Chronic Pain

Intractable Chronic pain

Chronic odontogenic pain are mostly caused by introgenic injury or infection, and characterized by pain elimination with local anesthesia.

Major causes of chronic pain

The refractory pain are composed by complexity of causes described below.
1.Pain by continued stimulation

2.Abnormality of neural fiber related to pain transmission (neuropathic pain)

The stump pain (phantom limb pain and determination edge nerve etc. )are included in the neuropathic pain.
In the root canal treatment, if the neural fibers that distribute in the dental pulp or the periodontal tissue are injured, it is possible to happen.

3.Systematic disorder, mental disease

The inflammation which cannot be controlled because of systematic disorder, steroid taking, or immunosuppressive agent’s taking.

4.Psychogenic pain

Uneasiness to continuation of pain

#What is the Wind up phenomenon(central sensitization)?

An example of non-associative learning in which the progressive amplification of a response follows repeated administrations of a stimulus. An everyday example of this mechanism is the repeated tonic stimulation of peripheral nerves that will occur if a person rubs his arm continuously. After a while, this stimulation will create a warm sensation that will eventually turn painful. The pain is the result of the progressively amplified synaptic response of the peripheral nerves warning the person that the stimulation is harmful. Sensitization is thought to underlie both adaptive as well as maladaptive learning processes in the organism.

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