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PAIN



             Pain starts with the stimulation of one or more of the three pain receptors mentioned previously, these receptors may receive information about intense heat, extreme pressure, sharp pricks or cuts, or other events that can cause the body damage. There are specialized receptors in the skin that are sensitive to stimuli that are painful. These receptors are called nociceptors, two types of fibers carry this information from the nociceptors to the spinal cord. A-delta fibers which transmit information quickly and appear to be responsible for the acute sense of pain, and C-type fibers, which transmit impulses more slowly and may cause the nagging sense of pain (Encarta 1998).
             The relationship between pain and injury or disability has led to the assumption that pain must be proportional the severity of the injury. In many instances, however, this relationship fails to hold up. About 65 percent soldiers who are severely wounded and 20 percent of civilians who undergo major surgery report feeling little or no pain for hours or days after injury or incision. In contrast, about 70 percent of people who suffer from chronic, low-back pain do not show any readily detectable injury. Clearly, the link between pain stimulus and pain perception is highly variable. Injury may occur without pain, and pain without apparent injury (Slavkin, 2000). .
             Perception of pain is a multi-step process, originating at the site of injury with the stimulation of specific nerve fibers known as nociceptors. Some nociceptors react to several kinds of painful stimulation. Others are more selective. Certain nociceptors will react to a pinprick, for example, but ignore painful heat. After these nerve fibers or nociceptors are stimulated, the damaged cells release chemical mediators of pain and inflammation. These mediators include potassium ions, bradykinin, prostaglandins, serotonin and histamine (Edelson, 1991). .
             The resulting sensitization of the peripheral nerve endings produces an exaggerated and prolonged sensitivity to later stimuli (peripheral hyperalgesia).


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