Pain - Types And Homoeopathic Approach In Management Of Pain
Dorland's medical dictionary defines pain as: a more or less localized sensation of discomfort, distress, or agony resulting from the stimulation of specialized nerve ending.
The International Association for the Study of Pain (1979) defines pain as:
"an unpleasant, subjective, sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage"
Â—Task Force on Taxonomy of the International Association for the Study of Pain (IASP) defines pain as
"An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage."
Orofacial pain has been defined by the American Academy of Orofacial Pain (AAOP) as:
"Pain conditions that are associated with the hard and soft tissues of the head, face, neck and all of the intraoral structures".
Pain, however, is much more than a physical sensation caused by a specific stimulus. It is a complex mechanism with physical, emotional, and cognitive components.
It is subjective, and highly individual
Pain has many meanings:
To the scientist: Senses, receptors, thresholds, reflexes
To the clinician: A symptom -diagnostic tool, disease
To the patient: Unpleasant frightening experience
Ancient Egypt - Pain resulted from evil sprits related to the religious influence of (1000 BC) Gods. The heart was the center of all sensations. (a concept that prevailed for more than 2000 years).
Ancient China - A normal person has two opposite unifying forces: (800-500 BC) the Yin (a negative, passive force) and the Yang (a positive, active force). The state of Chi represents a balance of these forces. imbalances in Yin and Yang produce pain and/or disease.
Ancient India - Buddhist and Hindu were the first to attach emotions to the pain (500 BC) experience.
Jewish-Christian - Pain is the punishment for sin. The English word â€œpainâ€ is derived (0-300 AD) from the Latin word â€œpoenaâ€ which means punishment.
1664 AD - Descartes introduces the concept of pain pathways
Pain good or bad?
Normal Pain Perception:
Warning signal against harmful stimulus
Ability to perceive pain is important in everyday life
Pain makes us conscious of the presence of the injurious agent & that is why we seek removal of the injurious agent by appropriate measures.
Neural Anatomy of Pain:
The structural unit of the nervous system is the nerve cell or neuron. It is composed of a mass of protoplasm termed the nerve cell body, which contains a spherical nucleus and gives off one or more processes. Protoplasmic processes from the nerve cell body are called dendrites and axons. An axon or axis cylinder is the central core that forms the essential conducting part of a nerve fibre and is an extension of cytoplasm from a nerve cell.
Depending on the number axons present, a nerve cell in unipolar, bipolar or multipolar.
Depending on their location and function, neurons are designated by different terms. An afferent neuron conducts the nerve impulse toward the CNS, whereas an efferent neuron conducts it peripherally. Internuncial neurons or interneurons lie within the CNS. Sensory or receptor neurons, afferent in type, receive and convey impulses from receptor organs. The first sensory neuron are called the primary or first order neuron. Second-and third-order neurons are internuncial.
Motor or efferent neurons convey nerve impulses to produce muscular secretory effects. A preganglionic neuron is an autonomic efferent neuron whose nerve cell body is located in the CNS and terminates in an autonomic ganglion and terminates peripherally.
Nervous impulses are transmitted from one neuron to another only at a synaptic junction, or synapse, where the processes of two neurons are in proximity.
The primary afferent neuron (first order neuron) receives stimulus from the sensory receptor. This impulse is carried by the primary afferent neuron into the CNS by way of dorsal root to synapse in the dorsal horn of spinal cord with a secondary (second order) neuron. The cell bodies the primary afferent neurons are located in the dorsal root ganglia.
Clinical Characterstics of Pain
Accurate pain localization
Accurate correlation between lesional site and pain source
Temporary pain abolition by topical anesthetic
Dull pain, depressing in quality
Site may/may not correlate with lesional site
Bright, burning pain
Close correlation between site of pain and lesion
Possible accompaniment by other sensory, motor or autonomic symptoms.
Site of pain often has no correlation with a possible cause
Clinical behavior / response to therapy may be non-physiological,& unexpected
Trigeminal neuralgia(tic dolourex)
sharp, stabbing, episodic pain in the region of the face supplied by trigeminal nerve
Generally unilateral pain
Presence of trigger points
Pain can be arrested by anesthetic blocking of the involved nerve
Vesicles along the distribution of mandibular nerve But most commonly along ophthalmic division
Dull depressing pain
Subjective localisation variable
Intensity increases on provocation
Â—Central excitatory effects frequently accompany
Deep somatic type pain
Â—Diffusely localised pain to joint region
Secondary effects like headache, deep palpable tenderness and masticatory muscle co contraction may be present
Homoeopathy and Pain Management
There are many homeopathic pain medicines and which has employed their use successfully for many years. Homeopathy can be particularly useful for treating pain associated with problems that cannot be diagnosed, as it is selected according to presenting symptoms rather than disease diagnosis.
Perhaps the most well-known Homeopathic treatment for pain is Arnica montana. Used in both homeopathic and herbal formulations this mountain meadow flower offers great benefit for muscular pain as well as pain in general.
Homeopathic Hypericum (St Johnâ€™s Wort) provides great relief for nerve pain, especially in the fingers, toes and nails. When professionally prescribed in its homeopathic form it can be used along with anti-depressantsunlike the herbal version.
Magnesium phos and Chamomilla are perhaps the most widely used homeopathic remedies for spasms and cramps, and Nux-vomica is just one of the many remedies that offer great relief for headaches.
Homeopathic Arnica is very widely prescribed and used, with many first class sports person employing its marvelous healing benefits for traumatic injuries such as bruising, muscle strain, ligament sprain, fractures and so forth.
Theory and Application
Homeopathy is rooted in the Hippocratic method of medical therapeutics which emphasizes: (1) rational principles of observation, (2) the study of the patient who is sick is rather than the disease, and (3) assisting the natural process of healing by strengthening the individualâ€™s resistance to illness.
List of homeopathic medicines and some of their common applications in pain management.
Aconite- Acute, sudden violent pains. Anxiety, fright and shock. Asthma, Bronchitis, Dysmenorrhea, Headache, Muscle Pain, Myelitis, Nephritis, Otitis, Peritonitis, Pleurisy, Toothache.
Arnica montana- Acute and chronic affects of trauma, bruising, and injury. Back pain, Pleurodynia, Gout, Headache, Rheumatism.
Bryonia alba- Pains worse from motion. Apthous Ulcers, Asthma, Bronchitis, Cancer, Constipation, Dyspepsia, Eczema, Hernia, Migraine headache, Nephritis, Pericarditis, Ovarian Cysts, Pleurisy, Pleurodynia, Pyuria.Rheumatism, Toothache.
Calendula officinalis- Abrasions, Corneal Abrasions, Gunshot Wounds, Lacerations, Mastitis, Muscle Tears, Paronychia, Post Operative Pain, Puncture Wounds, Ruptured Tympanic Membrane, Soft Tissue Injuries, Varicose Veins.
Chamomilla matricaria- Intolerable pains, unendurable pains, oversensitive tissue. Asthma, Blepharitis, Dysmenorrhea, Dyspepsia, Gout, Headache, Intestinal Colic, Labor Pains, Neuralgia, Otalgia, Rheumatism, Sciatica, Seizures, Toothache.
Colocynthis- Cutting pains better from hard pressure. Abdominal Pain, Arthritis, Coxalgia, Cramps, Facial Neuralgia, Headache, Peritonitis, Sciatica.
Eupatorium perfoliatum- Violent deep aching pains. Back Pain, Bone Pains, Headache, HSV, Opthalmia, , Rheumatism.
Hepar sulpuris calcareum- Splinter-like pains. Angina Pectoris, Asthma, Blepharitis, Constipation, Corneal Pain, Diaphrapmitis, Eczema, Headache, Hemorrhoids, Hepatitis, Labial Abscess, Otalgia, Laryngitis, Menorrhagia, Pleurisy, Rheumatism, SLE.
Hypericum perforatum- Asthma, Brachial Neuralgia, Coccyx Injury, Crush Injuries, Headache, Herpes Zoster, Hemorrhoids, Lacerated Wounds, Neuralgia, Neuritis, Nerve Injury, Painful Scars and Keloids, Post Concussive Syndrome, Reflex Sympathetic Dystrophy, Rheumatism.
Staphisagria- Back Injury and Backaches, Blepharitis, Cystitis, Crural Neuralgia, Dyspareunia, Epididymitis, Gastralgia, Irritable Bladder, Lacerations, Post Operative Pains, Post Traumatic Pains, PID, Rheumatism, Salpingitis, Sciatica, Testicular Pain, Throat Pain.
The use of homeopathy is widespread, worldwide and growing. Its use by those with chronic problems such as chronic pain, arthritis, and neurodegenerative diseases is extensive. Its safety profile is outstanding. The practice of homeopathy lends itself to an integrated medical approach so long as the standards of conventional care and the fundamental principles of homeopathy are observed and respected.
Dr Atul. B. Rajgurav
Head of the department of Homoeopathic Pharmacy
DR.D.Y.PATIL HOMOEOPATHIC MEDICAL COLLEGE AND RESEARCH CENTRE
Bhosari, Pune-411 026.
Phone : 020 - 27120045, 27120046
FAX : 020 â€“ 27120046
Mobile : 9850909081