Pain | Pathway and Analgesics (NSAIDs, Opioids, Antidepressants, and Anticonvulsants)

Everything you need to know about pain! Well, nearly...
- Pain pathways (spinothalamic) versus fine touch (dorsal column) pathway to the brain.
- A delta versus C fibres
- Painful stimuli (mechanical, thermal, chemical)
- Brown-sequard syndrome (clinical implications)
- Pain gate theory
- Endogenous Opioid system (endorphin, enkephalin, dynorphin)
- Non-steroidal antiinflammatory drugs (NSAIDs) (aspirin, ibuprofen, celecoxib, paracetamol)
- Opiates (Morphine)
- Antidepressants (Tricyclics, SSRIs, SNRIs)
- Anticonvulsants (Gabapentin)
- And more!!
Listen to our podcast for more info: podcasts.apple...
Instagram: / channel

[@kenfine1469]

This is a Command Performance: It's so incredibly good. I'll be watching this one several times over to get the detail. There should be a KZbin award for educational videos like this.

[@DrMattDrMike]

Thank you, Ken. That is very kind.

[@chrishenly9728]

I think crash course would win lol

[@marksawatzky8562]

Yes!! Excellent presentation.😆❤

[@craigyoung6371]

These dudes are probably full time doctors and/or lecturers, so pretty impressive to get this material up with a proficient explanation, cheers fullas.

[@kannupoonia7523]

I can’t believe you did this for free .. omg what a great lecture.!! So well put together. Thank you so much.

[@thebluemonkey100]

I watched this video last year when we were talking about pain & painkillers in my second year of MED school. Now, in my third year, we are talking about it again, and this video saved me for the second time. Thank you so much for this, and all your other amazing lectures!

[@DrMattDrMike]

😊 🙏

[@jukodebu]

dont let people suffer because some abuse it.

[@emulychan]

thank you for using a whiteboard and drawing! i'm so sick of powerpoint graphics to explain anatomy

[@philipmaxwell669]

Thank you Dr Matt. It is a shame that uni lecturers sometimes forget that unless the information is interesting and coherently presented it’s really difficult to absorb or even stay awake.

[@DrMattDrMike]

Very true!!

[@marksawatzky8562]

@@DrMattDrMike And very easy on the eyes doesn't hurt either!!🎼🎵🎶🌞♨🔊

[@drumeshdash]

Ppt pppp

[@shreyabhowmik5510]

Sir, you are an amazing teacher! Your videos are the best in you tube. Thank u soo much for your efforts. Really helpful and life saving!!

[@howtomedicate]

Yea, I really enjoy them to! They are informative, but also fun to watch!

[@DrMattDrMike]

Thanks!!!

[@mezza2920]

I was literally having so much anxiety over this topic! Watched the lectures and tutorial, read over lecture notes multiple times, did the readings and it was like a big info jumble and fog in my head! Was feeling really stressed until I found your video. Thank you so much for this!

[@howtomedicate]

An other fantastic video! I do not know how you guys keep it up?!

[@MemeCrew5690]

Words cannot describe how grateful I am to you for making this excellent education video! Your deep knowledge and logic explanation is respectable! I am in nursing program and have to do a lot of assignments & textbook reading today; but I feel like watching your video is more important. Thank you so much!

[@yachiapatel]

Can't imagine how would I can understand such complicated theories with simple explanations..... All credit goes to Dr. Mike and his team.... Thank-you very much sir for letting us know all such theories with absolute concepts. Your commendable efforts are just speechless.

[@JCResDoc94]

56:00 they do work. and you have to stay in front of pain, as you said, so a low dose for a long period has almost no dose escalation (case dependent): and sttop it progressing to severe chronic pain. puritanical fears of also having pleasant fx are all this is about. which is why ppl get abandoned by health, and turn to alcohol or street drugs. bc they have no choice. and sub standard care. also, the antiDeps react w everything AND ARE addictive. and dont start w the hypersensitisation crap either, whcih is largely what it is.

[@sameeds.8270]

Wow what a lecture! now even a non medical person like me knows what is pain and how we feel pain. More power to you doc. Thanks alot!

[@rachell4576]

Hi Dr. Mike, I'm freaking out after two weeks of nursing class because I can't manage all the new knowledge in my assigned textbook. Then I thought, let's seek the issue I don't comprehend on your channel like I did in physiology class. And now I'm watching this video, even though it's been 4 years, but I appreciate your time and effort, which never expired even 20 more years because without your channel my nursing profession would never start. Even if the Pain gate theory fooled me the first time I read it in a study guide, I now find it quite enjoyable. Your explanation makes a lot of sense to me, and it makes me want to learn more. If you have time, could you correlate "first pass effect, bioavailability, protein binding" with "pharmacokinetics' vs "pharmacodynamic"? Thank you so much for this helpful video!

[@nstats3250]

Great content thank you. Would you consider generating some content regarding the use of Naltrexone for chronic pain treatment? Cheers

[@gregkass2010]

Literally stubbed my toe watching this video. Really brought everything together -___-

[@healthscoutptwernergrosse1579]

Sorry Dr. Mike: when you sense pain you should NOT only try to find a vai to mitigate it. Rather you should worry about the CAUSES behind it and try to avoid its causes 😊.

[@ghazalataskeen1618]

After watching your videos I have changed my mind set now I want to become a teacher like you I have one more thing to say seriously I have no doubts regarding this topic Thank you very much

[@speaklifegardenhomesteadpe8783]

Opioids are highly effective for long term chronic pain in millions of patients. Your body gets used to the dosage and it needs increased over time, but it still is highly effective without adding the tricyclic anti depressants etc., which carry horrible potential side effects. I've witnessed this in a multitude of high functioning cancer survivors, well they used to be functioning, working, volunteering in cancer orgs, running businesses, etc. Until recent years propaganda stigmatizing opioids and discriminating patients, forcing the end of these high effective treatments. Actually, several are no longer with us. Not from cancer returning, but from suffering in torturous pain so long their hearts failed or their will to live failed without even a hope their effective treatments would be restored. Barbaric.

[@kristen5484]

Around minute 8, are we sure that the mechanically-gated ion channels that open due to mechanical pressure let in Na?? Could it be any other positive ion? I can not find a good reference for this as of yet...I am just finding that the ion is not known.

[@autoimmunewarriorqueen7130]

But not all chronic pain is neuropathic. Sometimes long term opioid therapy is necessary. Ppl with progressive immune disease have reason for their pain, it’s not neuropathic and if you treat these patients you know that management medications like biologics are not stopping progression just prolonging it. So medications like antidepressants and anticonvulsants aren’t treating their pain effectively and need to be treated using different guidelines or they will be living a very low quality of life.

[@speaklifegardenhomesteadpe8783]

💯 Exactly.

[@daska1410]

I am currently studying for pharmacology exams and this video (among your others) has been so helpful. Thank you :-)

[@user-vdjxbwkskbc]

really great video, very helpful thank you! but why is there an advert like every 2 minutes or so

[@sadehavvad]

Fantastic. I've prepared my thesis on pain and was watching to prepare my mind for the thesis defense. I realized my mind was unclear on many small topics until I watched your video. Thank you very much.

[@thespeechmasterali2499]

Love u mike

[@rajivanand236]

Awesome lecture bro 👌👍1st time ⏲️ 1 hr I didn't lost my concentration and you have a great future in teaching profession. I wish you all the best and make some more videos 📹 keep continue the videos

[@tkdpll135]

Did anyone else start feeling their socks when he started mentioning them? Now I can't stop feeling them

[@philipmaxwell669]

Thank you so much for your videos. The depth and clarity of knowledge presentation is superb

[@antondonovan2810]

If you ever revisit pain and pain management, it would be nice if you could throw in more pharmacology and possibly talk about other potential meds like Ketamine and Cannibis regardless of how unusual they are. Would also be nice if you spoke about how age groups affect pain perception and/or management.

[@Nanobot888]

Wow, this is some genius level explanation right here. They teach us neuroanatomy + pain pathways in dentistry school and it has never made sense together like after watching this video. I cannot capture in words the usefulness of this. Thank you so much.

[@mariyazaman5946]

Excellent teaching method. Hatts off to you 👏👏👏 I am Mariya Shah your fan from Pakistan🇵🇰, a BSC Nursing student. You made all topics so easy for me. Lots of prayers and well wishes 👍🏻🤲🏻

[@phill6159]

Excellent execution, of detailed information, I learned so much, such an important subject. Thank you.

[@zarakaushik2206]

This was awesome, you are an amazing teacher and I learnt so much. Please keep making such videos. I am doing my Masters and this really helped me understand pain so easily, rather painlessly.

[@owaisrashid3680]

Doc if you come up like this on board it becomes difficult to concentrate on things you are teaching

[@OldPain2GoStevenBlake]

I loved this, some great detail there. Only let down by talking about pain receptors and signals instead of harm signals as these harm signals only become pain once the brain decides it is necessary. Without explaining that people will continue to be baffled by chronic pain which actually does have purpose and isn't a faulty system. All the rest of it you did a great job.

[@roland.j.ruttledge]

Excellent, many thanks

[@kyriakeka4447]

Thank you Dr Matt, amazing video as always. Could you please explain how medications such as Lyrica work in pain management?

[@stewartpagano1571]

Legend mate that was super informative and direct explained some issues I’m previously having . Cheers

[@amandacrowe5280]

One study is focusing on a protein called TREM2, which is essential for proper microglial function during stress events, including neurodegenerative diseases. When TREM2 does not function normally, plaques build up between neurons.

[@tepuiabawitlung2252]

Oh My God....Thank you so much sir 😢❤❤❤...I couldn't thank you enough...You are such an amazing teacher...Do you make notes to buy..I really appreciate the way you taught ❤❤❤❤

[@paulbarron2796]

wow!!! thank you so much. I have watched my lectures over and over and read and read and in 1 hour you have made it all so clear. I will definitely be watching your other videos. Thank you so very much for taking the time to produce these video's

[@DrMattDrMike]

Paul Barron Thanks for watching, Paul!

[@cairoona]

michael why dont u take off your shirt while teaching.. i reckon this will help the student focus lol

[@الإدارةالعامةلمكافحةالمخدرات]

cairo andrea lol

[@SingZeon48]

Would you like it if men said it to a female teacher?

[@healthscoutptwernergrosse1579]

There seems to be so much intention out there right now to confuse us about the simplest 'things' ongoing in our body ... but THANKS to God we have Dr. Mike to keep it easy and us informed properly 🙏🙏🙏

[@shanazporter2417]

This was an excellent lecture. Thank you sooo much for creating it. You have one of the best channels!

[@Kat-zc4lt]

WOW. Very well explained. Thank you!! Will definitely be watching more of your videos.

[@willyjensen8595]

I was hoping for a scientific explanation of pain which align with a different science fact. I make a medicine from pharmaceutical components which manipulate the mast cell. The result is that you can drop a gran piano on you foot. You may hear and feel the bones in you foot crush, treat with my medication, and all pain will disappear to the point that you can walk and use your broken foot without feeling pain, two minutes after treatment. You will feel an irritation when exerting your foot beyond its new mechanical limitations, but no pain.

[@scrub_itoff9849]

This was so helpful 👍🏻👍🏻👍🏻

[@josephvubya2010]

Wow, it's such a wonderful lecture, thank u Dr. Mike

[@taif5570]

This is amazinnng!!! thank youu so muchhh. keep going the world's best teacher .

[@SG333_]

Dr Mike I genuinely don't know what we'd do without you. This is such an excellent video, so clearly explained and helpful. Your knowledge and passion for teaching comes across and I wish we had more educators like you! Thank you so much! (You don't know how much you're helping me get through this med degree 😂)

[@p.kallas6692]

I have a decompartment in my arm. And it been so long now it will not work 100%again. I'm on hi doses oxicodon. Then my son died and now i have ssri xanax and sleeping pills. And i never felt this bad and depressed.

[@mohamedabomera5598]

Man you have just saved my life ❤

[@speaklifegardenhomesteadpe8783]

I watched an er doctor on a TV show covering real life er doctors...give morphine to assist in a patient with inflammation in their lungs, be able to breathe. It worked and was amazing!

[@jessicaelliot2031]

You. are. AMAZING!!! REWATCHING X100000000000000 TIMES! THANK YOU!

[@valched1]

Dr. Mike, Does pain from a tooth ache also go through the spinothalamic pathway since its close to the head?

[@DrMattDrMike]

Hi! Pain from toothaches will be transmitted by one of the cranial nerves (Trigeminal) to the brain.

[@TheBeatjunkee]

Thank you for this incredibly informative video. I was searching the internet on why when I stopped my SSRI that I have been on for 18 years I had an exponential increase in my back pain. I finally made the connection to the SSRI after months of suffering, and I am now back on it for only 3 days, and my pain seems to be under control again. I guess I am now an SSRI lifer even tho I no longer need it for what it was originally perscribed for.

[@Bigbang_Tripz]

🔝🔝🔝for all your shrooms, DMT, Lsd,MdmA, ketamine, psilocybin infused bar, wock, ayahuasca, xtc and other opioids

[@p.kallas6692]

What did the ssri effect the pain? I have oxicodon for nervpirrande and when I raised the amount ssri the oxicodon stopped work the same. What ssri do you use?

[@vaishnaviramakrishna265]

You nailed it Sir! Thank you so much!!!!! :-D

[@marksawatzky8562]

Fascinating!!😆😆 Just subscribed from Canada.👍👊✌

[@dhillonamarsingh5033]

Fantastic Explanation Thanks

[@amiruladib9760]

superbly good. easy to understand. TQVM

[@emilychiechi4446]

Thank you! Much appreciated :)

[@Bigbang_Tripz]

🔝🔝🔝for all your shrooms, DMT, Lsd,MdmA, ketamine, psilocybin infused bar, wock, ayahuasca, xtc, psychedelics and opioids.

[@H-Nawafleh]

Very useful content, many thanks 🇯🇴🇯🇴❤

[@drshetewy]

Excellent Thanks a million 🌹🌹🌹

[@raunaq15]

You are some horrible speller but a great teacher and thats commendable keep up you doing great

[@sarahabed805]

Thank you for the clear explanations 🥲🙏🏻

[@scokim]

Wow - comprehensive and yet simple to understand. Thank you.

ur in good shape there dude... wish i had the energy to work ut and no fucken pain... why u think im watching this.. in pain wtf.

[@damiandamiano3651]

Pani is my life

[@dessertthingy]

This is an awesome explanation, thank you!

[@tha_denzel_lit]

thanks Doc.

[@jessicacorley]

Thank you for this!! I am set to conquer my exam

[@pastorbrightamegazo9231]

Good job!

[@sarayounis9776]

This is so good it has brought me back hope that I can pass med school

[@iqbaladin7444]

Great explanation. 1 hour of lecture feel so short.

[@عليالسجادمحمدعليحمود]

you made it very clear , thank you doctor you helped me❤❤

[@ravindarbethi8675]

One sincere request. Kindly edit the transcript . It has no punctuation marks. Also there are spelling errors (paying is mentioned in place of pain here in this video transcript) that makes one difficult to catch the new terms of technology. All this is probably due to auto-generated text. KZbin too must develop auto-punctuation, automatic capitalisation, and continuous updating of technical terms and acronyms. This is otherwise a “must watch” video about pain. Excellent, and very much informative. Thanks for updating our knowledge. Simply superb.

[@summergirl198]

Amazing!! Thank you so much!!!

[@jenniferlyke9608]

Thanks!

[@sarayounis9776]

Thank you so much sir you are amazing

[@kaiwt2133]

Thank you for this. It helps a lot 👍🏾

[@fareehaadnanali1019]

Amazing video!! Thank You

[@goodnessattah8113]

Great video but sound is too low.

[@Jules.A.C.]

Came for the muscles. Stayed for the Aussie accent.

[@chavviattri7204]

Thanks sir 😊

[@anut32]

Thanks for such a wonderful video.

[@tbas8741]

After struggling for over 12 years with severe back pain after spinal injury. Was using THC for long term to help with Forgetting about the pain not so much in stopping it but recently quit as cant afford it anymore. Recently trying to get onto opioids for pain control and doctor is resistant as its "addictive" but will happily prescribe me much more toxic and more addictive anti depressants, which have much worse side effects. Why is it ok to be addicted to anti depressants but not opiates. Specially as euphoria & feelling of well being on Opioids defines Anti depression.

[@m.a6894]

The way I pay £9000 a yr for education but those idiots can’t even teach close to how u teach. This video was phenomenal. Ur saving me literally

[@springsh6678]

Thanks alot perfectly done...

[@buombothmut]

You're smart Doctor Thanks so much

[@ruditesalina4973]

Brilliant!!! Thank you so much!

[@mkras6037]

our 4 hours university lecture nowhere near as thorough and to the point.. WHY? Thank you so much for the material!

[@Penguin24766]

Nicely done :)

[@Just_mhide]

Hello Dr Matt It's 2024 and your video has literally saved my life Thankyouu

[@Helena-u7z]

Hello Doctor, thank you for your very helpful videos. Can you please make some videos on midwifery subjects?

[@DrMattDrMike]

Hi AAA, are you able to suggest some topics please.

[@Helena-u7z]

@@DrMattDrMike Hello Doctor, thank you for your concern and attention. Some of the areas that I find difficult are the pharmacology during labour and postpartum and also for the newborn, and also if you could show us an ultrasound of the foetus or how do you know what you are looking at it's all in grey shades and ..., OGTT test has a big question mark in front of it for me why not just do the blood test and if they have it we offer treatment. I will be bothering you with my questions as I progress in this course if it's okay. Thanks again

[@penelopebaba]

I am so grateful for your videos... My Physiology instructor is so hard to follow, I love physiology now, watching the videos you put out that clarify everything.... So Great!!!!!!!!!

[@lilywhite8123]

Thanks a lot. I appreciate your work. You made me understand more than my lecturer God bless

[@dawndomenico1377]

Thank you!

[@sarvinozakhadova]

thank you so much for information

[@cmble1147]

You are amazing!! This is amazing! Really helped me to understand a topic that just made no sense on paper! Thank you so much!!!

[@dipenshakya2184]

Exceptional work. Your videos always help me to clearly understand the concepts. Thank you for your work

[@dhyaneshvu6390]

Sir thanks much for posting the lecture Your videos helps me to get deeper subject grip in very clear manner that too in this lock down scenario Moreover ur videos became a part of preparations for my boards I am very much thankful Hope u will be continuing this with the same best .....