Pain is one of the most common symptom to lead a patient to seek a doctor's advice and whatever the cause it demands relief. Pain may be acute or chronic. This classification is based on duration of pain. Acute pain has occurred recently and gets better and goes away in short time. It has a definite beginning and end.
Chronic pain is frequent pain persisting for many
months. It may not respond to usual treatment unlike acute pain. Chronic
pain may effect people differently. It often causes mild depression, decreased
sleep or appetite. It may effect ones performance at work and at home.
Chronic pain may be seen in older people as many conditions such as cancer, arthritis are seen in older people, but is not a feature of aging.
Why does it occur?
Pain serves many useful functions. It may be 1)Protective
For example; It is protective when we withdraw our finger from fire to avoid burns due to pain.
It is defensive when restricting the mobility of inflamed joints and it may be diagnostic as in acute conditions of abdomen.
Each person experiences pain differently. It is a subjective feeling. Consequently the management also depends on the patient.
How is it evaluated ?
Complaints of chronic pain needs detailed evaluation and may involve a number of health care workers such as physicians, nurse, psychologist, social worker and physiotherapist. Doctors take a detailed medical history including a thorough drug and previous medical history. It'll be followed by complete medical examination, what are the limitation to work, daily activity will be taken into account. The patients stance, gait etc. also prove helpful.
You may be asked to keep a pain diary on how often and how long the pain lasts. It should include
Pain management requires drug treatment and non drug treatment.
than narcotics are needed for mild to moderate pain e.g. acetaminophen,
aspirin, and ibugesic.
These are non-addicting. Side effects include upset stomach, bleeding stomach, kidney damage etc. It varies from drug to drug.
Narcotic drugs are used for severe pain e.g. associated with cancer. These drugs are addictive. However, if used as prescribed , the dependence may be less. Side effects are nausea, vomiting, breathing problems and hallucinations. They are used as pills, injection suppository and patch. Other types of medicines used are steroids, sedatives and some drugs used to treat depression and convulsions.
Non medicinal treatment
2. Cold compress
3. Exercise program
5. TENS-transcutaneousnervestimulation 6. Hydrotherapy
7. Hypnosis 8. Acupuncture 9. Massage 10. Psychotherapy.
11. Biofeedback 12. Relaxation technique like meditation.
13. Healthy diet. 14. Hobbies
15. Neurectomy; it can be chemical or surgical. It is the last resort in intractable pain.