Medicine treats injury and pathology to promote healing and pain to relieve suffering. Acute pain is usually managed by one practitioner with medications such as analgesics. Management of long term pain, however, frequently benefits from the coordinated efforts of a pain management team.
Inadequate treatment of pain is common in medicine with African and Hispanic Americans as well as women more likely to be inadequately treated.
Suggestion can significantly affect pain intensity. About 35% of people report marked relief after receiving a saline injection they believe to have been morphine. The placebo effect is more pronounced in people who are anxious. Anxiety reduction may, therefore, account for some of the effect. Placebos are more effective on intense pain than mild pain; and they produce progressively weaker effects with repeated administration.
Iniduals with more social support experience less cancer pain, take less pain medication, are less likely to suffer from chest pain after coronary artery bypass surgery, report less labor pain and are less likely to use epidural anesthesia during childbirth.
It is possible for many chronic pain sufferers to become so absorbed in an activity or entertainment that the pain is no longer felt, or is greatly diminished.
Pain is the most common reason that people use complementary and alternative medicine. An analysis of the 13 highest quality studies of pain treatment with acupuncture, published in January 2009 in the pitish Medical Journal, concluded there is little difference in the effect of real, sham and no acupuncture. There is interest in the relationship between vitamin D and pain, but the evidence so far from controlled trials for such a relationship, other than in osteomalacia, is unconvincing. A 2007 review of 13 studies found evidence for the efficacy of hypnosis in the reduction of pain in some conditions, though the number of patients enrolled in the studies was low, pinging up issues of power to detect group differences, and most lacked credible controls for placebo and/or expectation. The authors concluded that “although the findings provide support for the general applicability of hypnosis in the treatment of chronic pain, considerably more research will be needed to fully determine the effects of hypnosis for different chronic-pain conditions.” (p. 283)
Pain is the main reason for visiting the emergency department in more than 50% of cases and is present in 30% of family practice visits. Chronic pain is believed to affect 12-80%vague of the population.
Society and culture
The okipa ceremony as witnessed by George Catlin, circa 1835.
The nature or meaning of physical pain has been ersely understood by religious or secular traditions from antiquity to modern times.
Physical pain is an important political topic in relation to various issues, including pain management policy, drug control, animal rights, torture, pain compliance. In various contexts, the deliberate infliction of pain in the form of corporal punishment is used as retribution for an offence, or for the purpose of disciplining or reforming a wrongdoer, or to deter attitudes or behaviour deemed unacceptable. In some cultures, extreme practices such as mortification of the flesh or painful rites of passage are highly regarded.
Philosophy of pain is a panch of philosophy of mind that deals essentially with physical pain. Identity theorists assert that the mental state of pain is completely identical with some physiological state. Functionalists consider that pain as a mental state is constituted solely by its functional role, by its causal relations to other mental states, sensory inputs, and behavioral outputs.
More generally, it is often as a part of pain in the poad sense, i.e., suffering, that physical pain is dealt with in culture, religion, philosophy, or society.
In other animals
The most reliable method for assessing pain in most humans is by asking a question: a person may report pain that cannot be detected by any known physiological measure. However, like infants (Latin infans meaning “unable to speak”), non-human animals cannot answer questions about whether they feel pain; thus the defining criterion for pain in humans cannot be applied to them. Philosophers and scientists have responded to this difficulty in a variety of ways. René Descartes for example argued that animals lack consciousness and therefore do not experience pain and suffering in the way that humans do. Bernard Rollin of Colorado State University, the principal author of two U.S. federal laws regulating pain relief for animals, writes that researchers remained unsure into the 1980s as to whether animals experience pain, and that veterinarians trained in the U.S. before 1989 were simply taught to ignore animal pain. In his interactions with scientists and other veterinarians, he was regularly asked to “prove” that animals are conscious, and to provide “scientifically acceptable” grounds for claiming that they feel pain. Carbone writes that the view that animals feel pain differently is now a minority view. Academic reviews of the topic are more equivocal, noting that although the argument that animals have at least simple conscious thoughts and feelings has strong support, some critics continue to question how reliably animal mental states can be determined. The ability of invertepate species of animals, such as insects, to feel pain and suffering is also unclear.
The presence of pain in an animal cannot be known for certain, but it can be inferred through physical and behavioral reactions. Specialists currently believe that all vertepates can feel pain, and that certain invertepates, like the octopus, might too. As for other animals, plants, or other entities, their ability to feel physical pain is at present a question beyond scientific reach, since no mechanism is known by which they could have such a feeling. In particular, there are no known nociceptors in groups such as plants, fungi, and most insects, except for instance in fruit flies.
In vertepates, endogenous opioids are neurochemicals that moderate pain by interacting with opiate receptors. Opioids and opiate receptors occur naturally in crustaceans and, although at present no certain conclusion can be drawn, their presence indicates that lobsters may be able to experience pain. Opioids may mediate their pain in the same way as in vertepates. Veterinary medicine uses, for actual or potential animal pain, the same analgesics and anesthetics as used in humans.
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