Inspired Pain

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The urge to find a meaning for pain is surely biological. We are hardwired to determine what is causing our pain so that we could avoid such things in the future. The only problem, however, is that we don’t always have the answer to why. Not just in Job’s time, but also in the 21st century. And, in the absence of knowledge, we tend to invent reasons and meanings. In Greco-Roman times the answer to why was that I must have offended the gods in some way. McGlone, F.; Wessberg, J.; Olausson, H. Discriminative and Affective Touch: Sensing and Feeling. Neuron 2014, 82, 737–755. [ Google Scholar] [ CrossRef] [ PubMed][ Green Version]

Pain Hustlers | TIME The True Story Behind Pain Hustlers | TIME

Pleuritic chest pain refers to pain felt worse on inspiration. It usually occurs due to visceral and parietal pleura rubbing over each other but can be due to musculoskeletal or nerve-related pathology. DiagnosisThe sensations of my own body may be the only subject on which I am qualified to claim expertise. Sad and terrible, then, how little I know. “How do you feel?” the doctor asks, and I cannot answer. Not accurately. “Does this hurt?” he asks. Again, I'm not sure. “Do you have more or less pain than the last time I saw you?” Hard to say. I begin to lie to protect my reputation. I try to act certain [( 13), p. 70]. On the other hand, if patients can provide good descriptions of their pain, and if doctors can help them do so and are willing to listen, those descriptions can be as useful in pinpointing the source of pain as an abnormality seen on a CAT scan or X-ray. By knowing your North Star and means values, you can consciously choose to live in a state of inspiration rather than requiring motivation. Inspiration comes from within; motivation comes externally. Living your values Contemporary models of goal-directed choices (e.g., Rangel and Hare, 2010) posit that the decision whether to pursue an action (e.g., pursuing physical activity in the presence of pain) or not depends on the value of this action that results from the difference between the value of the outcome that is generated by each action (e.g., pleasure experienced during physical activity) and the associated costs (e.g., increase in pain).

Pulmonary causes | Diagnosis | Chest pain | CKS | NICE

Although pain is a highly subjective and rather personal experience, it is sensitive to social influence. So far, the emerging strand of research on the influence of social factors on pain perception has mainly focused on two aspects: pain modulation through social support and social threat. Social support has been found to alleviate experimental and clinical pain, including labor, cardiac, and postoperative pain (see Brown, 2003 for an overview). In line with this change in pain intensity, participants exhibited less threat-related activation in various brain regions (including the anterior insula, DLPFC, and hypothalamus) when they were holding the hand of their spouse while they were awaiting a painful stimulation than when they were holding the hand of a stranger or in a non-hand-holding condition ( Coan et al., 2006). Interestingly, this buffering effect was stronger the higher participants rated the quality of their marriage. In a recent study, Eisenberger et al. (2011) extended these observations to the period of pain receipt. Here, participants reported less pain when they were presented with a picture of their romantic partner during the application of the noxious stimuli. This modulatory effect was paralleled by increased activation in the VMPFC and as in the study by Coan et al. it scaled with perceived partner support. Moreover, activity in the VMPFC was related to decreased engagement of the dorsal anterior cingulate cortex (dACC) during pain receipt. Based on the association of the VMPFC with safety signaling (e.g., Klumpers et al., 2010) the authors concluded that social support might modulate pain via top–down regulatory mechanisms. Pulmonary infarct (due to embolus arising from DVT in leg, silent pelvic vein thrombosis, silent right atrial thrombosis) And this actually brings us to the downside of the imagination and metaphor when it comes to pain, which also happens to be the subject of Susan Sontag’s book, Illness as Metaphor. On the one hand, metaphors are so critical because they are the only way to conceptualise and communicate the experience. But, on the other hand, because of the urgent demand to determine the why of pain, there is a tendency to keep on inventing and imagining reasons, to never be completely satisfied.Because pain is so blurry – perceptually and conceptually – there’s nothing to point to or grab on to. So the only way to go is to fill the blur with objects that we can see and describe. We are forced to speak of pain in terms of other, more visible objects, i.e. we are forced to speak metaphorically. The most common metaphor of pain is the weapon. We say, for example, that pain is shooting or stabbing or crushing. If you’re living to your highest means values, you will be most inspired. When you’re living in your highest means values, you’re in ‘in-spirit-ation’. To summarize, there is cumulative evidence suggesting that the prospect of pain is integrated into the evaluation of appetitive stimuli and might thereby affect the net evaluation of these stimuli. The translation of this experimental research in healthy volunteers into patients suffering from chronic pain could provide novel, clinically highly relevant insights into pain-related choices and more specifically, the compromised ability to implement top–down processing in goal conflicts. A particularly promising focus is the characterization of impaired DLPFC functions, which comprise not only a top–down influence on stimulus and action evaluation but also executive functions such as “goal shielding” through biased attentional processing. Furthermore, future neuroimaging studies on pain-related goal conflicts should consider other conflict-relevant dimensions apart from valence. In contrast to experimental settings in which participants choose between simple stimuli that are delivered immediately, conflict in the context of (chronic) pain often arises from more complex scenarios in which the options are typically on different time scales (e.g., pain relief from analgesics as short-term benefit vs. side-effects as long-term adversity). Insights into the integration of action outcome with different time constants could help in understanding the preference for immediate pain relief despite the detrimental long-term costs. Finally, future studies on the resolution of goal conflicts in the context of pain should explore the integration of relevant information in the brain in more detail. The exchange and comparison of information regarding costs and benefits as well as the subsequent decision-making processes require dynamic brain circuitries rather than single brain regions. Tools focusing on dynamic parameters (e.g., analysis of functional connectivity) and computational models that inform brain imaging analysis based on behavioral data can therefore add valuable new insights. Interruptive Function of Pain: Attentional Processes Suggested by: sudden onset shortness of breath, pleural rub, cyanosis, tachycardia, loud P2, associated DVT, or risk factors such as recent surgery, cancer, immobility.