الفهرس 
Physiology of painOnly 14 pages are availabe for public view
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Abstract
Chronic pain is defined as pain that persists longer than the temporal course of natural healing, associated with a particular type of injury or disease process. (Shipton and Tait, 2005).
The International Association for the Study of Pain defines pain as ”an unpleasant sensory and emotional experience associated with actual or potential tissue damage”.(Merskey ,1994).
Nociception (pain) may arise from injury or disease to visceral, somatic and neural structures in the body. More broadly pain is described as malignant or non-malignant in origin. (Vanderah ,2007).
It is rare to completely achieve absolute and sustained relief of pain. Thus, the clinical goal is pain management. Pain management is often multidisciplinary in nature. It has been recognized recently the importance of comprehensive pain programs(CPPs) in the management of chronic pain. CPPs offer the most efficacious and cost-effective treatment for persons with chronic pain, relative to a host of widely used conventional medical treatment. (Henningsen et al. ,2007).
This work highlights the physiological mechanisms of pain transmission and control, as well as the different modalities for treating this syndrome other than the classical analgesics, the different drugs to be used in such cases, the role of peripheral nerve blocks as well as the physical modalities and invasive procdures.
Pulsed radiofrequency, neuromodulation, direct introduction of medication and nerve ablation may be used to target either the tissue structures and organ/systems responsible for persistent nociception or the nociceptors from the structures implicated as the source of chronic pain. (Varrassi et al. ,2006).
An intrathecal pump used to deliver very small quantities of medications directly to the spinal fluid. Also epidural steroid injection helps in rehabilitaion programs or physiotherapy. (Ferrante et al. ,1991).
A spinal cord stimulator is an implantable medical device that creates electric impulses and applies them near the dorsal surface of the spinal cord provides a paresthesia (”tingling”) sensation that alters the perception of pain by the patient. Other modalities used in the treatment of chronic pain. These include: physical modalities such as thermal agents and electrotherapy. ( Geertzen et al. ,2006).
Applied behavior analysis treats pain as mixture of respondent and operant conditioning in which normal tissues learn to fire pain responses in the presence of specific environmental antecedents and consequences. behavioral treatment can be an effective and economical means of treating chronic pain.