Chronic pain persists for at least three months or greater, despite intervention to relieve the injury, surgical, holistic, or medicinal, when the treatment does not control the original issue. Chronic pain is disruptive to sleep patterns and activities of daily living, and as a pain syndrome, it serves no protective or adaptive function (Rodriguez, 2015). 

Chronic pain persists for at least three months or greater, despite intervention to relieve the injury, surgical, holistic, or medicinal, when the treatment does not control the original issue. Chronic pain is disruptive to sleep patterns and activities of daily living, and as a pain syndrome, it serves no protective or adaptive function (Rodriguez, 2015). Anwar (2016) acknowledges that there are three ascending pathways: the first-order neuron; start from the periphery (skin, bone, ligaments, muscles, and other viscera) travels through the peripheral nerve reaches the dorsal horn of the spinal cord, second-order neuron: start at the dorsal horn cross over to the contralateral side and then ascend in the spinal cord to the thalamus, and other brain areas like dorsolateral pons and third order neuron: starts at the thalamus and then terminates in the cerebral cortex. The descending pathway begins in multiple areas of the brain, sending signals across nerve fibers.

Referred Pain

Referred pain is felt in an area removed or distant from its point of origin-the area of referred pain is supplied by the same spinal segment as the actual site of pain (Huether & McCance, 2017). Making the diagnosis difficult for practitioners, referred pain also presents differently in men and women. It is fairly common in some conditions, such as heart attacks and osteoarthritis (Ungvarsky, 2019). Impulses from many cutaneous and visceral neurons converge on the same ascending neuron, and the brain cannot distinguish between the different sources of pain (Huether & McCance, 2017).

Impact of Gender and Age on Pain