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Pain mechanisms in the elderly 

Pain mechanisms in the elderly
Chapter:
Pain mechanisms in the elderly
Author(s):

Khalil Ullah Shibli

and Sabina Shibli

DOI:
10.1093/med/9780199604999.003.0011
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date: 18 August 2019

This chapter focuses on the mechanisms of pain and includes definitions, types, and descriptions of pain, how pain is initiated or caused, detected, transmitted, facilitated, inhibited, modulated, and finally perceived. The current theories on the underlying mechanisms are detailed and the anatomical, physiological, and functional changes in pain perception in the elderly are described. There is a clear review of pain processing with age against the background of occupational and mechanical pain followed by increasingly painful degenerative conditions such as arthritis. The loss of myelinated fibres in peripheral nerves is described with the predictable effects on pain modulation. The loss of neuropeptides with predominately inhibitory action and the manner in which this leads to a fall in pain tolerance are reviewed. Similar changes in the autonomic nervous system are described that predispose the elderly to chronic pain syndromes.

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