Pain is sensed when a nerve ending is stimulated sending an impulse along the neural pathway to the brain that interprets the impulse as pain. Pain is assessed in a patient by asking the patient to describe the intensity of the pain on a pain scale—the higher the value, the more severe the pain. Besides intensity, pain is assessed according to onset, duration, frequency, what started the pain (precipitating cause), and what relieves the pain.

There are six classifications of pain: acute pain, chronic pain, visceral pain, somatic pain, neuropathic pain, and psychogenic pain. Pain can be treated non-pharmacologically or pharmacologically.

Nonpharmacological pain treatment includes massage, imagery, music, distraction, humor, acupuncture, chiropractic interventions, hypnosis, herbal therapies, therapeutic touch, and transcutaneous electronerve stimulation. Surgical interventions are also sometimes performed to relieve pain.

Pharmacological pain treatment involves administering medication that relieves the patient of pain. There are four categories of pain medication: non-narcotic analgesics, nonsterioidal anti-inflammatory drugs (NSAIDs), narcotic analgesics, and salicylates (discussed in Chapter 12).

Narcotic analgesics are opioid narcotics that can induce respiratory depression. The effects of a narcotic analgesic can be reversed by administering a narcotic antagonist.

Many patients and healthcare providers are concerned that a patient will become addicted to narcotic analgesics or develop a tolerance for these drugs. Both can occur. However, proper pain management can alleviate these potential problems.

This chapter concludes the look at pain medications. In the next chapter, we'll take a look at medications that are used to control the immune system.

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