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PAIN MANAGEMENT
Characteristics of Pain Millions of Americans
suffer from chronic pain which is one of the nation's
most serious and baffling health problems. While many
people focus on their back, their head or other
localized sources of pain, there are some specialists
who believe that pain could be a disease in itself
rather than just a symptom. Every year forty percent
of American have acute or chronic pain requiring
treatment. All pain, whether acute or chronic is a
message carried to the brain by nerves near the
surface of the skin or deep within the body. The
message is usually a warning of injury, organic
disorder, or the effects of stress on the body. Acute
pain - which is a sudden onset of brief duration, may
be caused by an infection, accident or surgery.
Chronic pain which may be the result of a specific
condition, does not diminish with treatment and does
not go away with the passage of time. As the pain
continues, it can affect personal relationships,
professional commitments and self-image.
Pain Theory
An understanding of how pain happens is basic to
finding more effective ways in dealing with it. There
are millions of sensory receptors on the surface of
the body and in it that keeps the brain informed about
temperature, condition of organs, unusual changes and
so forth. These receptors and the brain communicate in
a complicated code through a network of nerves located
throughout the body. Every nerve consists of bundles
of fibers which can be categorized as large and small
bundles. The large bundles carry impulses related to
touch. The small bundles send messages slower than the
large ones and carry pain the pain impulses. Both sets
of bundles meet at the spinal cord. Scientists believe
that there is a gate-like mechanism in the spinal cord
that can shut against pain messages. Relief associated
with electrical stimulation or acupuncture may be the
result of the pain gate being closed by using these
methods.
Pain Categories
Pain specialists have separated pain sources into
six categories. These include:
* Joint and muscle pain, which account for the
majority of patients attending pain clinics.
* Causalgia, which is the burning
pain that follows a bullet wound or some other sudden
shock to the nervous system. This type of pain is
likely to go away within a few months, but in some
cases, it could continue for years.
* Neuralgia, which originates in the
peripheral nerves is triggered by cold air, chewing or
stress.
* Phantom limb pain, which may originate sometime
after an amputation is a mild sensation of "pins and
needles" that turn into shooting pains that continue
for years.
* Vascular pain is associated with dilated blood
vessels around the brain that cause migraine
headaches.
* Cancer pain is the result of destruction of
tissue or blockage of major organs by a growing tumor,
or spread of certain cancers that reach the spine and
press on nerves.
Perception of Pain
Some people seem to be more sensitive to pain than
others, and different people respond differently to
different kinds of pain. In almost all cases, loud
music or intense physical effort can override the pain
messages. On the other hand, the intensity of pain can
increase during fatigue, depression, or anxiety.
Experiments have shown that the pain threshold can be
raised not only be distractions, but by such
techniques as hypnosis or meditation. A study on the
chemistry of pain indicates that men are less
sensitive to pain than women while older people are
less sensitive than young. Many responses to pain are
learned through cultural or parental patterns, and
individual character traits have a great deal to do
with susceptibility to chronic pain syndrome.
Acupuncture:
- Pain Relief Method
Many Western scientists remain skeptical about the
validity of acupuncture as a therapeutic discipline,
there is some evidence to indicate that the technique
stimulates the release by the brain of endorphins
(en-door-fins), naturally occurring painkilling
chemicals, into the bloodstream. Acupuncturists use
stainless steel fine-gauge needles inserted and
rapidly rotated, and is sometimes combined with
electrical stimulation. This stimulation is done at
specific pressure points in the body.
Anesthesia - Pain Relief Method
Local anesthesia in the form of cocaine derivatives
is used to deaden sensation. It is most frequently
used in dentistry, although it may also be used on a
short-term basis in back pain and to treat accident
patients. It has limited long-term application, but it
may be practical for alleviating the acute pain of
certain neuralgias or bursitis
(burr-si-tis).
Behavior Modification - Pain Relief
Method
This is a form of therapy that has is uses with
people for whom chronic pain has become a way of life.
It's also for those who use their pain as a way of
gaining control over others. It's based on the
assumption that many symptoms that started as
authentic pain have become a habit that needs to be
unlearned. People whose lives are closely involved
with the patient are usually asked to participate in
the therapy. Behavior modification is usually one of
the many approaches used in pain clinics.
Biofeedback - Pain Relief
Method
This is a technique that requires an intensive
practice in concentration in which patients learn how
to control certain involuntary body processes such as
constriction of blood vessels. By mastering this
method, patients can reduce the chronic discomfort of
vascular headaches and some types of stress-induced
muscle tension.
Chiropractic - Pain Relief Method
This is a treatment based on the idea that most
disorders results from pressure on the nerves caused
by the faulty alignment of the spinal vertebrae. Manipulation of the spine is the main
technique. However, where problems of the spine itself
are not the source of the chronic pain, chiropractic
treatment has not proved relevant. Chiropractors are
licensed to practice in most states.
Electrotherapy - Pain Relief Method
Electrotherapy seems to have an effect on the
larger nerve fibers that either short circuits
messages of pain, or that stimulates the release of
endorphins. The compact easy-to-use
equipment can be operated by the patient as necessary.
It's reported to be helpful in reducing chronic neck,
shoulder and lower back pain.
Exercise - Pain Relief Method
Most chronic lower back pain is alleviated by
strengthening particular muscles. Exercise such as
swimming that induces relaxation can be helpful in
alleviating stress-induced pain such as headaches, and
regularly schedules running is known to stimulate
endorphin production in the brain and is
responsible for a gratifying "high". The very fact
that exercise provides distraction, and in some cases,
acute discomfort, increases its effectiveness as an
antidote to certain kinds of pain.
Hypnosis - Pain Relief Method
There seems to be no general agreement about how or
why it works, but hypnosis is not a generally accepted
method of controlling and reducing pain. All hypnosis
is self-hypnosis in the sense that the subject has
decided to concentrate on producing a mental state
that will diminish anxiety and suffering. When it does
work, it has the advantage of being free of unpleasant
side effects not matter how often it is used.
Massage - Pain Relief
Method
People who suffer from acute pain are rarely free
of anxiety and can benefit from the relaxing results
achieved by a competent manipulation of tight muscles.
One technical explanation for the effectiveness of
massage is this -- if you bombard the nervous system
with impulses from the periphery, you
interfere with other impulses. Masseurs must be
licensed in most states, and referral by a doctor or
hospital insures reliability.
Medication - Pain Relief Method
Painkilling drugs range from over-the-counter
medications such as aspirin and acetaminophen to
powerful narcotic analgesics. Some painkilling drugs
work through the central nervous system to alter local
pain perception. Others act as muscle relaxants, and
still others alter a body process. Examples of the
latter are drugs that inhibit the body's release of
hormone-like substances that are thought to contribute
to certain types of pain. These drugs, commonly called
non-steroidal anti-inflammatory agents, are now
prescribed to treat arthritis and other
musculoskeletal pain, menstrual
cramps, and certain inflammatory disorders. Doctors
have long been award of the placebo effect -- the
beneficial results to many patients of providing the
equivalent of sugar water as medication. It has
recently been discovered that when a placebo is taken
by a patient with the anticipation of benefit, this
state of mind triggers the release of endorphins. Some specialists go so far as to say
that discreetly administered placebos provide pain
relief to about one-third of the population.
Meditation - Pain Relief Method
One of the most popular self-help techniques of
recent years for the alleviation of pain is
meditation. Like biofeedback, this enables people to
gain control over their body states once they've
mastered the discipline. The positive results of
diminishing pain and pain perception through this
altered state of consciousness is yet another
indication of the relationship between brain, mind and
body.
Psychiatry - Pain Relief Method
Pain presumed to originate in the stress of
emotional conflicts is called, function or psychogenic
(sy-col-genic) pain. It's just as real and distressing
as pain that has an obvious cause. Most often,
function pain has a component of anxiety or suppressed
anger that leads to constant and immobilizing
headaches or right muscles causing neck and shoulder
problems.
Surgery - Pain Relief Method
One of the oldest procedures for surgical relief of
pain is a chordotomy, in which certain
nerve pathways are cut or sectioned off. This is now
considered the treatment of last resort and is usually
reserved for certain types of neuralgia
or the burning pain that follows a shock to the
peripheral nervous system.
Pain Clinics
Since 1960, when the first pain clinic was
established at the University of Washington in
Seattle, similar comprehensive treatment centers have
been organized all over the country. Most of them are
attached to hospitals and call on the services of many
specialists. |