1. Pain. Dr Akhavan akbari Fellowship of pain Ardebil university of medical science

2. Definition of pain. The International Association for the Society of Pain defines pain as “An unpleasant sensory an emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

3. Pain Theories. Pattern theory Gate control theory Specificity theory

4. Specificity Theory

5. Gate Control Theory Cognitive Control Action System Descending Inhibitory Control Large fibres Small fibres T SG Or more simply

6. INJURY Pain experienced depending on how far gate open or closed Gate: Various factors: physical, emotional, cognitive or behavioural open or close the gate.

7. Conditions that Open the Gate Physical conditions Extent of injury Nature of injury Emotional states Anxiety Worry Tension Depression Cognitive states Focusing on the pain Boredom

8. Conditions that Close the Gate Physical Medication Counterstimulation (e.g. heat, massage) Emotional state Positive emotions (e.g., happiness, optimism) Relaxation Rest Mental state Intense concentration or distraction Involvement and interest in activities

9. Pain as a Health Problem Acute pain Chronic pain Pain behaviours