Noxious input to the spinal cord is known to produce central sensitization, which consists of allodynia , exaggeration of pain, and punctuate hyperalgesia , extreme sensitivity to pain. Two types of mechanical hyperalgesia can occur: 1) touch that is normally painless in the uninjured surroundings of a cut or tear can trigger painful sensations (touch-evoked hyperalgesia), and 2) a slightly painful pin prick stimulation is perceived as more painful around a focused area of inflammation (punctuate hyperalgesia). Touch-evoked hyperalgesia requires continuous firing of primary afferent nociceptors, and punctuate hyperalgesia does not require continuous firing which means it can persist for hours after a trauma and can be stronger than normally experienced. In addition, it was found that patients with neuropathic pain, histamine ionophoresis resulted in a sensation of burning pain rather than itch, which would be induced in normal healthy patients. This shows that there is spinal hypersensitivity to C-fiber input in chronic pain. 
After that, I had a whole different outlook on the use of meds and performance enhancement. I still use NSAIDs on my own stiffness, but I won’t accept a joint injection of cortisone–it weakens the joint. I don’t give a horse Bute until the vet has seen it, and I know it’s partly a cover-up, not a cure. Nor do I work a horse that’s on Bute–it’s off work until it’s sound without Bute. If a dressage horse “needs” its hocks injected to keep doing upper-level work in collection, it needs to quit doing upper-level work in collection.
Patients with acute cholecystitis should be admitted to the hospital for intravenous antibiotics. Cholecystectomy is usually performed within 24-48 hours. Patients who are poor operative candidates can be managed with antibiotics alone with success. However, in the presence of a palpable gallbladder or abnormal liver function tests nonoperative therapy usually fails. Persistence or worsening of fever or elevation in the white blood cell count despite antibiotic treatment are indications for immediate surgery. In most cases laparoscopic cholecystectomy will be successful. Conversion to open cholecystectomy is more likely in patients with acute cholecystitis.