疼痛的世界

巴尔的摩—疼痛在生活中无处不在。这是一种无法摆脱的知觉,所有具有高级神经系统的生命体都有疼痛的体验。对于生活危机四伏的我们的祖先来说,疼痛是一种进化优势,表明你需要远离疼痛源。但进化赶不上生物医学和技术的进步,这让慢性疼痛(在急性伤口或症状消失后继续存在的疼痛)本身也成了一种疾病。

慢性疼痛的社会影响是巨大的。据美国医学会(US Institute of Medicine)估计,三分之一的人饱受慢性疼痛的折磨——比心脏病、癌症和糖尿病加起来还要多。疼痛是残疾的主要诱因,特别是45岁以下背痛人群和关节痛老人。光是在美国,慢性疼痛每年就要造成大约6,000亿美元的成本。

疼痛可以根据不同因素区分,比如持续时间或区域。但最有用的分类方法是根据疼痛机制区分。伤害性疼痛——因非神经组织受伤而产生——往往会在(如)扭到脚踝时发作。慢性伤害性疼痛的一个例子是关节炎。相反,神经性疼痛的原因是机能损害或疾病影响了神经系统。糖尿病引起的神经损伤(糖尿病性神经病)和带状疱疹后的持续疼痛(后遗神经痛)是最常见的例子。

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