2. INTRODUCTION Pain is a cardinal symptom attributed to Vata humor or dosha. Vata disorders are seen arising out of three main mechanisms – When the momentum of vata is obstructed, vata gets vitiated. When the body elements are depleted, vata fills the vacant space and gets vitiated. Momentum of vata is obstructed by its subtypes or dhatus or malas. Obstructed vata moves in reverse direction, but, obstructed again and gets enveloped. This process is known as ‘avarana’ and is also responsible for vitiation of vata.
3. PAIN – DEFINITION AND SCOPE Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” Intellectual Pain, Emotional Pain, Interpersonal Pain, Financial Pain, Spiritual Pain, Bureaucratic Pain, and Physical Pain. Pain is what the patient says it is, and exists whenever the patient says it does.
4. ASSESSMENT OF PAIN HISTORY 1. When the pain started? 2. What events or illness coincided with the onset? 3. Where does it hurt? (Location) 4. How does it feel? (Character) 5. What are the aggravating and relieving influences? (Upashaya-Anupashaya) 6. What investigations have been done? 7. What treatments have been tried? 8. Past medical and surgical history is important to identify existing disease and previous experience with pain and analgesic use.
6. CLASSIFICATION OF PAIN ASHUKARI (visarp, anta vidradhi) – CHIRAKARI (sandhishoola, vatarakta) EKANGA(affecting a single site or organ)- SARVANGA(affecting entire body or multiple organs/systems) UTTANA (superficial) - GAMBHIRA(deep) ACCORDING TO DOSHA DOMINANACE – vataj, pittaj, kaphaj, vatakaphaj, vatapittaj and sannipatik ACCORDING TO ORGAN- skin, stomach, bones, joints etc.
7. MODREN ASPECT Nociceptive pain is due to the stimulation of nerve fibers that transmit signals in a normal way from nerve endings to brain centers. Somatic pain Visceral pain Neuropathic pain is the abnormal sustained stimulation of the nerve fibers that transmit signals from the nerve ending to brain center and/or from a dysfunction in the central nervous system. dysesthetic pain lancinatingpain
8. PRINCIPLES OF MANAGEMENT OF PAIN HETU NISCHITI (DETERMINATION OF CAUSATIVE FACTOR) SAMPRAPTI (PATHOGENESIS) SHODHANA CHIKITSA (PURIFICATION METHODS) SHAMAN CHIKITSA (PACIFICATION METHODS) VIHARA CHIKITSA (NON PHARMACOLOGICAL MANAGEMENT)