Women have more pain but deal better

Here is my experience as a dentist: men complain a lot more about painful stimulus, they are more anxious, and more frequently faint more than women. Who agrees?

I have seen a lot of times this scene: a man is siting at the dentist chair, opens his mouth, a simple dental procedure. Ultrasound touches his teeth. Panic. I ask “is it hurting?” “No, everything is fine” (already pale). Cold sweating. I ask again “do you need anesthesia?” “No, no” – almost saying “quick finish, please!” 

They also suffer more when collect blood, say the statistics. They have less pain, but more fear. women see more doctors, do more exams. Face their pain and go ahead with triple workdays. Aren´t them more brave? Women revenge.

Join your treatment on pain

The time of controlled acess to the literature from the Name of the Rose (Umberto Eco) has ended. At the last decades, it had even became free and easy to get on the internet. That´s why the patients are able to follow the treatment choices of their doctors very close, in order to understand everything about the diagnosis and therapeutics. More over, currently it is possible to actively participate during the treatment to make the decisions among several choices that are available. 

Reading about your diagnosis and about the treatments can make you more able to adequate the options according to your pain together with your doctor. And, finally, with a higher chance of success.

 

Interesting experience for someone who treats pain – to have pain.

I had that experience about 5 years ago. Pain close to the hip, only while using the right leg, never while resting. After 3 weeks of antiinflamatory drugs, the orthopedist said to me that… I should use antiinflamatory drugs!! Could they work if they were not working!?

All I know is that, with my experience with TMJ, I was suspecting an articular problem. He did not care about what I said.

My husband, worried about it, told me to ask for an exam. Two months had passed by. I am from that group of doctors that thinks that the clinical exam has all clues with the history of the patient to get a diagnosis, and that exams are complementary, but I agreed with that last chance – an MRI!

A colleague that was examining me asked for it. And, surprise! Edema at the femoral neck, with risk. I could not walk without crutches for at least 45 days. IT WAS AN ARTICULAR PROBLEM!

For me, it was a good experience as a pain patient. To learn that we need to have persistance, and that the doctors need more study.

Final lesson: do not give up your diagnosis.

Overcoming pain and having success in life

There are several paths to cope with pain. Of course, it is too much difficult to know that some chronic pain diagnoses are forever, that possibly you will need to take medications during a long period and that almost always the pain will not completely disappear. Thus, you will have to deal with it.

A patient with chronic neuropathic pain at the mouth, after a teeth extraction, is the best student of a graduation course of Mathematics; one of the best faculties of Maths of the country. Among the 20 or 30 students that start the course, it is common that only 3 or 4 graduate within the 4 years that the graduation takes. And guess what? She is among them. How can it be!?

People have two choices – to cope with pain and go ahead for their objectives in life or accept pain as a factor of failure or a motive to attribute unsuccess in life.

With or without pain, to succeed is possible according to your strategy to overcome pain. And it only depends on you.

 

 

Can anxiety worse pain?

A lot of articles discuss the effect that pain causes in life. Depression and anxiety can be secondary to chronic pain. Of course, it is almost impossible to live with pain and do not feel anything about it. It is known that depressed people commonly report pain episodes and headache, however, few is discussed about anxiety as preliminary to the onset of pain.

It is not a recent issue, because dentists know that if you control anxiety before an extraction, for example, you will have less pain in the intraoperatory and postoperatory periods. The news are that to identify the role of anxiety even in chronic patients as etiological and not secondary can help in the management of the life of these patients.

 

 

Why have women more pain?

Everybody knows that women complain more about pain. Men need to be tough, right? While she is educated to report pain and to be the fragile sex, he cannot cry.

For a long time, only psychosocial aspects were considered as reasons for this difference. However, recently, the role of sexual hormones and genetic factors became more evident.

Estrogen can altere the number of receptors and neurotransmitters involved in all sensitive functions (pain, touch, taste, smell, etc) and that´s why women can detect any new odorant or flavor while pregnant – she is full of hormones!

Discussing pain, estrogen can even reduce the eficacy of some types of analgesics.  Thus, don´t worry. It is not only things on your mind; it is also biological.

 

 

 

Trigeminal neuralgia: how to identify

Pain at the face, usually close to the teeth, very sharp and lancinating. With a trigger zone or triggering factors (eating, talking, washing the face, brushing the teeth, touching the skin of the face, etc). It can be dental pain, and may need dental treatments, but it can also be trigeminal neuralgia.

How can I identify both?

Well, most of us would answer: “go to the doctors” but many doctors do not have training and are not able to make this differentiation. So, you may need a specialist.

And what are the risks if I do not identify this disease soon? Besides the fact that it hurts a lot, and it is considered one of the most severe pains of the human being, you may treat other cases of pain and start to use medications, to treat the teeth, to extract teeth and put dental prosthesis, and still have pain. You may need to go to other health professionals, and loose a lot of weight because people with trigeminal neuralgia cannot eat when they are in crisis, and still have pain.

Try to avoid dental treatments as trials. If there are no dental diseases, it is possible that your pain has other origin for example trigeminal neuralgia.

What is you motivation to overcome pain?

How many of us have pain? Chronic, probably few. But eventual, physical or emotional, all of us. Pain is always a symptom that something is not well. For the chronic patient, it is the disease. It is a sensation, a perception, that determines a memory and that depends on memories, and puts us in an alert state. It has conscious and unconscious representations, and generates a behavior. Although a great part of it is not under control, it is possible to make a choice. An athlete wins pain for a result; a mother, for her family; a professional or executive, for a performance. After all, what is your motivation to overcome pain?

Can inflammatory cytokines be underlying the variable expression of voltage-gated sodium channels in neuropathic pain?

The involvement of inflammatory cytokines and glial cells in neuroplastic changes and the role of voltage gated sodium channels in chronic neuropathic pain have extensively been studied. In the literature, few studies had investigated a common mechanism for both, despite the scientific evidences of correlations. These findings should influence future studies in the investigation of this hypothesis, supported by the current findings, and the role of anti-inflammatory treatment in chronic neuropathic pain. In conclusion, protocols of investigation of the mechanisms how cytokines and glial cells induce neuronal mechanisms involved in chronic neuropathic pain are necessary, and voltage gated sodium channels are an important clue; the evidences of central inflammatory involvement also support the need of pharmacological strategies for the CNS for neuropathic pain treatment or surgical techniques to access the CNS with anti-inflammatory drugs. Future studies should focus on the correlation among the present evidences and in the elucidation of such mechanisms.

Evidences about the role of inflammatory cytokines and sodium channels in trigeminal neuropathic pain

Many studies have demonstrated that there is an intense communication between neurons and glial cells in neuropathic pain in general, and cytokines underlie at least part of it; the glial cells are implicated in neuroplastic processes of pain chronification. Currently, many researchers are searching for the establishment of mechanisms and pathways involved. On the other hand, some voltage gated sodium channels have been implicated in the nociceptive conduction and also in neuropathic pain mechanisms. Little is known about the influence of inflammatory cytokines on the expression of these sodium channels, especially in the trigeminal system. The objective of this study is to review the literature about the role of voltage gated sodium channels and inflammatory cytokines in the trigeminal neuropathic pain.