Pain And Its Management - Online Article

Pain –introduction

Pain is an unpleasant subjective sensory and emotional response to a stimulus, which causes actual or potential tissue damage. It is a personal and subjective experience. The psychological aspect of pain is as important as the physical aspect.

Purpose of pain

Pain is a protective mechanism for the body, occuring whenever any tissues are being damaged and it causes the individual to react to remove pain stimulu, e.g. when the skin becomes painful as result of ischemia the person normally shifts weight unconsciously.

Acute pain is useful pain,a symptom of underlying disease or trauma. It is localised ,sharp and self limiting,lasting,for at the most 3 months. The head and lower limb are the most common sites of acute pain.

Chronic pain on the other hand is pain that has lost its biological purpose, differing significantly from acute pain. It is pain or discomfort that has been relieved and associated with continuing pathology. It is poorly localised and continuously present for at least 6 mnth. The back is the most common site.

Pain behaviour is characterised by verbal expression of pain symptoms, guarding movements, decreased activity level,limited rom, avoidance of certain activity, overuse pain relieving medication, signs of depression and inability to do work.

Aetiology

  1. Viral,bacterial,fungal
  2. Inflammatory
  3. Neoplastic,degenerative 
  4. Ishaemic
  5. Metabolic 
  6. Autoimmune
  7. Traumatic

Classification

  1. Anatomical region affected 
  2. Systemic etiology
  3. Intensity 
  4. Temporal characteristic

Factors affecting perception of pain

  1. Personality:extrovert express pain more freely but are less sensitive to pain whereas introverts feel the pain more intensely but complains less.
  2. Social context:pain is percieved differently during wars,surgery,labours,rituals.
  3. Culture:people of some culture tend to withdraw and face pain alone whereas others openly seek support to endure pain.some view that pain is a necessary evil that has to be tolerated for future spiritual benefit. 
  4. Past experience of pain:example an earlier childbirth.
  5. State of mind: anxiety and depression increase the perception of pain. 
  6. Threshold:varies from person to person.
  7. Site of origin of pain,extent of pathology.

Pain receptors and their stimulation

  1. Mechanical
  2. Thermal
  3. Chemical
  4. Pain management
  5. Aims
  6. To identify and treat the organic cause 
  7. To improve the patient ability to cope with the pain
  8. To improve function

Medical intervention used to manage chronic pain

  1. Pharmacological
  2. Physical
  3. Behavioural
  4. Vocational rehab and volunteer activities
  5. Non steroidal anti inflammatory drugs like nimesulide
  6. Adjacent analgesics like paracetamol
  7. Surgery also b done if there is abscess

Cognitive behavioural methods

  1. Relaxation exercises
  2. Aroma therapy
  3. Hypnotherapy
  4. Music
  5. Group therapy
  6. Counselling
  7. Biofeedback 
  8. Reiki
  9. Physical agents used in management of pain
  10. Cold therapy 
  11. Heat
  12. Light radiation
  13. Laser
  14. UV Rays
  15. Tens
  16. Faradic currents
  17. Galvanic current
  18. Vibration
  19. Massage
  20. Traction
  21. Compression
  22. Hydrotherapy
  23. Therapeutic exercisess

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Comments

Prashant Gaur on 2009-03-18 23:54:58 wrote,

@sonia arora,
Nice one dear...!!!