Pain syndrome

Pain syndrome is an unpleasant, sometimes unbearable, sensation that occurs when sensitive nerve endings located in organs and tissues are irritated (trauma, inflammation).

The perception of pain is individual for each person. The reaction to pain can be: normal (normesthesia); increased (hyperesthesia), which is often caused by psychasthenic conditions or hormonal disorders, for example, with adrenal insufficiency (Addison's disease), thyrotoxicosis; decreased (hypesthesia), which is caused by the suppression of pain centers of the cerebral cortex under the influence of various factors - hypoxia, the effect of drugs, analgesics, psychotropic drugs, autotoxins, self-hypnosis, hypnosis, reflex action, for example, acupuncture, etc. Complete loss of tactile sensitivity can occur extremely rarely.

Pain is the earliest and leading symptom of diseases and injuries. But due to irritation of the receptors of the vegetative part of the sympathetic nervous system, it causes a number of protective neurohumoral reactions and, with prolonged exposure, can form a chronic focus of excitation in the cerebral cortex. Thus, pain is a trigger for the development of a complex protective reaction of the vegetative type, accompanied by a violation of the function of all organs and systems. This determines the essence of pain syndrome, which is considered an integrative function of the body, mobilizing a wide variety of functional systems to protect the body from the effects of an aggressor factor. It includes such components as consciousness, sensation, memory, motivation, vegetative, somatic and behavioral reactions.

Pain syndrome is accompanied by objective changes affecting a variety of functional systems: respiration, blood circulation, hormonal, statics and homeostasis. Clinical changes in pain syndrome are diverse and depend not only on the strength and duration of pain stimulation, which determine the activation of the hormonal system and the release of catecholamines into the blood, but also on the general condition of the body, the central nervous system, the hormonal system, the cardiovascular system, the state of the adaptive mechanisms and the emotional status, which determines the perception of pain and the emotional response to it. Patients with a labile nervous system react more actively to pain and give a vivid emotional reaction even to minor irritation. Their response from the cardiovascular system is also very labile. Due to their low shock threshold, even a minor pain stimulus can cause the development of a spasm of pain shock.

But in all cases, the pain syndrome is accompanied by a protective stress reaction. Selye defined them as stress syndromes. Distress syndromes can also develop: respiratory, hypovolemic, hypoxic, shock, etc., no longer as protective, but as a consequence of extreme impact on the body.

Vegetative reaction in pain syndrome, clinically, is manifested by: agitation, pale skin, profuse sweating, dilated pupils; tachycardia and increased blood pressure, rapid breathing, frequent and sometimes involuntary urination and defecation. Even after the cessation of the irritant effect, the pain syndrome persists for another 12-72 hours. In cases of accumulation of pain impulses above the shock threshold, inhibition of the cerebral cortex develops with the development of shock syndrome.

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