Facts on Chronic Pain and Management
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Facts on Chronic Pain and Management
Chronic pain has been defined as a form of pain that will persist for longer than expected with a natural normal healing. This pain is usually associated with some forms of injuries or fierce attack. Chronic pain may from range from mild manifestations to severe ones, which may progresses or persist for longer times. Different medical experts have different meanings attributed to chronic pain. Since long time ago, the major distinction existing between chronic pain and acute pain is something that relied entirely on some arbitrary intervals from the onset of the pain. This means that, it is from the acute that the chronic pain develops (Kotarba, 2003). This will take place in three to six months upon initiation of the pain. However, under some circumstances the period of acute transforming to chronic pain may be at least twelve months. Some other theorists have argued that acute pain will last for less than thirty days while chronic pain may go for over six months. It is the degree and persistence of this pain that determines the group or category of that pain. Chronic pain may last for over six months, while sub-acute to pain may last for around one to six months (Koenig, 2002). Another commonly applied definition for chronic pain is the kind of pain that has extended beyond the anticipated healing time or period. With this research, it was necessary that we understand some of the underlying facts behind chronic pains in order to come up with appropriate measures through which chronic pain can be treated or managed.
In the human body, pain will spring from some kind of injury or a given disease that had taken shape in the body. These pains can as well result from visceral, neural and somatic integral structures within the human body. In broad terms, pain in the human body will be classified to be either non-malignant or malignant in its origin. Chronic pain has become one of the common problems facing man today. Once there is persistence activation of nociceptive transmissions, this condition will automatically induce what is known as winding up phenomenon. This kind of phenomenon will induce some major pathological changes, which will automatically lower the level, or pain signal threshold being transmitted (Rowbotham, 2000). The phenomenon can as well generate nonnociceptive fibers to react to the pain induction signals. Nonnociceptive fibers for nerve transmission will result in the generation and transmission of pain signals into the brain. When in chronic pain, the process becomes extremely hard to eradicate or reverse (Rosenfield, 2004).
The Nociception Concept: Noniceptors are what will convey any given information pertaining to any kind of trauma or damage that has occurred in the body. This information is conveyed successfully to the brain’s Central Nervous System. This process is known as nociception whereby the information delivered will be interpreted as pain in the brain (Marcus, 2008). This nociception process will occur in any given organ or tissue in the body from which the signals of pain are arising from. This pain is more often than not because of some ongoing disease process in the human body or some form of trauma. Should this kind of pain occur or result from damage or dysfunction of the nerves, the kind of pain in the body is known as neuropathic pain (Rosenfeld, 2004).
Diagnosis of the pain: Pain will more often than not be because of injury in the body, or due to a number of infection states provoking nociception in the body. This will be sent in the Central Nervous System as acute pain, which will call for medical attention. In the diagnosis of any particular pain in the body, there is advancement in electrophysiological imaging, which has made medical experts capable of understanding and detecting some deeper insights regarding the characteristics, properties and phenomenon associated with chronic pain (Koenig, 2002). Some of the chronic pains have been found to be psychosomatic. Some of the well documented indicators for psychosomatic pains include diffusing, difficulties in describing the underlying symptoms, and more often than not when the pains are allover the body, and no given or stated physical cause to the pains. If an individual experiences some unexplained pain occurring in three or more parts of the body, this becomes an indicative sign for this kind of pain.
Management of Chronic Pain: Since it is well known that it may be extremely tricky in treating chronic pains, it is quite true that the best way through which this kind of pain can be dealt with is through management (Kotarba, 2003). Any completely sustained remissions towards a number of neuropathies and some other idiopathic pains, especially the pain extending beyond the projected period of healing, or any pain that has no indicated treatment, is something that cannot be easily achieved. Since this is an irrefutable fact, many things can be done in ensuring that the suffering faced by these patients is minimized so that they can as well lead a better lifestyle. This will be achieved successfully through pain management, also known as pain medicine by a number of medical practitioners. Pain management is one of the medicine branches that employ an interdisciplinary strategic approach in relieving pain and improving the quality of life of those individuals living with such pains.
In most of the medical practices, a typical pain medicine team will include a number of medical practitioners, psychotherapists, medical psychologists, some occupational therapists, and nurse physiotherapists. With their combined efforts, it becomes very easy to deal with some kind of persistent pain that may compromise an individual’s living standards. It is a well known fact that acute pain will resolve around the efforts applied by one practitioner in the course of pain treatment. However, in the management of this kind of pain, the frequent practices will always require that there are a number of coordinated efforts within the pain medicine team. Although a number of practitioners will argue that narcotics may be the ultimate solution to chronic pain, researchers have found out that the usage of the same narcotics in high dosages will be associated to very high risk of opiois overdose, which may have detrimental impacts on the human body.
The other important thing revolves around prognosis of chronic pain. As we have already noted, chronic pain will more often than not produce itself with a number of symptoms and conditions ranging from prolonged anxiety to high-rate depression (Benjamin, 2009). Once an individual has chronic infection, there will be a reduction in the physical activity, which results from an apprehension from the exacerbating body pain. As psychologists argue, an individual experiencing this kind of pain will do very little or almost no work. There are some cognitive effects due to chronic pain, and most of them have been based on pain cognition.
Attention with Chronic Pain
Chronic pain will impair ones ability in directing his or her attention. This means that the occurrence of chronic pain in an individual will affect his coordination thus being unable to engage in high demanding tasks and operations (Marcus, 2008). This lowers the attention of the individual so that no better performance can be obtained as a result. The occurrences of these pain sensations have therefore been known to express so strongly delimit the attention of these people. From the research study, it was found out that people who experience these pains will have reduced concentrations in whatever they are doing as compared to the same peers who are not experiencing similar chronic pains. From a number of experimental testing, it has been found out that two-thirds of all individuals suffering from chronic pain will demonstrate an increased impairment in terms attention (Rowbotham, 2000). This will be independent of the people’s age, their level of education, their medication provision, and any sleep disruptions. Individuals having the highest level of chronic pain will as well show the greatest disruption of attention. This impairs memory interpretation hence depriving the individual’s concentration.
With chronic pain, a number of causes can be mentioned. There can be cancer-related pains, postherpetic neuralgia, diabetic neuropathy pain, and central poststroke. These major syndromes are common within the elderly groups in different societies. However, any age group is vulnerable to this pain, only the differences will be on the major cause of the pain (Bellissimo, 2005). Once this kind of pain has been detected in a patient, it becomes very hard to deal with it, and especially when the pain has surpassed the treatment period. Adjunctive analgesics have therefore been noted to play a very big role when it comes to the management and treatment of chronic pain. Once applied as the initial form of therapy, it can be quite effective in minimizing and containing the intensity of the pain.
For a number of years now, tricyclic antidepressants are some of the major compounds that have been considered by many therapists in the management of diabetic neuropathies and central poststrokes in the elderly (Bellissimo, 2005). Adjunctive therapy has been advised for any pain that is cancer-related pain. A number of useful agents have been gabapentin, lamotrigine, and carbamazepine, and have been found effective in treating patients suffering from burning pain and lancinating. In some other patients, mexiletine, baclofen, and clonidine have as well been found quite useful. Some cancer-related pains will as well respond effectively to corticosteroids; some pain occurring in bone metastases will effectively respond to some compounds like strontium and bisphosphonates. Practitioners have to make sure that they consider the relevant alternative compounds in the treatment of chronic pain. However, it should be known that, any increased use of these drugs will have intense impacts on the patient. Because of these facts about these treatment chemicals, a number of medical practitioners have always insisted in the pain management ideology as the right method through which this condition can be addressed to give the patient better lifestyles (Jay, 2007).
From this study, we have been able to note some of the underlying facts about chronic pain. It can be seen that these pains will vary in terms of their intensity, hence making it necessary for medical practitioners to come up with appropriate measures through which the chronic pain can be treated or managed. Since it is a well known fact that there are a number of compounds that can be employed in the treatment of chronic pain, it would be necessary that the cause of any given pain is identified in the first place. Once the cause of the pain has been successfully identified, the medical experts can give the appropriate medication for the pain. However, most of the commonly used agents and compounds have been found to have side-effects on the user and hence it would be necessary that precautions are taken when administering these chemicals compounds (Weiner, 1999).
Since the impacts of chronic pain can be very devastating to an individual, it would be necessary that all family members are supportive in the provision for medicine, care, mutual and emotional support to the patient. This will ensure that the pain is addressed with the appropriate treatment so than it can be lessened within the shortest time possible (Strong, 2006). As the rule goes, sometimes it would be better that we prevent than treat. This means that all people should be motivated to engage in healthy living standards so that the chances of developing chronic pain can be highly reduced (Jay, 2007). This will be easily achieved through exercising and eating healthy foods. This will ensure that most of the causes for the pain do not occur in the human body. Should an individual test positive with the pain, it would be necessary that the right medication or pain medicine be provided to him or her. Through the application of the above-mentioned strategies, all the people having chronic pain will be reduced, and at the same time reduce the chances of developing chronic pain.
Bellissimo, A. (2005, April 9). ‘Chronic pain: the psychotherapeutic spectrum,’ New York Times, p. 15.
Benjamin, L. (2009). ‘Chronic pain: further observations from City of Hope medical center’, Snippet View, 33(45), 88-89.
Jay, G. (2007). Chronic Pain: New Jersey: Prentice Hall.
Koenig, H. (2002). ‘Chronic pain: biomedical and spiritual approaches,’ Health and Fitness Journal, 34(44), 73-102.
Kotarba, J. (2003). Chronic Pain: its social dimensions: Oxford: Oxford University Press.
Marcus, D. (2008). Chronic Pain: A primary care guide to practical management: New York: Penguin Books.
Rosenfield, A. (2004). The truth about chronic pain: patients and professionals on how to face it. New York: Oxford University Press.
Rowbotham, D. (2000). Chronic Pain: New Jersey: Prentice Hall.
Strong, J. (2006). ‘Chronic pain: the occupational therapist’s perspective,’ International Health Journal, 22(23), 44-47.
Tunks, E. (1999). ‘Chronic Pain: psychological factors in rehabilitation,’ Medical Journal, 34(54), 67.
Weiner, R. (1999). ‘Chronic pain: assessment diagnosis, and management.’ Journal of psychology, 21(32), 89-102.