{{ :office_hours:series:pain.png?400 |}}
===== Overview =====

Pain management is one of the most common—and most difficult—challenges in medicine.

Effective treatment requires understanding:

  * Pain physiology
  * Pain pathophysiology
  * Mechanistic classification
  * Acute vs chronic transitions
  * Pain syndromes
  * Pharmacologic targets
  * Patient-specific risk factors

This series is organized in a structured framework:

  Physiology → Classification → Time Course → Syndromes → Drug Classes → Special Populations → Clinical Application

----

===== I. Pain Physiology & Pathophysiology =====

==== Pain Physiology ====

See: [[pain_management:physiology|Pain Physiology]]

  * Nociceptors
  * A-delta vs C fibers
  * Peripheral transduction
  * Dorsal horn processing
  * Substance P
  * NMDA receptors
  * Ascending pathways
  * Descending inhibitory pathways

----

==== Pain Pathophysiology ====

See: [[pain_management:pathophysiology|Pain Pathophysiology]]

  * Peripheral sensitization
  * Central sensitization
  * Wind-up phenomenon
  * Neuroimmune activation
  * Reduced descending inhibition

----

===== II. Types of Pain =====

==== Nociceptive Pain ====

See: [[pain_management:nociceptive_pain|Nociceptive Pain]]

  * Somatic
  * Visceral
  * Inflammatory mediators

----

==== Neuropathic Pain ====

See: [[pain_management:neuropathic_pain|Neuropathic Pain]]

  * Nerve injury or disease
  * Ectopic firing
  * Sodium channel dysfunction

----

==== Nociplastic Pain ====

See: [[pain_management:nociplastic_pain|Nociplastic Pain]]

  * Central sensitization
  * Altered nociception
  * Amplified pain processing

----

==== Mixed Pain States ====

See: [[pain_management:mixed_pain|Mixed Pain States]]

  * Combination of mechanisms
  * Common in chronic pain

----

===== III. Acute vs Chronic Pain =====

==== Acute Pain ====

See: [[pain_management:acute_pain|Acute Pain]]

  * Protective
  * Tissue injury driven
  * Short duration

----

==== Chronic Pain ====

See: [[pain_management:chronic_pain|Chronic Pain]]

  * Persistent beyond normal healing
  * Nervous system remodeling
  * Central amplification
  * Psychosocial interaction

----

===== IV. Pain Syndromes =====

==== Musculoskeletal Syndromes ====
[[pain_management:musculoskeletal_pain|Musculoskeletal Pain]]

==== Neuropathic Syndromes ====
[[pain_management:neuropathic_syndromes|Neuropathic Pain Syndromes]]

==== Centralized Pain Syndromes ====
[[pain_management:centralized_pain_syndromes|Centralized Pain Syndromes]]

==== Visceral Pain Syndromes ====
[[pain_management:visceral_pain_syndromes|Visceral Pain Syndromes]]

----

===== V. Pharmacologic Drug Classes =====

Pain pharmacotherapy must match mechanism. This series will cover the drugs that can be used for pain

See: [[pain_management:drug_classes|Pain Pharmacotherapy]]

----

===== VI. Special Populations =====

See: [[pain_management:special_populations|Special Populations in Pain Management]]

  * Elderly
  * Chronic kidney disease
  * Liver disease
  * Pregnancy
  * History of substance use disorder

----

===== VII. Case-Based Clinical Applications =====

See: [[pain_management:case_based_learning|Case-Based Clinical Applications]]

  * Acute injury
  * Chronic low back pain
  * Diabetic neuropathy
  * Fibromyalgia
  * High-risk opioid patient

----

===== Guiding Clinical Principles =====

<WRAP round important 80%>
  * • Pain classification determines therapy  
  * • Chronic pain often reflects central amplification  
  * • Mechanism-directed prescribing improves outcomes  
  * • Opioids are powerful but limited tools  
  * • Multimodal therapy reduces risk  
</WRAP>

----