Understanding pain management. Pain remains one of the commonest reasons for medical consultation, affecting the lives of more people than heart disease, diabetes and cancer combined.
Most of us have endured finite episodes of severe pain whether that be a fractured bone, toothache or headache, and are fortunate to remember these as distant memories.
Some are, however, denied this luxury of forgetfulness and suffer from chronic pain which simply explained is pain persisting beyond the healing period of 3-6 months.
Persistent pain beyond this period can lead to changes in the nervous system and transform into continuous pain even after the original cause for the pain is removed, and hence timely treatment is a priority.
Chronic pain conditions are amongst the leading causes of disability as even mild joint pain can have a debilitating impact on mobility and quality of life.
In contrast, acute pain, such as after an injury, has a distinct beginning and end, and abates with healing or appropriate treatment.
Understanding Pain Management
The complexities of pain and the fact that surgery or pills cannot resolve all pain issues have been long recognised.
After all, it is the pain which brings a patient to the hospital whether it’s a slipped disc or cancer hiding deep inside the tummy, so why should the treatment of pain be a second priority.
It is time chronic pain is managed as a disease and not as a symptom. In certain situations where the root cause cannot be removed the emphasis shifts to the management of pain and prevention of flare-ups.
Like diabetes and high blood pressure, pain therapy needs to be adjusted from time to time. Often this concept is not well appreciated, and suffering is prolonged in the quest for a cure.
Early initiation of treatments is a priority in conditions such as rheumatoid arthritis as this reduces the detrimental disease consequences and long-term disability.
This raises a need for a robust primary health care system with established care and referral pathways.
The impact of pain is not just limited to physical suffering as it affects all aspects of one’s life.
It is not uncommon for people to become irritable, depressed, anxious, socially isolated, develop strained relations, have financial and work problems.
In chronic pain the disability is not always visible, making it challenging for others to appreciate what one is going through.
Often the lesser-known pain conditions fall between medical specialities with no one being able to pinpoint the root cause and the patients keep seeing one specialist after another with a battery of investigations coming back as normal.
New Developments And Pathways In Pain Managemen
Increasing emphasis on the quality of life is challenging the medical fraternity to improvise and keep pace with community expectations.
A number of new drugs and interventional options for pain treatment have been developed in the last few years. Unfortunately, not all of these are available in some countries currently, but it is only a matter of time.
Newer drugs such as a strong Capsaicin patch (consult your doctor before taking), used in patients with localised nerve pain, have the potential to relieve pain for months with just one application and have minimal side effects.
New medications for relieving constipation have helped improve the tolerability of existing strong morphine-like painkillers.
Besides medications, new interventions such as radiofrequency treatment for knee, hip and shoulder pain offer advantages in terms of being minimally invasive day care procedures without prolonged rehabilitation requirements and with the potential of offering long-lasting relief.
Some of these options are emerging as alternatives to joint replacement and as a rescue technique for those with unsatisfactory pain outcomes after replacement.
Regenerative medicine is opening new doors and offering new insights into how we deal with pain conditions.
The availability of portable high definition ultrasound machines has drastically refined diagnostic and interventional skills in pain management.
Genetic and molecular tests are being closely studied to enhance our understanding and will hopefully provide new targets for pain relief.
An essential component of managing chronic conditions is prevention. So the obvious question which arises is what can we do to prevent chronic pain?
Maintaining a healthy lifestyle goes a long way. This includes a healthy diet and weight, regular exercise, healthy postures, managing stress and eliminating unhealthy practices such as excessive alcohol use and smoking.
After all this is also the key learning from this year’s pandemic – Health is the Real Wealth.
Understanding pain management? Drop your comment