Complete Pain Management Guidelines
Although Pain is an unpleasant sensation and an emotional experience, it still is a part of body’s own defence mechanism which warns the body of something going wrong and compels us to react and protect from further harm. Any noxious signal sent through nerves, from site of problem, to brain, is interpreted and felt as Pain. This feeling of pain may mostly be felt at the real sit of signal or it may be referred to a remote site of body.
Pain is neither experienced nor is described in an identical way, by different people.
Types of Pain:
Depending on intensity, spread or duration of pain, it could be described as Acute, chronic, localized or diffused over an area of body.
Acute pain: is generally intense and short-lived. It normally is resolves by treating the cause of pain.
Chronic pain: It can be mild or severe, continuous (arthritis) or intermittent (migraines). Chronic pain typically lasts far longer than acute pain and is often, not easily resolved.
According to researchers, people in United States (U.S.) lose, 560 to635 billion Dollars each year, in terms of treatment costs, lost wages, and missed days of work because of Pain alone.
Diagnosis of Pain:
For identification of the type of pain, there is no objective scale available. Diagnosis depends on;
the character of pain, as described by the patient. Such as burning, stinging, stabbing or radiating.
Factors involved in aggravating or relieving the pain.
Time of the day pain occurs.
The impact of pain on person’s mood and daily life functions.
Thus, the most important factor in identifying and diagnosing pain, is the degree of pain as patient feels and its clear communication to the physician.
To assess the efficacy of any treatment for pain, there must be a baseline value to which a post treatment condition could be compared. In trying to measure pain, professional have come up with a few methods like;
Numerical rating scales: pain is measured on a scale of 0 to 10, where 0 means no pain at all and 10 means the worst pain imaginable. Patient is asked to allot a number to his pain initially and further assessment is done by an increase or decrease in this number.
Verbal descriptor scale: This type of measure may be used for cognitively impaired children, seniors and people with autism or dyslexia. Instead of numbers, different descriptive questions are asked to narrow down the type of pain the patient is feeling.
Faces scale: A series of faces is shown to the person in pain, ranging from distressed to happy. This is mainly used with children and has alsobeen shownto be effective in people with autism. It is sometimes used as a standard method of pain assessment.
Brief pain inventory: This is a more detailed written questionnaire gauging the effect of pain on mood, activity, sleep patterns, and how the pain may have affected the patient’s interpersonal relationships. It also charts the timeline of the pain to detect any patterns.
McGill Pain Questionnaire: This encourages people to choose words from a group of 20-wordsto obtain an in-depth understanding of the type of pain felt. Group 6, for example, is “tugging, pulling, wrenching” and group 9 is “dull, sore, hurting, aching, heavy.”
Other indicators of pain:
When people with cognitive impairments cannot accurately describe their pain, there can be clear indicators as to the presence of pain which include:
moaning and groaning
resistance to care
reduced social interactions
After making an assessment, physician either will actively treat the underlying cause of pain or willprescribe medication, to manage the Pain.
Treatment and management:
There are different ways to treat different types of pain as all types may not respond
Pain is mostly managed by medicines, some of which may be available over the counter (Non-steroidal anti-inflammatories (NSAIDs) and others mayrequire a prescription(Opioids) from a doctor.
Due to an emerging realization of painkiller’s side effects, non-medicinal or alternative therapies to manage pain are gaining popularity.
Alternatives Therapies for Pain management:
A range of non-drug therapies can help relieve pain.These include
Acupuncture: .Based on centuries old recognition of “Qi” (Chi), a vital energy circulating in body and
Modern-day Acupuncture needles are sterilized, single-use, precision made, and have specific designs for use in different areas of the body, for different treatment needs. The needles are approved for use, by the US Food and Drug Administration Authority (FDA).
This ancient treatment is now more widely used as complementary care to effectively treat not only Aches and Pains, but also has established its efficacy in the treatment of Addictions, Anxiety, Allergies, Asthma, Depressions, Migraines, Athletic Injuries, and Post Stroke Rehabilitation.
Acupuncture has gained such a popularity that a concept of Pain management feels incomplete without its use. The realization of analgesic’s side effects, by the medical profession and public at large, has also been fanning its popularity. Acupuncture is an ancient technique developed in China but is successfully being used for help in a variety of medical conditions.
Does Acupuncture Actually Work?
Acupuncture has survived the centuries-long history, and this has not been without proving its efficacy or it would have died its own death. The evidence of the efficacy of Acupuncture does not only come from the World Health Organization (WHO) but also from the US Department of Veteran Affairs as well. (https://www.acupuncture.org.au/wp-content/uploads/2017/11/28-NOV-Acupuncture-Evidence_plain-English-Web-version_Reissued_28_Nov.pdf). A wide body of research supports the use of acupuncture to treat many medical conditions, including migraines, depression, and arthritis, frozen Shoulder and many more.
A 2017 study found that regular acupuncture could help to prevent migraines episodes and a review from 2012 indicated that acupuncture may treat migraines as effectively as other medical options.
More research is needed to determine whether acupuncture can help to treat arthritis, but some people find a new lease of life with Acupuncture, in which their pain is considerably reduced or abolished, and their life is much more manageable, with no medication side effects.
Results of a 2018 medical research review show that acupuncture may reduce the severity of depression in some people when used alongside traditional treatments.
Acupuncture is used for pain management in wide range of conditions like;
Aches and pains in muscles
Elbow pain/Tennis Elbow
Wrist pain/Carpal Tunnel Syndrome
Headache, cluster HA, Tension HA
Back pain, lower back Pain, Upper Back Pain.
Neck pain, stiff neck
Pain associated with Childbirth and Labor
Readers are encouraged to read the following scientific articles as well:
Battle Field Acupuncture is a type of Acupuncture used by US Armed Forces. Moreover, the effectiveness of Acupuncture in several scientific studies, has been verified by using Functional Brain scans. Release of Endorphins by Acupuncture needles, is also a scientifically proven fact.
These injections can numb a group of nerves acting as a carrier of pain froma specific limb or body part.
This can help with the emotional side of anongoing pain. Chronic pain can often affect the joys of everyday activities and can lead to an inability to work. Psychotherapist can help to enhance an understanding and put in place lifestyle changes to cope with this inability.
Transcutaneous electrical nerves stimulation (TENS):
TENS aims to stimulate the brain’s opioids and pain gate systems to provide relief.
Various surgical procedures done onnerves, brain, and spine make it possible to relieve chronic pain. These include rhizotomy, decompression, and electrical deep brain and spinal cord stimulation procedures.
This is a mind-body technique. Through biofeedback, people can learn to better control their organs and automatic processes, such as their heart rate, with their thoughts.
This covers a wide range of controlled relaxation techniques and exercises, mostly in the realm of alternative and complementary medicine. This can include hypnosis, yoga, meditation, massage therapy, distraction techniques, and tai chi.
A physiotherapist or chiropractor can sometimes help relieve pain by manipulating the muscle tension a person’s body.
Heat and cold: .Using hot and cold packs can help. These can be alternated or selected according to the type of injury or pain. Some medications have a warming effect when applied topically to the affected part.
If the pain is due to an injury or a repetitive action, rest may be the best option.