Understanding the complexity of pain
PAIN is a necessity; we feel pain in order to understand that something is wrong or damaged within our body and it signals us to take protective actions. However, pain is also the most common reason people seek medical care and ongoing pain can have negative consequences with a significant impact on overall health and quality of life.
Pain is a complex phenomenon that can arise from different origins and can be divided into the following key types – nociceptive, inflammatory and neuropathic.
Nociceptive pain is pain after tissue damage or injury, without damage or impairment in the function of the nervous system. Examples are burns, sprains, bone fractures, and bruises.
Inflammatory pain is pain associated with immune system responding to tissue injury, such as in an infection or inflammation. The nervous system is not impaired in this type of pain.
Neuropathic pain is pain arising from nerve damage or disease affecting the nerve fibres.
Examples are nerve injuries, postherpetic neuralgia (persistent nerve pain that occurs at the site of a previous attack of shingles caused by the chickenpox virus), toxic and metabolic peripheral neuropathies (for example, nerve damage caused by diabetes).
Characteristics of neuropathic pain include burning, tingling, pins and needles, as well as abnormal responses to non-painful or painful stimuli.
Pain is a complex disease and in many cases, patients suffer from painful conditions caused by multiple, co-occurring mechanisms. This mixture of pain types has been defined as the “mixed pain”.
Mixed pain is pain derived from both nociceptive/inflammatory and neuropathic origins. In many common conditions, such as low back pain and osteoarthritis, pain can have both nociceptive and neuropathic components.
Management of mixed pain
The nature of mixed pain requires a combination treatment addressing both pain components.
Neuropathic component of mixed pain could be managed with medicine indicated to relieve neuropathic pain and medicine such as non-steroidal anti-inflammatory drugs (NSAIDS) help to relieve nociceptive or inflammatory pain in mixed pain.
Alternative treatment options, such as neurotropic B vitamins target the underlying cause of the neuropathic pain – nerve damage. Vitamins B1, B6 and B12 have a multitude of effects on the nervous system.
The three B vitamins complement each other by acting via different modes of action. The combination works in biochemical synergy and has been found to regenerate damaged nerve fibres.
Vitamin B1: Facilitates propagation of the nerve impulse.
Vitamin B6: Promotes neurotransmission.
Vitamin B12: Regenerates damaged nerve fibres.
Neurotropic B vitamins can be used in combination with NSAIDS to relieve mixed pain.
Studies reported that a combination of diclofenac – a type of nonsteroidal anti-inflammatory drug (NSAID) and neurotropic B vitamins helps improve low back pain and shorten treatment period compared to taking diclofenac alone. While NSAIDS targets the nociceptive and inflammatory pain mechanisms, the neurotropic B vitamins nourish and help regenerate nerves.
Consult your doctor for examination and diagnosis of pain, for a proper treatment plan based on your condition.
As part of its continuous initiatives to raise awareness on the importance of healthy nerves, P&G is providing nerve test at selected pharmacies nationwide to encourage consumers to take the first step in identifying possible nerve damage and seek further medical consultation or treatment if needed.
■ For more details, email chmymmal. im@pg.com
Information contained in this article is for informational purpose only. For any medical advice, diagnosis or treatment recommendation, consult your healthcare professional.
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