Back Pain Assignment: Pain Mechanisms, Treatments, and References

This assignment explores the topic of back pain, differentiating between nociceptive, neuropathic, and psychogenic pain, with a specific focus on nociceptive pain as presented in a case study. The student analyzes the pain mechanism, involving peripheral neurons, the spinothalamic tract, and thalamocortical neurons. The assignment discusses the causes of lower back pain, such as muscle strain and injuries, often associated with physical labor. Furthermore, it details chronic low back pain types, emphasizing the use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) as a primary treatment, including their mechanism of action through the inhibition of Cyclo-oxygenase enzymes (COX). The assignment also acknowledges the side effects associated with NSAIDs and references relevant research papers.

Running head: Back Pain Assignment
Back Pain Assignment
Name of Student
Name of University
Author Note

1BACK PAIN ASSIGNMENT
Question 1:
Pain stimulus can be divided into three subtypes, Nociceptive pain, Neuropathic pain and
Psychogenic pain. The most common form of pain is nociceptive pain, which is seen in the case
study provided. Ms. Sue seems to be suffering from Nociceptive pain which is caused due to
external or internal injury. In cases of external injury the pain does not persist for long time Non
Steroidal Anti-Inflammatory Drugs (NSAID) is prescribed to the patients, but if the condition is
more severe, additional opioid prescription is also allowed. The pain mechanism consists of three
neurons, which connects peripheral tissues like skin and muscles with the cerebral cortex. The
neurons form a vast network to ensure as much tissues as possible is connected to the cortex
(Davidson et al., 2012). The peripheral tissues are connected to the spine by peripheral neurons,
which are further connected to the thalamus by Spinothalamic tract neurons. The thamalus is
connected to the cortex by Thalamocortical neurons. The progression of nerve impulse within
these three places occurs even less than a millisecond. Lower back pain can occur due to various
problems, like muscle strain, ligament sprain, lumbar disc injuries et cetra. These conditions can
result due to heavy object lifting, twisting of spine while lifting as well as sudden accidents of
movement that would injure or stress the bones and muscles in the lower back portion (Sterud &
Tynes, 2013). In the case study is it evident that the woman had public service which required
her to do heavy machinery and equipment operation as a part of her job. Fire-fighters are known
to lift or pull hose-pipes, perform rigorous training activities, and sometimes undergo service
injury (Guidotti, 2013).

2BACK PAIN ASSIGNMENT
Question 2:
Chronic Low back pain is of two types, Nociceptive and Neuropathic form. The most
effective and widely accepted form of chronic Nociceptive the LBP treatment is administration
of Non-Steroidal Anti-Inflammatory Drugs (NSAID) (Samraj & Kuritzky, 2012). The process of
management of chronic pain is done as the following- introduction of NSAID like paracetamol,
followed by additional administration of opioids, if the pain still persists, strong opioids like
morphine is prescribed. NSAID is a type 2 schedule drugs, which has anti-inflammatory and
anti-pyretic actions. These types of drugs are usually prescribed to patients with mild of
moderate pain in the pain numerical analysis, like in the case study provided. In cases with
gastrointestinal disorders, asthma allergy reduction and kidney damage is also prescribed NSAID
(Jóźwiak-Bebenista & Nowak, 2014). The mechanism of action of NSAID drugs are inhibition
of synthesis & release of Prostaglandins by prohibiting Cyclo-oxygenase enzymes (COX)
(Samraj & Kuritzky, 2012). The isozymes of COX-1 and COX-2 have separate physiological
action; painkilling function of NSAID is associated with inhibiting of COX-2, whereas other side
effects can occur due to the prohibition of COX-1 and COX-2. NSAIDs that are available
commercially, like acetaminophen and aspirin, seem to have potential side effects, affecting
gastrointestinal and cardiac output. The therapeutic activity of all NSAIDs function by inhibiting
the COX isozymes, researtchers are trying to find techniques to reduce the risk related with
NSAIDs while not hampering their pain relief functionality (Brune & Patrignani, 2015).

3BACK PAIN ASSIGNMENT
References:
Brune, & Patrignani, P. (2015). New insights into the use of currently available non-steroidal
anti-inflammatory drugs. Journal Of Pain Research, 105.
http://dx.doi.org/10.2147/jpr.s75160
Davidson, S., Zhang, X., Khasabov, S. G., Moser, H. R., Honda, C. N., Simone, D. A., & Giesler
Jr, G. J. (2012). Pruriceptive spinothalamic tract neurons: physiological properties and
projection targets in the primate. Journal of neurophysiology, 108(6), 1711-1723.
https://doi.org/10.1152/jn.00206.2012.
Guidotti, T. (2013). Critical Study of the Association Between Disease and Occupation as a
Firefighter. Archives Of Environmental & Occupational Health, 68(1), 1-2.
http://dx.doi.org/10.1080/19338244.2012.678195.
Jóźwiak-Bebenista, M., & Nowak, J. Z. (2014). Paracetamol: mechanism of action, applications
and safety concern. Acta poloniae pharmaceutica, 71(1), 11-23.
http://www.ptfarm.pl/pub/File/Acta_Poloniae/2014/1/011.pdf
Samraj, & Kuritzky, L. (2012). Nonsteroidal anti-inflammatory drugs in the treatment of low
back pain. Journal Of Pain Research, 579. http://dx.doi.org/10.2147/jpr.s6775
Sterud, T., & Tynes, T. (2013). Work-related psychosocial and mechanical risk factors for low
back pain: a 3-year follow-up study of the general working population in Norway. Occup
Environ Med, 70(5), 296-302. http://dx.doi.org/10.1136/oemed-2012-101116.

4BACK PAIN ASSIGNMENT