Current and Historical Pain Definition and Treatment - Coursework Example

Current and historical pain definition and treatment Introduction Pain is an unpleasant body feeling of discomfort sent to the brain through sensory neurons as a result of injury to the body that can be either potential or actual. The perception of pain in the brain provides information on the intensity, location as well as the nature of the pain. The major causes of pain are body injury and illness. It can accompany a psychological disorder such as depression, a medical condition such as meningitis or can even result in the absence of a recognizable trigger (Morley 26). It motivates an individual to withdraw from a damaging situation for them to protect damage from a body as it heals or avoid a similar body injury. Majority of the pain experiences resolves instantly when the painful stimulus is removed but at certain instances, it persist in spite of the removal of the stimulus. In the US, it is a major reason for physician consultation as it presents as a major symptom in a majority of medical conditions. Pain interferes with an individual’s normal quality of life as well as their general body functioning. However, psychological factors such as excitement, social support, and distraction are essential in modulating the severity and intensity of pain and analgesics medications are used in the treatment of pain. Pain can be classified according to different characteristics such as the region of pain involved, the system of body that is dysfunctional such as nervous system, the pattern, and duration of its occurrence, the intensity, and causes of pain. According to Melzack and Katz, pain is classified into three main classes that is nociceptive pain, pathological pain caused by disease damage to the nervous system and inflammatory pain associated with inflammation and tissue damage (1-15). Classification on duration Von Korff and Dunn, states that pain is normally transitory and only lasts for a period until the painful stimulus is removed from the body location or the pathology and damaged is completely healed (267-270). However, in some medical conditions, it may persist for a lengthy period such as in arthritis, idiopathic pain, and cancer. Pain only lasting for a short period is called acute pain while that which is persistent for a lengthy period is referred to as chronic pain. Traditionally acute and chronic pain distinction was relied on for time with markers at three and six months since the time of onset with some theorists placing the transition period up to 12 months. Acute pain results from damage to tissue muscles and is associated with cramps and headaches. It will resolve when the stimulus is removed or as the healing process takes place. Chronic pain, on the other hand, unlike acute pain, is usually persistent after injury or a medical degenerative condition. In the US approximately 1 in 3 individuals, usually experience chronic pains at one point in their lives especially the disabled individuals (Tracey 35). It may result from the genetic mutations such as transcription of receptors and neurotransmitters. An example is in psychological conditions such as depression. Chronic pain may also result in cases of hyperalgesia, phantom pain, and allodynia. Allodynia is a response to pain in a non-harmless stimuli resulting from nerve damage. Hyperalgesia is just similar to allodynia but in this instance; the pain is extreme. Phantom pain results from amputation of a limb where the individual continues perceiving the pain despite the absence of the limb. Nociceptive pain It results from peripheral nerve fibers stimulation that is responsible for responding to the painful stimulus that exceeds harmful intensities. This kind of pain can be further classified in respective to the mode of stimulation. Common categories are chemical, mechanical, and thermal classifications. It is also classified according to the intensity i.e. visceral, superficial somatic and deep somatic. Visceral pain is usually difficult to locate as is accompanied by vomiting and nausea. It is described as dull, deep, and sickening. Deep somatic pain includes broken bones and sprains resulting from nociceptors simulations in muscles and ligaments. Superficial pain, on the other hand, is on the skin and other superficial tissues and results from nociceptors stimulation (Morley 28). Neuropathic pain Results from damaged of the nervous system as a result of a disease condition. It can be described as stabbing, pinning, burning, shooting, and at times sharp pain. It can be as a result of a short episode of discomfort resulting to prolonged pain or mild pain being felt as severe pain; as a result, damage to the neurotransmitters. According to Breivik et al, the estimated incidence of neuropathic pain in the general population is approximately 1 percent. Phantom pain It is a delusional pain that never exists. It feels like it is coming from a part of the body that does not exist in reality especially after amputation. Therefore, it will occur amongst individuals who have their leg or arm amputated as well as other body parts such as the tongue, penis or the breasts. The painful sensations are believed to originate from the brain and the spinal cord. Phantom pain management can be challenging although it gets better with time among some patients. The prevalence of its occurrence after a lower limb amputation is 54 percent while upper limb amputation prevalence is 80 percent. The painful experiences vary in their intensity and times experienced while in others it may occur once or twice in a week. Psychogenic pain It is also referred to as somatic pain and results from increased emotional, behavioral and mental factors. Among the common symptoms diagnosed with this pain are head, back and stomach pain, high anxiety levels and decreased self-esteem. It is well managed by therapeutic intervention and is not difficult to manage, unlike other pain types. However, medical specialist considers is not to be real or harmful leading to stigmatization of the patients (Melzack and Katz, 12). Current and historical ways of pain management With the different types of pain, causes, intensity, and nature management will require some interdisciplinary approach that entails the utilization of invasive procedures, treatment with medications as well as non-pharmacological therapies that have been on the use over the years. The best way of pain treatment adopted is through preventing the cause of pain occurrence, but there is no assured guarantee of immediate relief of pain. Pain relief therapies have developed over time with current development being the most adopted pharmacological options and invasive procedures. Analgesics/ pharmacological therapy These entail a wide variety of classes of drugs such as narcotics, NSAIDS, anticonvulsants, acetaminophen, and antidepressants. NSAIDS and acetaminophen are the first drug of choice for pain treatment and is used in adjacent to other pain relieving therapies that will require a doctor’s prescription. Among the commonly used NSAIDs are naproxen, ibuprofen and aspirin whose mechanism of action is by blocking pain neurotransmitters such as prostaglandins. These drugs are recent developments in pain management and are effective for treating acute pain where severe and moderate pain types will recur stronger medications. Narcotics are best for handling severe pain and are used for pain management that is not responsive to NSAIDs and acetaminophen such as cancer pain. Narcotics are only available under the doctor’s prescription classified, as opioids are opiates. An example of an opiate is morphine while Opioids are synthetic drugs such as meperidine (Tracey, 39). These drugs are only used under the doctor’s prescription, and their use is restricted to only severe and chronic pain management. Antidepressant medications are utilized in depression treatment but are also effective in compacting headaches, pain associated with nerve damage, and cancer pain. On the other hand, anticonvulsants are used for management of seizures but have a similar background with antidepressants and are effective in treating pain associated with nerve damage i.e. Tegretol. Another class of drugs used in pain management is the corticosteroids that are effective against pain resulting from inflammation, migraine headaches and swelling. The drug of choice for pain management will depend on the severity and pain type where intravenous injections will be required where high doses of drugs are required to relieve pain such as surgery patients and patients undergoing invasive procedures. It is very important to determine correctly the type of pain that the patient is suffering from as well as its severity in order to determine the best type of pharmacological intervention to administer to the patient for pain management (Morley, 30). Non-pharmacological options These entails pain treatment options that never involve drugs and can be used adjustment to drug therapy. They are crucial as it enables the patient to take a more active stance in pain management. Among the traditionally adapted techniques, involve the yoga and meditation techniques. These therapies are effective in reducing muscle tension, as well as stress management. Biofeedback technique can also be used in reducing stress and tension where the patient’s heart rate, skin temperature, blood pressure, and muscle tension will be modified. Active patients involved in the exercise and normal activities help in controlling the levels of pain. Physical therapy causes the production of endorphins that are natural painkillers in the body resulting to body relaxation (De Pinto, Dunbar, and Edwards 23). As well, physical therapy is important for strengthening the body muscles and helps the patient to remain physically fit. Acupuncture pain management therapy is a tradition method of pain management that is adopted up to date. It entails the insertion of small needles in the skin at various key points. Pressure is then applied at these points, and the procedure relies on applying pressure rather than the insertion of the needles. This method works by causing the body to release endorphins causing relaxation of body muscles. A modification in the pain management includes massage and applying heat that help in relaxation and stress reduction. Pain signals can be interrupted by a procedure referred to as transcutaneous electrical stimulation of nerves inducing the body to release endorphins (Li 384). Invasive techniques Invasive procedures will involve surgery, and certain guidelines need to be followed before the procedure. Among these invasive procedures are ablative, anatomic, and augmentative procedures. Before the procedure, it is essential to determine the cause of pain, and the procedure needs to be done if it is only going to be effective. An anatomical procedure entails correcting the injury and removing the pain-causing stimulus. This may entail decompression surgeries such as nerve decompression relieve in carpel tunnel. A nerve block in the case of neurolysis can be corrected by removing the damaged part. An augmentative procedure includes a direct drug application or electrical stimulation to the nerves that transmit the pain signal blocking pain transmission. The procedure can also include implanted drug delivery system an example being implanting a catheter in the spine allowing for direct drug delivery to the central nervous system. The last invasive procedure ablative technique is characterized by disconnecting the pain-transmitting nerve from the central nervous system. Ablative technique is best used in the management of neuropathic pain (De Pinto, Dunbar, and Edwards 36). Psychological support Support is very essential in pain management as helps in pain reduction. This has been demonstrated and is evidenced during labor pains in pregnant women where with appropriate support, the woman experiences less labor pains. Support is important in reducing anxiety that can worsen the pain in a patient. Through proper integration by support, the patient can become so much integrated into the activity and entertainment such that they can no longer experience the pain. Cognitive behavioral therapy is very effective in pain management of chronic pain and is enhanced through physical activities. Psychological support has been adopted traditionally and currently and has been proved to be very effective (Eccleston 151). Conclusion Pain is an unpleasant body feeling of discomfort sent to the brain through sensory neurons as a result of injury to the body. The perception of pain in the brain provides information on the intensity, location as well as the nature of the pain. The major causes of pain are body injury and illness. Pain motivates an individual to withdraw from a damaging situation for them to protect damage from a body as it heals or avoid a similar body injury. Majority of the pain experiences resolves instantly when the painful stimulus is removed but at certain instances, it persist in spite of the removal of the stimulus. It is classified according to different characteristics such as the region of pain involved, the system of body that is dysfunctional such as nervous system, the pattern, and duration of its occurrence, the intensity, and causes of pain. With the different types of pain, causes, intensity, and nature management will require some interdisciplinary approach that entails the utilization of invasive procedures, treatment with medications as well as non-pharmacological therapies that have been on the use over the years. Pain relief therapies have developed over time with current development being the most adopted pharmacological options and invasive procedures. Work citied Breivik, H. et al. “Assessment of Pain.” British Journal of Anaesthesia 2008 : 17–24. 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