Pain is a sensation and experience that almost everyone has, and it is one of the most common complaints that patients hear when they visit the clinic. Therefore, pain is a great concern for patients and their families, and it is also an important topic of research in the medical field. However, so far our knowledge and understanding of pain is still superficial, as some people have compared it to “human beings do not know as much about pain as they do about the moon”. What is the reason for this? Through the unremitting efforts of many research workers in recent decades, we have gradually uncovered the mystery of pain that has been plaguing us humans for many years. Pain mystery a, pain and injury variable link From the biological sense, pain is the body is injured or suffering from disease is a signal and warning, so that people take timely measures to remove the injury stimulus as soon as possible, in general: this relationship between pain and injury is indeed, and is positively correlated, that is, the greater the severity of the injury, the more obvious the pain is more intense. For example, pinch the following, the finger can cause mild pain; when the door is suddenly closed, squeezed the finger is caused by severe pain, this is a situation we often encounter in life, it is well understood. However, there are many examples that do not support the law that the degree of injury and pain are positively correlated. It has been observed that: 65% of soldiers who were seriously injured in the war and about 20% of patients who underwent surgery reported only mild pain or no pain within a few hours or days after the injury or surgery; on the contrary, in the clinic, about 70% of patients with chronic low back pain could not find any obvious injury, which shows that the relationship between injury and This shows that the relationship between injury and pain is somewhat variable, as injury can be painless; pain is not necessarily accompanied by injury. In addition, there are some extreme examples to illustrate the mystery of pain, born without the ability to perceive pain in our life is rare, (rare in the country, mostly seen in the Jewish people), but does exist, the most typical example is a female university student in Montreal, Canada, this girl is very smart, in addition to the absence of pain, in all aspects and the same as normal people, according to her father, in her early childhood, chewing According to her father, when she was young, she often chewed her tongue when chewing food; when she looked out the window, her knees fell on the radiator and suffered third-degree burns, she never felt pain, and at the age of 29 she suffered from osteomyelitis, which was only discovered when her condition was very serious because she had no pain, but it was too late and she eventually died. From this example, it is easy to see the significance of pain for survival, and therefore to say that pain is a defensive reaction, a lucky warning that at the very least allows us to take early measures to avoid further damage to our organism from disease (injury). In contrast, another extreme example is the non-injurious pain, which seems to be the antithesis of congenital painlessness, and it has been reported that most of the patients suffering from this disease are children, with self-injurious behavior, and often do not live to adulthood. There have been articles describing such patients, in which children who are playing suddenly cry loudly and show a very painful expression, and then viciously damage some part of their body, giving the impression that it is the source of severe pain, and no abnormalities are found in their brains and nerves at autopsy after death. The third phenomenon is the pain after the injury has healed, and is by far the most difficult of the various pains to cure – phantom limb pain, which is unbelievable if not witnessed in person. Patients still feel painful long after amputation surgery (even for life) that their amputated limb still exists and is accompanied by severe pain, and there are statistics abroad: 35% of amputation patients have a history of phantom limb pain after their surgery, and the younger they are, the more obvious the symptoms are. suffer the painful ordeal of post-amputation after having already suffered a huge blow to their lives? The variability, diversity, and specificity of pain described above have indeed brought much confusion to our human understanding of pain and its eventual conquest. Description of Pain II: The Many Factors Affecting Pain Through long-term unremitting efforts, people’s understanding and knowledge of pain are deepening, especially in terms of the factors affecting pain, there is a more consistent view that the production of nociception varies from person to person and from one religious practice to another ……. Painful stimuli (traumas) that are unbearable for some people are endured without shouting for others. It is a true “story” that in some Indian tribes there still exists a ritual called hook – swing ceremony. This ritual originated from an ancient custom where the strongest young men of the tribe were chosen to represent the rights and incarnations of the gods, and the person chosen was called the priest, and at a specific time of the year, a pair of iron hooks were put through the skin and muscles on each side of the priest’s back, and the hooks were tied to the top of a crane with ropes, and then the crane went from village to village, while the priest was suspended only by the hooks and allowed to swing freely The priest was applauded by adults and children everywhere he went, and the priest always acted smugly, without any painful expression. In World War II, a surgeon named Beecher found that only one in three of the wounded sent from the front to hospitals in the rear reported pain and asked for morphine, and most did not admit to pain or reported only mild pain and did not need painkillers, while these patients were not in shock. When the surgeon returned to the clinic after the war, he surveyed a group of nonmilitary personnel who had suffered the same traumatic injuries as the warriors, and it turned out that 4/5 of these wounded men cried out in severe pain and urgently requested morphine injections. The final conclusion of Beecher’s study is that trauma is inevitably associated with pain, and the greater the extent of trauma, the more severe the pain column, but pain is largely influenced by other factors, and the significance of trauma is important here. For injured soldiers, being injured may be a good thing, a kind of azure, at least they can come back alive from the battlefield, and than those who died on the battlefield, they should be lucky. The above illustrates the influence of situation and religious beliefs on pain, that is, pain has great variability and tunability, which was later verified by the great Soviet physiologist Pavlov in animal experiments: when a dog is given a strong electrical stimulus to one side of the paw, the dog starts to react strongly, but if the dog is given food at a constant rate after each shock, a completely different reaction is found, and the dog secretes saliva immediately after each shock The dog secretes saliva immediately after each electric shock and wags its tail toward the food bowl, when the electric shock no longer causes a painful reaction, but becomes a signal for the arrival of food. The mystery of pain 3: How does pain really arise? The above has introduced some knowledge and phenomena related to pain, but it is still far from the real elucidation of the mechanism of pain and the understanding of pain experiments. Although this theory is not perfect, it has played a historic role in promoting global pain research. What is the “gate control theory”? What is its essence? The central idea of the doctrine, as it has been revised, is that there is a gate-like mechanism in a part of the body (now thought to be in the posterior horn of the spinal cord) that controls the transmission of pain signals from the periphery to the cerebral cortex and is controlled by two types of nerve fibers, one called coarse fibers and the other called fine fibers, and when we excite the coarse fibers, the gates tend to close and the pain stimulus cannot reach the brain. When we excite the fine fibers, the gate tends to open, the pain stimulus signal can be quickly transmitted to the brain, the patient produces pain, there are many phenomena in life can illustrate this problem, such as; when a child playing, accidentally fell, then the child’s parents often take the same or similar action (treatment measures) to the injured part of the gently touch or blow to the injured part, at this moment the injured child seems to pain Obviously better, stop crying and crying. In addition, people are also very used to gently touch or massage a painful part of the body, which can also reduce pain. The reason for this is that these simple actions can directly excite the coarse fibers, and thus can really make the pain be reduced. Every patient suffering from pain wants to end the pain as soon as possible through their own efforts or with the help of others. As the pain increases and the pain lengthens, the patient’s behavior, emotions and psychology are more and more influenced by the pain. What should I do in the face of pain? Which department should I see in the hospital? This is indeed a difficult problem for patients and their families. In our clinic, we often encounter such a situation: patients suffering from chronic (intractable) pain have run through almost all the major hospitals in the city, and even most departments, but the pain is not controlled in the end, which delays the disease, makes the patient suffer, and adds a burden to the family. In this regard, we can recommend to the patients that many hospitals in our city have opened specialized outpatient clinics for the treatment of various pains in recent years – pain removal department (pain removal department). Regarding the treatment (control) of pain, there are several ways or measures as follows 1.Medication (Chinese medicine, Western medicine) The methods of medication include: oral, intramuscular injection, intravenous injection, external medication, mucosal medication, etc. Oral medication is the most convenient, painless and applicable to general mild and simple pain. 2, physical therapy: now the market variety, painless, immediate results, mainly for the body surface soft tissue pain. 3.Tui na massage: it has a long history in China and is mainly used for pain caused by soft tissue injury. 4.Surgical treatment: mainly used for complex intractable pain or pain that conservative treatment is ineffective, such as: pain caused by lumbar disc prolapse, etc. 5.Interventional pain treatment is an advanced treatment method used in clinical practice only in recent years, often with the help of various instruments and equipment, which has the advantages of accurate positioning, precise efficacy and small trauma. As for what drugs to take for a kind of pain (or patient) and what methods to use for pain relief, it is recommended that it is best to consult a specialist, which should vary from person to person and from disease to disease, and not to blindly stop pain and eventually cover up the condition. Pain is a major problem that has no national boundaries. Solving this problem requires joint efforts worldwide, close cooperation between doctors and patients, and the understanding and support of all sectors of society, and it is believed that the problem of pain will be overcome in the near future.