pathways in the spinal cord and brain are damaged.

Psychogenic pain

Psychogenic pain occurs in various mental disorders (for example, depression). They can imitate a disease of any organ, but unlike a true disease, the complaints are characterized by unusual intensity and monotony - the pain can last continuously for many hours, days, months and years. The patient describes this condition as “excruciating” and “debilitating”. Sometimes painful sensations can reach such severity that a person is hospitalized with suspicion of myocardial infarction or acute appendicitis. The exclusion of an organic disease and a multi-month/long-term history of pain is a sign of its psychogenic nature.

How to cope with pain

Initially, nociceptive receptors react to injury, but after a while, if the irritation is not repeated, the signal from them subsides. At the same time, the antinociceptive system is activated, which suppresses pain - the brain thus reports that it has received enough information about the event. In the acute phase of injury, if the excitation of nociceptive receptors is excessive, opioid analgesics best relieve pain.

2-3 days after the injury, the pain intensifies again, but this time due to swelling, inflammation and the production of inflammatory substances - prostaglandins. In this case, effective nonsteroidal anti-inflammatory drugs - ibuprofen, diclofenac. As the wound heals, if a nerve is involved, neuropathic pain may occur. Neuropathic pain is poorly controlled by non-steroidal media and opioids, the optimal solution for it is anticonvulsants (such as pregabalin) and some antidepressants However, acute and chronic pain almost always indicate pathology or injury. Chronic pain can be associated with a persistent organic disease, such as a growing tumor, but most often the original source is no longer there - the pain maintains itself through the mechanism of a pathological reflex. An excellent model of self-sustaining chronic pain is myofascial pain syndrome - chronic muscle spasm provokes pain, which, in turn, increases muscle spasm.

We often experience pain and there is no need to see a doctor every time, especially if the pain is already known - we know its cause and know how to cope with it. In case of new pain, when a person does not understand its nature, or pain accompanied by alarming symptoms (nausea, diarrhea, constipation, shortness of breath, fluctuations in pressure and body temperature), you need to consult a specialist. Sometimes, in order to get rid of painful sensations, it is enough to select a painkiller and teach the person to avoid the causes of pain, for example, to avoid physical inactivity in case of myofascial syndrome.

If the acute pain goes away quickly, and you understand its cause, then there is no need to go to the doctor. But keep in mind: sometimes - after a “bright” interval - one type of pain can be replaced by another (as happens with appendicitis).

First of all, ibuprofen and paracetamol are available over-the-counter; they allow you to cope with occasional pain that does not threaten complications (in the head, back, after minor injuries and during painful menstruation). But if these drugs do not help within five days, you should consult a doctor.