ABSTRACT
Pain results when tissue damage of any type stimulates the sensory endings throughout the body of small, non-myelinated nerve fibres with low conduction velocities. Non-steroidal anti-inflammatory drugs have revolutionised the management of moderate pain due to tissue inflammation, particularly inflammatory arthritis. The initial cause of pain for example nettle sting, burn, abrasion - results in the local release of cell-signalling chemicals such as 5-HT and bradykinin, lactic acid, ATP, K+ ion and several of the prostaglandins. Pain due to damage to the pain-receiving pathway is a special form of pain which is not easily controlled even by opiates. All prescribers need to be acutely aware of the serious side-effects of the opiates, some of them life-threatening. Morphine and its near relation diamorphine are the strongest analgesics known, still unsurpassed in making bearable the unbearable. Naloxone displaces opiates from the binding sites, rapidly reversing all the toxic effects but also removing the analgesic effect.
