Jermyn R, Janora D, Surve S. Assessment and Classfication of Pain in the Elderly Patient. Clinical Geriatrics. Sept 2010. Volume 18. Number 8. Pp 16-22.
Key Points-
Nociceptive Pain- pain fibers stimulated by tissue damage. Outside of neurologic structures. arthritis, fracture pain, back pain, strains, sprains, ligament tears.
Neuropathic Pain- pain arises from damage or lesion in nervous system. traced to specific nerve injury. post herpetic neuralgia., thalamic stroke syndrome, fibromyalgia, diabetic polyneuropathy, sciatica. worse at night.
brain is unable to dampen pain stimulus coming from peripheral or central nervous system. increase in substance P and glutamate at dorsal horn of spinal cord.
Mixed nociceptive-neuropathic Pain- spinal stenosis causing neurogenic claudication. (back feels better with flexion.) cervical spinal stenosis. piriformis syndrome, cancer pain.
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