Introduction
The spinal cord acts as the first site where the relay and transmission of nociceptive information to the brain from the periphery. Transmission of sensory signals from the periphery to the dorsal horn of the spinal cord is performed by primary afferent fibers. At the dorsal horn of the spinal cord, these afferents synapse with neurons of the intrinsic spinal dorsal horn (Albisetti et al., 2019). This information then converses to higher centers in the brain where noxious and non-noxious signals can be perceived, a duty performed by the spinal projection neurons.
During pain transmission, the spinal cord output is dependent on various mechanisms of the spine, which increase or decrease the dorsal horn neurons’ activity. The mechanisms involved in the pain transmission process include the N-methyl-D-aspartate receptor activation, the real excitatory and inhibitory interneurons, and the descending influences from the brain stream. These can either be inhibitory or excitatory. Shifts in the excitatory and inhibitory mechanisms occur due to nerve injury or inflammation to modulate the excitability of the spine. This results in a heightened response of the dorsal neurons to signals from the afferents (Fakhri et al., 2021). The response after results in an increased output to the brain, a phenomenon referred to as central sensitization.
Blocking pain signals in the spine is performed by neuromodulation devices that deliver gentle electrical impulses to the peripheral nerves or the spinal cord that help decrease pain by blocking these pain signals from going to the brain. Various types of neuromodulations vary in the electrical waveform, device location, and intensity. These include spinal cord stimulation, which treats pain in the neck, back, arms, and legs it blocks pain at the spinal cord level (Saladin, 2018). Additionally, peripheral nerve stimulation targets specific nerves to relieve local pain.
Critical Thinking
Pain is an important function of the human body in all aspects. Reliable assessment of pain is important for effective pain management in the day-to-day life of human beings. As a phenomenon, pain is complex, and it involves interconnected psychological and physiological mechanisms. This complexity of pain poses a great challenge to clinicians and scientists dealing with the physiological, anatomical, cognitive, and affective components of pain. Nociceptive signals from injuries have to follow central nervous pathways as well as peripheral pathways (Saladin, 2018). However, the impulses will need to be modulated by endogenous mechanisms, which function to either increase or minimize the signal and the stimuli that have been perceived as pain. In scientific terms, nociception is different from pain in that, while nociception is the signal that travels in the nervous system, pain is the actual perception of the experience that is unpleasant.
In the case of neuromodulation, to block pain, one can easily remember the process of relieving pain by mastering the different types of neuromodulations. For instance, one can master how these processes vary in terms of the electrical waveform, the location of the device, and the intensity. Here, one can use initials to differentiate these types of neuromodulators. These would include EWLODI to stand for the electrical waveform, the location of the device, and intensity, respectively. Consequently, one could observe the area where specific stimulation aims to relieve pain. For instance, one would check into spinal cord stimulation, which helps relieve pain in the back, neck, legs, and arms, which are all areas around the spinal cord. Additionally, one would try to recall stimulation at the peripheral nerve, which is known to target specific types of nerves that help relieve local pain.
Conclusion
Understanding pain in a person is essential in reducing the fear and anxiety surrounding it. This knowledge helps in reducing the impact of pain on a person. Professionals in the medical field need basic knowledge of the concept of pain to assist their patients better. Having an idea of pain modulation helps medics to explain to patients why a similar painful stimulus can have varying individual responses from different people. Globally, gaining knowledge of the underlying pain mechanisms offers significant promise in developing effective and more specific therapies for pain in the medical field.
References
Albisetti, G. W., Pagani, M., Platonova, E., Hösli, L., Johannssen, H. C., Fritschy, J. M., & Zeilhofer, H. U. (2019). Dorsal horn gastrin-releasing peptide expressing neurons transmit spinal itch but not pain signals. Journal of Neuroscience, 39(12), 2238-2250.
Fakhri, S., Abbaszadeh, F., & Jorjani, M. (2021). On the therapeutic targets and pharmacological treatments for pain relief following spinal cord injury: a mechanistic review. Biomedicine & Pharmacotherapy, 139, 111563.
Saladin, K. S. (2018). Anatomy and Physiology: The Unity of Form and Function. McGraw Hill.