You must have experienced pain in a part of the body, right? Pain is a very common condition. According to the Association for the Study of Pain (IASP) pain is defined as an unpleasant sensory and emotional experience associated with, or similar to, actual or potential tissue damage.
Pain occurs with many disease processes or in conjunction with some other diagnostic tests or treatments. Pain can originate from any part of the human body such as skin, muscles, ligaments, joints, bones (nociceptive pain), injured tissues (inflammatory pain), nerves (neuropathic pain), internal organs (visceral pain) or a combination of these types of pain (mixed pain).
It is important for people with pain to get the right treatment so that their pain can be reduced and their quality of life improved. Pain management is a way to identify and manage pain caused by tissue damage or problems with body function. The goal is to reduce pain that interferes with daily activities.
Pain management can be given when a person has severe or long-lasting pain. This is done to reduce pain, improve the function of the affected body, and improve quality of life. Pain can be managed using medication and non-medication methods.
There are several types of pain:
1. Acute Pain: Pain of short duration (relatively speaking) lasting from a few minutes to about three months, occurring in a specific area of the body and is the body's response to physical injury. It usually resolves after treatment. Examples include cuts, bruises or pulled muscles.
2. Chronic Pain: Lasting more than three months, can be due to an injury or illness that does not heal properly. Some examples of chronic pain are low back pain, knee pain
3. Nociceptive pain: Occurs when there is tissue injury or inflammation, the nerve endings will send pain to the brain. Examples include a broken bone or an injured hand.
4. Neuropathic Pain: Caused by problems with the nervous system, leading to erroneous pain signals. Examples include pain due to diabetes, trigeminal neuralgia.
The pain can be more than just discomfort. It can affect your overall feeling. In fact, pain can lead to mental health issues such as depression and anxiety, so pain cannot be taken for granted.
Pharmacologic pain management means managing pain by using pain medications. Pharmacologic pain management includes the use of non-opioid analgesics, opioids, adjuvant analgesics, and corticosteroids:
1. Non-opioid analgesics are commonly used to manage mild to moderate pain. Non-opioid analgesics can be classified into three main categories: non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and topical agents.
2. Opioid analgesics are pain relievers used to manage moderate to severe pain. Opioid analgesics can be classified into three main categories: natural opioids, synthetic opioids and semi-synthetic opioids. However, the use of opioids requires special attention regarding potential side effects and addiction.
3. Adjuvant analgesics are a diverse group of drugs that can be used in combination with other pain management drugs to enhance their analgesic effect or to manage specific types of pain. Adjuvant analgesics can be classified into several categories based on their mechanism of action and therapeutic indications: antidepressants, anticonvulsants, local anesthetics, and corticosteroids.
4. Corticosteroids are potent anti-inflammatory agents used for pain associated with inflammation. They are commonly used for pain associated with conditions such as rheumatoid arthritis and back pain.
Non-pharmacological pain management means managing pain without medication. Here are ways to manage pain that can be done by medical professionals and patients themselves without drugs:
1. Stimulation and massage of the skin: Massage on the body, especially the back, can help reduce pain by making the patient more relaxed.
2. Cold and warm compresses: Cold compresses reduce the production of prostaglandins that can increase pain, while warm compresses help increase blood flow and promote healing.
3. Transcutaneous Electrical Nerve Stimulation (TENS): A TENS device is placed on the skin and produces a tingling or vibrating sensation in the painful area.
4. Distraction: Shifting the focus of attention away from the pain in some way can help reduce distraction from the pain.
5. Relaxation techniques: Performing deep breathing techniques regularly can reduce muscle tension and relieve pain.
6. Guided imagery: With guidance, patients use positive imagery to distract from the pain.
7. Music therapy: Listening to instrumental music can provide calmness and distract from the pain.
IPM is a minimally invasive pain management technique that is more optimal in pain management with less risk. There are several modalities of IPM such as radiofrequency (RF), nerve block, and injection of certain drugs at the site of pain.
Radiofrequency is the process of delivering waves with a high frequency of about 50-500 kHz to the tissue using RF electrodes connected to a generator to induce biological effects to reduce pain. RF therapy is effectively used in the treatment of chronic pain. RF is divided into three types, namely:
1. Continuous Radiofrequency (CRF)
CRF is a pain management technique with continuous delivery of radiofrequency waves to specific nerves or nerve areas to create thermal lesions (heat) in the nerve tissue, which can interfere with pain signals transmitted to the brain. CRF uses temperatures in the range of 70-90 oC.
2. Pulsed Radiofrequency (PRF)
PRF is a pain management technique with radiofrequency wave delivery with a certain time lag (usually given at a frequency of 2 or 4 Hz, with pulses of 20 or 10 ms for 360 seconds). This allows a decrease in heat temperature so that it does not cause tissue damage as in CRF. The tissue temperature is kept below 42 oC. In some studies, PRF is effective in pain management such as neck pain, trigeminal neuralgia, back pain, facet arthropathy, radicular pain, hip pain, myofascial pain, and adhesive capsulitis.
3. Cooled Radiofrequency (CRFA)
CRFA is a relatively new technique, involving the circulation of cold water through the probe tip to maintain a lower temperature at the tissue tip. CRFA produces larger spherical lesions than those produced by conventional RF, increasing the likelihood of target nerve tissue ablation. However, research on CRFA is still limited.
A nerve block is a type of pain management that uses local anesthesia or drugs such as steroids to block nerves so that pain signals to the brain are interrupted. When used to manage pain from surgery, nerve blocks can reduce or eliminate the need for general anesthesia, reduce pain after surgery, and reduce the need for opioids. Nerve blocks are also used to manage some types of pain for example:
1. Facet Joint Block and Medial Block
Facet Joint Block and Medial Block are used to reduce pain related to bone bruising. Local anesthetic or steroid injections are done to reduce inflammation and irritation, which in turn reduces pain.
2. Peripheral Nerve Block
Peripheral Nerve Block is performed to block pain signals from the periphery for example genicular nerve block for knee pain, suprascapular nerve block for shoulder pain, interscalene block for upper arm pain, or supraclavicular or infraclavicular block for elbow, arm or hand pain.
3. Selective Nerve Root Block (SNRB)
SNRB is a nerve block injection used to diagnose and treat inflamed spinal nerves.
4. Sympathetic Nerve Block
Sympathetic block is widely used to treat visceral, ischemic, neuropathic, and sympathetic pain, as well as many other conditions.
Multimodal analgesia is performed by using a combination of several modalities (analgesic drugs or techniques with non-pharmacological interventions) to target several mechanisms in the central and peripheral nervous system related to pain. Multimodal analgesia may have a synergistic effect and be more effective in reducing pain than single modality interventions.
A comprehensive pain management plan can help you feel better physically and mentally. Research shows that many people with chronic pain enjoy a better quality of life with pain management
Some of the benefits of pain management include:
1. Improved quality of life: Effective pain management can help patients experience significant changes in their quality of life. This includes an improved sense of well-being, more stable emotions, and the ability to better enjoy daily activities.
2. Improved mobility: Good pain management can help patients improve mobility. This is especially important for patients with chronic conditions that may restrict their movement, such as osteoarthritis or low back pain.
3. Reduction in risk of complications: Proper pain management can also help reduce the risk of complications. For example, patients who receive good pain management after surgery tend to experience fewer post-surgery complications.
4. Minimize the impact on daily activities: Uncontrolled pain can interfere with daily activities, including work, social activities, and sleep. Effective pain management helps patients minimize this negative impact.
The effectiveness of pain management depends on the cause of the pain and the treatment you are receiving. Pain management is most likely to be effective if you have first consulted a doctor or are assisted by a competent expert.
Also Read: Getting to Know the Spine Surgery Method with Small Incisions
Pain in certain parts of the body will greatly interfere with productivity. Persada Hospital has pain management services at the Hip and Knee Clinic. To get the best care, you can visit Persada Hospital, which has professional doctors and modern medical facilities. Feel free to consult with our doctors to find out the best options for your health.
Visit the Hip and Knee Clinic for further assessment if you feel any discomfort in your joints. Check the schedule of Persada Hospital doctors to make a consultation visit at the orthopedic clinic. Also learn the latest health information through Persada Hospital's article page.
For more information on medical treatment and consultation, please call the Persada Hospital hotline at 0811-3058-8585.
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