Pain price of a few calories but failure

Pain is a combination of nervous stimulation
and emotional feeling. The body over periods of time has gained adaptive
advantages of pain, in particular, the body being able to send signals to the
brain indicating that there indeed is an issue that needs to be handled inside
of the body or the reaction to an outside simulation of pain. The body itself endures
two types of pain: nociceptive and neuropathic. Pain is often classified by the
duration of pain under the categories of acute or chronic pain. People feel
pain in different thresholds and have different tolerances of pain. The
management of pain is becoming more non-traditional as people are finding more
relief in the non-traditional methods rather that the traditional pill
cocktails and injections. In a wide variety of states people are leaning
towards the on-traditional use of medicinal marijuana for pain relief. The
marijuana acts as a sedative to bring the people suffering some sort of control
and relief when it comes to long-term pain management.

How Does It Feel? : Pain Paper Perplex

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Pain has evolved in
many ways one being the ability to respond to pain in a way that is safe for
survival. Pain is a trait by natural selection. Little is known whether it was
because of random variation, selected for survival, or a byproduct of another
trait. However, it is known that those who don’t feel pain have a shorter life
expectancy. They fail to realize they are experiencing discomfort inside the
body. This discomfort limits the blood supply to that area thus leading to
death by tissue damage or infection. The body has evolved in such a way that
when it experiences abnormalities inside the body, it comes up with a defense
mechanism. For instance, when there are toxins in the stomach that are
unfamiliar to the body it will cause one to vomit. The false alarm set off in
the body is at the price of a few calories but failure for the alarm to go off
in the presence of a real threat can result in death. Reports by Acerbi and
Parisi (n.d.) suggest:

inputs from inside the body, unlike inputs from the
external environment, are not automatic consequences of the independent
physical structure of the internal environment but they must coevolve together
with the body. The body itself must “learn” to send signals to the nervous
system and must decide which specific signals to send and in correspondence
with which specific states of the body. (p. 5-6).

The
body itself had to learn how to send signals from the external stimulus through
the nervous system. Millennia’s before us the people could not differentiate
between when it was time to rest the body to heal or when it was time to move
the body for food because they could not feel pain. According to Acerbi and
Parisi (n.d.), after 200 generations the body was able to detect pain from
external stimuli and transmit a signal through the nervous system to develop a
reaction. (p. 6).

Pain is a stimulus picked up by receptors
and carried on sensory tracts to the brain which establishes the feeling of
pain. The receptors which respond to painful mechanical, chemical, and thermal
stimuli are called, nociceptors. There are a range or nociceptors that are in
various locations in the body that respond to different stimuli. For example,
there are skin nociceptors can be broken down into four categories. Firstly,
specific nociceptors which respond to intense mechanical stimulation such as
pinching or cutting. Secondly, there are thermal nociceptors which respond to
the stimuli mentioned before as well as temperatures in the range of 42°C and above 50°C. Thirdly, in the skin is chemical nociceptors that respond only to
chemical stimulation such as, acids from inside and outside of the body.
Lastly, there are polymodal nociceptors which responds to high levels of the
mechanical, thermal, and chemical stimulation like the previously mentioned
types. Additionally, there are joint nociceptors which contain a high threshold
of other nociceptors, but respond to hitting the joint or painful rotation
against the tissue. Likewise, there are visceral nociceptors located in the
visceral organs like the urinary tract, the ischemia, and the stomach, that
responds to pathological changes in the body. The last type of nociceptor is
called the silent nociceptor because these receptors are usually unresponsive
until tissue damage and inflammation has occurred. When the depolarization is
strong enough and action potentials are developed they are conducted by the
axon to the spinal cord and carried to the brain on special ascending spinal
pathways.

The anterolateral system carries sensory
information to the brain from the receptors of the skin and it includes the
spinothalamic, spinoreticular, and spinomesencephalic tracts, which are all
associated with nociceptors. The spinothalamic tract projects to the thalamus,
and the axons from the thalamus connect to the somatic sensory cortex where
sensations are perceived, therefore conveying information we are consciously
aware of. The spinoreticular tracts project to the reticular formation and the
spinomesencephalic tracts project to the midbrain, therefore, conveying sensory
information we are not consciously aware of. The spinothalamic tracts are
formed by three neurons. The primary neurons, located in the dorsal root
ganglia enter the spinal cord and synapse with the interneurons. The
interneurons, (which are not named in the sequence) synapse with the secondary
neurons, which decussates the spinal cord and travels to the thalamus. In the
thalamus, the secondary neuron synapses with the tertiary neuron, and then
connects with the somatic sensory cortex. The input from the anterolateral
system originates on one side but is perceived on the other side due to
decussation in the spinal cord. 

 Pain is an experience different for all.
Pain comes under many classifications and can be tolerated better by some. Pain
is classified by duration, cause, mechanism, and others that fall into their
own category. Pain by duration is referred to as acute or chronic pain. Acute pain
lasting from about three to six months and is associated with trauma, such as a
broken leg or appendicitis. Chronic pain is pain lasting longer than suggested
healing time. It is basically sending transmissions of a pain that is
supposedly in the tissue but is not there. Pain by cause is said to be
cancerous and noncancerous. Cancerous pain is caused by cancer while
noncancerous is caused by many things such as, trauma, childbirth, and
degenerative disease. Both are usually chronic pain but can be acute. Lastly,
pain classified by mechanism is called nociceptive, neuropathic, or
neuroplastic.  Nociceptive pain is tissue
damaging pain, while neuropathic is nerve-damaging pain, and neuroplastic is
neuro-processing pain. Pain that falls into their own category is visceral pain
(pain from internal organs), referred pain (pain that is not felt directly at
the source of pain), and phantom pain.

“Phantom limb phenomenon was first described by a
French military surgeon Ambroise Pare. 1 The phantom phenomenon consists of
three distinct elements: 

Phantom limb pain (PLP): Painful sensations that are
being referred to the amputated limb

 Phantom limb
sensation (PLS): Sensations other than pain that are being referred to the
amputated limb

 Stump pain
(SP): Pain localized to the amputated stump.” (Ahmed, Bhatnagar, Mishra,
Khurana, Joshi, Ahmad, 2017. P. 24)

This
pain is said to be partly psychological as there isn’t a limb to feel pain and
can be connected to the pain that was once there or the desire to have what was
once there. These episodes involve various components such as the nervous
system, the brain, and the spinal cord and can vary in duration, intensity,
frequency, and location. The phantom pain can exist in an area as small as
getting a tooth pulled to having a leg or arm amputated.

Pain can be managed in many ways but is
traditionally managed with pills and injections. The way how pain will be
treated will be based on your pain history, intensity duration, aggravating and
relieving conditions, and the structures that cause the pain. The point of pain
management is to identify the source of pain and give optimally effective
treatment. The most easily accessible form of fast relief is topical
analgesics, which are prescribed in the form of a cream or patch over the
counter. These medications break the pain cycle by tricking the sensory nerves
by giving them another sensation to focus on, usually cold or tingling.  Most commonly prescribed is opioids, which
need a doctor’s prescription because they contain morphine and codeine and can
be life-threatening if used incorrectly. Similarly, some physicians will give
their patients corticosteroids such as prednisone and cortisone in the form of
an injection which will reduce the swelling, thus relieving the pain.  For more serious cases, anesthetics are also
used in the form of an injection near the nerve to block the transmission of the
action potential. This is referred to as local anesthesia which will give loss
of sensation in that part of the body, while general anesthesia will give loss
of consciousness due to action on the reticular formation.

Becoming more prevalent in society today
are non-traditional methods of pain management called complementary and
alternative medicine (CAM).  Little is
known as to why people are leaning toward this form of relief, whether it be
over the fear of drug dependence or unsuccessful treatment from mainstream
drugs, but it has become highly popular today. There are many forms of CAM that
people turn to for relief. A prominent type of alleviation is mind – body
therapy which is meant to help the mind’s capability to influence the body to alleviate
the symptoms in the form of meditation or hypnosis. This is commonly used to
relived chronic pain. In the like manner, acupuncture is used to bring relief
from things along the lines of carpal tunnel, headaches, menstrual cramps,
osteoarthritis, and lower back pain. This ancient Chinese remedy is performed
by sticking needles in the body’s fourteen energy channels to fight against
illnesses and relieve pain by rebalancing the imbalanced energy channels. Chiropractic
treatment and massage therapy are becoming increasingly used to manage things
like back pain, neck pain, and even headaches. These practices can increase
blood flow to the area and relieve stress and tension building up in the area.
Furthermore, not only are people beginning to take the dietary approach to get
some sort of relief from pain, they go as far as using dietary supplements. The
generally crude veggie lover eating regimen was appeared to give an expansion
in weight reduction and physical movement and convey alleviation to individuals
suffering from fibromyalgia and osteoarthritis. Likewise, the nutritional
supplements have shown early benefits, but further research is needed.

Medicinal marijuana has become increasingly
popular and legalized in some states such as Montana, North Dakota, Arizona,
and Ohio. These places have made medical marijuana the only way to carry
marijuana legally. The patients that need it undergo strict policies such as
being referred by a doctor after many failed attempts of traditional methods of
pain relief. To purchase the marijuana, you must buy it from a registered
dispensary and you must have a certificate. The medicinal marijuana is sold in
dispensaries so that doctors, scientist and law makers can keep track of the
dosage, usage, and relief of every person. You must be registered with the
dispensary and carry valid identification to make your purchases. Although
medical marijuana is legal in some states, other states have made recreational
marijuana legal. This form of sale is called adult use and is legal in places
like California, Oregon, Colorado, and Alaska. The use of recreational
marijuana is almost the same as medicinal marijuana. You must purchase from a
dispensary at the age of twenty-one and older with valid identification only.
Majority of recreational dispensaries have a menu for buyers to access inside
an out of the store. Even less than recreational use some states have limited
laws that only allow the use and carrying of hemp oil with specific levels of
tetrahydrocannabinol and cannabidiol.

The use of medicinal marijuana has become a
successful form of pain relief for some people. For Mr. Z it was his only form
of relief for his lower back pain that he suffered with for years. Mr. Z is a
60-year-old who had a fall at work years ago and had to receive an L2-3
laminectomy. A laminectomy is a procedure that removes part of the vertebral
bone called the lamina.  He had this
procedure done in 1996. From the procedure, Mr. Z had received epidural
injections, lidocaine, and even took part in a spinal cord stimulator trial.
Mr. Z had been diagnosed with failed back following his laminectomy and he was
on a pill regimen that included taking 10mg of oxycodone and 600mg of ibuprofen
every six hours to get pain relief. In the words of Dr. Hill (2015):

In an effort to obtain better control of his chronic pain, he began
using medical marijuana after receiving a certification from a local specialty
medical marijuana clinic. He thought that medical marijuana improved his pain
control and approached his primary care physician about continued use of
medical marijuana. (p. 2475).

Mr. Z’s use of
medicinal marijuana acts as a sedative and aids Mr. Z in getting a better sleep
at night and even pain relief the following day.

            Pain is universal, everyone is
affected by it. Everyone may not endure the same pain, but the feeling can
always be empathized. The adaptive advantages of pain are essential to our
survival. Without the body adapting to the stimulus we would not be able to know
that there is an issue. The reaction to the external stimulus creates a
threshold to react to pain and the internal reactions help us to fix and fight
off any problems. The management of pain which is today becoming more
nontraditional than traditional has different results for everyone. Likewise,
the use of medical marijuana is becoming increasingly popular. In my own
opinion, I prefer the nontraditional methods over the traditional methods. I
believe that the use of medical marijuana serves a different purpose for every
user and should be used as a form of treatment. 

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