Pain: is an unpleasant emotional experience usually initiated by a noxious stimuli and carried

through a specialized neural network to the Cetral Nervous System where it is interpreted as
such.

Referred Pain:is that pain which is experienced at a site distant from site of injury.

Melzack & Wall proposed Gate Control Theory for pain.

PAIN CONTROL:
I.Removing the cause:

a.most desirable method

b.environmental change causing pain is eliminated.
c.Method affects PAIN PERCEPTION,as impulses are still carried by nerves formerly involved in
pain transmission.
d.no permanent environmental change in tissue occurs.

II.Blocking Pathway for Painful Impulses:

a.mostly utilised in dentistry.

b.L.A. is injected into vicinity of nerve.
c.This L.A. prevents nerve depolarisation from hat point onwards
d.No impulse conduction beyond that point.
e.Method affects PAIN PERCEPTION.

III.Raising Pain Threshold:

a.depends upon the pharmacologic property of drugs with ANALGESIC properties.

b.Pain threshold raised Centrally.
c.PAIN REACTION is decreased by increasing Pai Reaction Threshold.
d.if too noxious stimuli is present it becomes obligatory to block the transmission pathway locally
or generally as threshold can only be raised not beyond a certain level.
e.Analgesic drugs may only act to thier MAXIMAL EFFECTIVE DOSE.increasing dosage beyond
it would not yield any increase in Pain threshold unless accompanied by some other undesirable
effect.
f.Modulation of painful input @ first synaptic level occurs.

IV.Cortical Depression & prevention of Pain Reaction:

a.Under general Anaesthesia

b.increased deprssion of CNS is done so as to prevent any reaction to the Painful Stimulus.
c.PAIN REACTION affected.

V.Psychosomatic Methods:

a.Depends for effectiveness on putting patient to proper frame of mind.

b.PAIN PERCEPTION/PAIN REACTION/BOTH affected.
c.No use of drugs.
d.Patient is kept well informed and what is to be expected.
e.Patient is made to understand by kind consierate approach the extent of discomfort that may be
experienced.
f.Patient should be assured that any unpleasant sensory experience can be adequately cotrolled
& these would be used if any question of discomfort arises.