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neurophysiology of pain

modulation
"Pain
is an unpleasant sensory and
emotional
experience associated with actual or
The Internationa Associatio for the Stud of Pain

potential

tissue damage, or described in terms of


such
damage-

PTE 3053

PREMIER - RECOGNISED - TRUSTED

FEBRUARY 2013

Acute pain(0-3months)

Pain is predominantly due to


physical impairment
chronic pain(3months and above)
Psychological distress, Distorted self
and
Fear often accompany impairmen
image,
experience

the

d
as

physica impairmen

sadness,

PREMIER - RECOGNISED - TRUSTED

perceive
themselves
as
ugly and

Pain
pathway
MECHANICA
L
&THERMAL

NOCICEPTORS

CHEMICAL

POTENTIAL TISSUE
DAMAGE
,THERMAL
(A-DELTA AND
C
STIMULAT
FIBERS)
AND MECHANICAL
E

Produce witdrawal refex and are

Produce secondary aching and burning and

short

are

duration in nature

of long duration

Stimulation of

PHERIPHERAL PAIN
betaMODULATION
fibers which inhibits assending response at SC by

Gate via activation


of
closing
A
SG

ASCENDIN PATHW
G

AY

Spino thalamic
tract
The spino thalamic
tract
carries the information
for
pain discrimination
(what,
where) from spinal
level to

Spino thalamic tract and


spino

Carries the

affective
reticulthalamic
(feeling,interpretiv
The spino
tract
e)

reticulothalamic

component of
system
pain. connects

nociception with the


older centers of our

DECENDING PATHWAY
(PAIN
MODULATION
)
RELEASE NEUROTRANSMITTERS
{
EXERCISE
, RELAXATION
ENDORPHINS(ENDOGENOUS
TECHNIQUES, MEDITATION,
MORPHINE)
IMAGERY, DISTRACTION
AND ENKEPHALINS } present in
periaquaductal gray(PAG) matter,

ENDORPHINS(ENDOGENOUS MORPHINE)
AND
ENKEPHALINS

MID BRAIN
MEDULLA
RETICULOSPINA
L
TRACT

Pain modulation throught


drugs which include dopamine,
Neurotrasmitters
serotonin,
norepinephrine, acetylcholine, glutamate,
Function
gammas
aminobutyric
acid(GABA)
and
glycineof synaptic
Neurons
receive
a constant
barrage
some
inhibitory, some excitatory. Impulse are summed at the
signals
level
of nerve cells. And if the balance favors inhibition the
nerve
cell will not fire .If the balance favors excitation the