Pain

Pain is a function needed for survival. It is the reflex which makes us withdraw immediately if our finger comes in contact with a flame, or if we feel the irresistible desire to rest an injured limb. It is a completely subjective phenomenon which is felt differently, according to the individual and the situation. The pain can result in mild discomfort that is relatively faint, to extreme pain which may affect a person psychologically. Pain is an abnormal and disturbing occurrence that is felt by the body and perceived in the brain. It is an unpleasant sensory and emotional occurrence associated with possible tissue damage.

Generally, following an aggression generating a wound, an infection or constant trauma such as surgery, a wound occurs that may turn infective and cause pain to the body. Among other feelings, pain is the result from activities of the nervous system. To better understand pain, here is a summary of its mechanism of action.

Pain, like all feelings, is a result from nervous system activities. More complex than the most advanced electric circuit, the nervous system is the most mysterious system of the human body. We are aware of certain mechanisms since ancient times where the Greeks described and analyzed various branches of peripheral nerves (sensory and motor nerves) that connect the spinal cord to the brain.

The amazing complexity of the nervous system is partly explained by the fact that it virtually extends to all parts of the body, from the ends of the toes to the top of the scalp. It terminates at tip of the hair follicles and connects muscles as well as other tissues of the body. There is no part of the human body which is not affected or is controlled by the nervous system.

Process Direct signs Medical references
As quick as it may seem, pain is not instantaneous.  If the chronic pain signal transmitted by the nerves ends seems instantaneous, it is only because it is uninterrupted.  When we hurt ourselves, a series of phenomenons happen:

  • Pain messages, called noxious messages, are stimulated when pain is felt by nerve terminations of cutaneous, muscular, and joint tissues as well as internal organs;
  • This message is then conveyed by “nociceptors” which are specific nerve fibers (afferent path);
  • Detection and encoding of cutaneous pain intensity are carried out by polymodal C-nociceptors. These fibers are activated by mechanical, thermal, and chemical stimuli;
  • The body secretes signals that acts as a warning to the body;
  • The nervous network is directly activated by peripheral terminations where chemical stimuli is involved (bradykinin, histamine, serotonin, prostaglandin, etc.). Their function is to sensitize adjacent nervous terminations;
  • The molecules allow for the release of nerve impulses along afferent nerve fibers that are sent to the spinal cord;
  • Following their way towards the peripheral nerves, the nerves join either the posterior roots or the cranial nerves of the nervous system;
  • Spinal cord of the brain: a certain number of noxious neurons transmit painful messages to the cerebral point, the ascending bundles lead the noxious messages to various cerebral areas involved in the pain mechanism;
  • The messages finally progress towards the brain where the pain message is decoded;
  • The brain provides instructions transmitted by efferent nerves to various muscles and glands;
  • Noxious messages are modulated by efferent nerves. Afferent nerves, which transmit tactile messages, inhibit nociceptors at the medulla. Cerebral neuronal inhibition is caused via its effect on the supraspinal. By blocking pain reflexes, the affected area obtains an analgesia effect;
  • A series of motor effects results. For example, the withdrawal of crushed finger by a hammer may occur concurrently with the compression of the other hand or sometimes, a swearword, etc.
DIRECT SIGNS OF PAIN
  • Analgesic position at rest and movement;
  • Protection of painful areas;
  • Complains of localized pain;
  • Reactions during an examination of the painful area.

CPillai AD, Rathod PD, Xavier FP, Vasu KK, Padh H, Sudarsanam V. Related Articles, Design, synthesis, and pharmacological evaluation of some 2-[4-morpholino]-3-aryl-5-substituted thiophenes as novel anti- inflammatory agents: generation of a novel anti-inflammatory pharmacophore. Grevet et al. 2002.

World Health Organization (WHO). WHO Monographs on Selected Medicinal Plants.

Geneva ( Switzerland ): World Health Organization;1999

Bisset NG, Wichtl M, editors. Herbal Drugs and Phytopharmaceuticals. 2nd ed.

Stuttgart ( Germany ): medpharm GMbH Scientific Publishers; 2001.

Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Klein S, et al. The Complete German Commission E Monographs.

Boston (MA): Integrative Medicine Communications;1998.

Blumenthal M, Goldberg A, Brinkman J. Herbal Medicine: Expanded Commission E Monographs.

Boston (MA): Integrative Medicine Communications;2000.

Foster S. 101 Medicinal Herbs: An illustrated guide.

Loveland (CO): Interweave Press; 1998.

McGuffin M, Hobbs C, Upton R, Goldberg A, editors. Botanical Safety Handbook.

Boca Raton (FL): CRC Press;1997.

World Health Organization (WHO). WHO monographs on Selected Medicinal Plants.

Geneva , ( Switzerland ):World Health Organization;1999.

DerMarderosian A et al. Indian Frankincense Tree, The Review of Natural Products - Facts and Comparisons, Etats-Unis, 1998.

Schulz V, Hänsel R, Tyler VE. Rational Phytotherapy - A Physicians' Guide to Herbal Medicine, fourth edition, Springer, Allemagne, 2001.

The Natural Pharmacist (Ed). Natural Products Encyclopedia, Herbs & Supplements -

MSM , ConsumerLab (Joint Supplements (Glucosamine, Chondroitin, and MSM ) http://www.consumerlab.com/

Therapeutic Research Faculty (Ed).

MSM . Natural Medicines Comprehensive Database. www.naturaldatabase.com Methylsulfonylmethane. Monograph. Altern

Potvin Caroline. À quoi sert le methylsulfonylmethane dans le traitement de l'arthrite rhumatoïde? Quebec Pharmacie, vol. 49, janvier 2002. http://www.quebecpharmacie.org

Lawrence RM. "Methylsulfonylmethane (

MSM ) A double-blind study of its use in degenerative arthritis." International Journal of Anti-Aging Medicine 1998, 1-50.

Chrubasik S & al Treatment low back pain exacerbations with willow bark extract: a randomized double-blind study. Am J Med. 2000 Jul; 109(1): 9-14. & Meyer-Buchtela, 1999; Wichtl, 1989; Wichtl and Bisset,1994.

Altman RD, Marcussen KC Are Ginger and

Willow Bark Extracts Viable Alternatives to Treat Osteoarthritis?: Reviewed:. Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis HerbalGram. 2002; 55: 20-24 (willow 25)

Boullata JI, McDonnell PJ, Oliva CD. Related Articles, Links Anaphylactic reaction to a dietary supplement containing willow bark. Ann Pharmacother. 2003 Jun;37(6):832-5.

PMID : 12773073.

Sandoval M, &al Anti-inflammatory and antioxidant activities of cat's claw (Uncaria tomentosa and Uncaria guianensis) are independent of their alkaloid content. Phytomedicine 2002 May;9(4):325-37.

Piscoya J, Rodriguez Z, Bustamante SA, Okuhama NN, Miller MJ, Sandoval M. Efficacy and safety of freeze- dried cat's claw in osteoarthritis of the knee: mechanisms of action of the species Uncaria guianensis.Inflamm Res 2001 Sep;50(9):442-8.

Volker Schulz, Rudolf Hänsel, and Varro E Rational Phytotherapy: A Physician's Guide to Herbal Medicine. Fourth Edition HerbalGram. 2001;53: 75 (cat's 1, claw 1)

Sheng Y, Li L, Holmgren K, Pero RW. Related Articles, Links

DNA repair enhancement of aqueous extracts of Uncaria tomentosa in a human volunteer study. Phytomedicine. 2001 Jul;8(4): 275-82.

Alternative Medicine Review, Monograph Boswellia serrata. vol.3, Number 4, 1998. www.thorne.com

Natural Standard (Ed). Herbs & Supplements - Boswellia, Nature Medicine Quality Standard. www.naturalstandard.com

Sarrazin Julie. Le Boswellia Serrata, Quebec Pharmacie, vol. 48, numero 9, octobre 2001. http://www.quebecpharmacie.org

Ammon HP. [Boswellic acids (components of frankincense) as the active principle in treatment of chronic inflammatory diseases]. [Article en allemand, resume en anglais]. Wien Med Wochenschr 2002;152(15-16):373-8.

Gupta I, Parihar A, Malhotra P, Gupta S, Ludtke R, Safayhi H, Ammon HP. Effects of gum resin of Boswellia serrata in patients with chronic colitis.Planta Med 2001 Jul;67(5):391-5.

Krieglstein CF, Anthoni C, Rijcken EJ, Laukotter M, Spiegel HU, Boden SE, Schweizer S, Safayhi H,

Senninger N, Schurmann G. Acetyl-11-keto-beta-boswellic acid, a constituent of a herbal medicine from Boswellia serrata resin, attenuates experimental ileitis. Int J ectal Dis. 2001 Apr;16(2):88-95.

Gupta I. et al. Effects of Boswellia Serrata Gum Resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res 1998 Nov 17;3(11): 511-4.)

Badria F. & al. Boswellia-curcumin preparation for treating knee osteoarthritis. Alternative & Complimentary Therapies. 2002.

Galijatovic A, Otake Y, Walle UK, Walle T. Extensive metabolism of the flavonoid chrysin by human Caco-2 and Hep G2 cells. Xenobiotica. 1999; 29:1241-1256.

Nagao A, Seki M, Kobayashi H. Inhibition of xanthine oxidase by flavonoids. Biosci Biotechnol Biochem. 1999; 63:1787-1790.

USDA, ARS, National Genetic Resources Program. Germoplasm Resources Information Network - (

GRIN ). Curcuma longa: http://www.ars-grin.gov/cgi-bin/npgs/html/tax_search.pl

Niederau C, Gopfert E. [The effect of chelidonium- and turmeric root extract on upper abdominal pain due to functional disorders of the biliary system. Results from a placebo-controlled double-blind study]. [Article en allemand, resume en anglais]. Med Klin 1999 Aug 15;94(8):425-30.

Satoskar RR, Shah SJ, Shenoy SG. Evaluation of anti-inflammatory property of curcumin (diferuloyl methane) in patients with postoperative inflammation.Int J Clin Pharmacol Ther Toxicol 1986 Dec;24(12):651-4.

Mukhopadhyay A, Basu N, Ghatak N, Gujral PK. Anti-inflammatory and irritant activities of curcumin analogues in rats.Agents Actions 1982 Oct;12(4):508-15.

Duvoix A, Blasius R, Delhalle S et al. Chemopreventive and therapeutic effects of curcumin. Cancer Lett. 2005 Jun 8;223(2):181-90. Review.

Chainani-Wu N. Safety and Anti-Inflammatory Activity of Curcumin: A Component of Tumeric (Curcuma longa). J Altern Complement Med. 2003 Feb;9(1):161-8

Park SY, Kim DS. Discovery of natural products from Curcuma longa that protect cells from beta-amyloid insult: a drug discovery effort against Alzheimer's disease. J Nat Prod. 2002 Sep;65(9):1227-31.

Voir Monographie du Gouvernement du Canada http://www.hc-sc.gc.ca/hpfb-dgpsa/nhpd-dpsn/mono_turmeric_f.html

Altman RD , Marcussen KC Are Ginger and Willow Bark Extracts Viable Alternatives to Treat Osteoarthritis?: Reviewed: Effects of a ginger extract on knee pain in patients with osteoarthritis. Arthritis HerbalGram. 2002; 55: 20-24.

Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. European journal of obstetrics, gynaecology, and reproductive biology 1991;38: 19-24.

Voir Monographie du gouvernement du Canada http://www.hc-sc.gc.ca/hpfb-dgpsa/nhpd-dpsn/mono_ginger_f.html http://www.ars-grin.gov/cgi-bin/npgs/html/tax_search.pl. Walsh et al. 1986; Russell et al. 2000).