Pain: What it is, Diagnosis and treatment



Pain is the most common symptom of disease. It is an unpleasant sensation localized to a part of the bodyPain is the most common symptom of disease. It is an unpleasant sensation localized to a part of the body. It is often described in terms of a penetrating or tissue-destructive process (e.g., stabbing, burning, twisting, tearing, squeezing) and/or of a bodily or emotional reaction (e.g., terrifying, nauseating, sickening). Any pain of moderate or higher intensity is accompanied by anxiety and the urge to escape or terminate the feeling. 

Diagnosis

Self-report is the key to pain assessment. In non- or pre verbal children, facial expression is the most valid indicator of pain; therefore use faces pain scale to assess severity. Pain should be assessed by:
     Duration
     Severity, e.g. does the patient wake up because of the pain site
     Character, e.g. stabbing, throbbing, crushing, cramp like
     Persistent or intermittent
     Relieving or aggravating factors
     Accompanying symptoms
     Distribution of pain
     In children pain can be assessed by child’s crying voice, posture, movement and color. 

Treatment for Acute and Mild pain

Aspirin, Paracetamol, and Non -steroidal Anti-Inflammatory Agents (NSAIDs); these drugs are considered together because they are used for similar problems and may have a similar mechanism of action. 



Treatment for Severe Pain

Opioids are the most potent pain-relieving drugs currently available. They have the broadest range of efficacy, providing the most reliable and effective method for rapid pain relief.  

Treatment for Chronic Non Cancer Pain

Chronic pain is a pain that persist for more than 4 weeks chronic pain can arise from:
  • Tissue damage (nociceptive pain), e.g. arthritis, fibromyalgia’s, lower back pain, pleurisy, cancer pain etc
  • Injury to nerves (neuropathic pain) e.g. post herpetic neuralgia (pain following shingles), trigeminal neuralgia, diabetic neuropathy, HIV related peripheral neuropathy, drug induced peripheral neuropathy or phantom limb
  • Abnormal nerve activity following disease
Psychological evaluation and behaviorally based treatment paradigms are frequently helpful, particularly in the setting of a multidisciplinary pain-management center.

Chronic Cancer Pain

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