The International Association for the Study of Pain’s definition states: “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.”
Pain can be classified as acute and chronic pain based on the duration.
Is normally short lived and mainly secondary to trauma or tissue damage. It normally gets better with the healing process.
Any pain lasting for more than 3 months duration is called chronic pain. It can also be defined as the “pain that extends beyond the expected period of healing”.
Cancer patients experience severe pain at any stage of the disease. Most commonly the pain is due to direct compression of the nearby nerves by the tumour itself. Pain may also arise due to metastasis to distant organs like bones and secondary to the various treatments offered to cancer patients including surgery, radiotherapy and chemotherapy.
Latest research shows that any pain of long duration (for more than 3 months) induces changes in the nervous system both peripherally and centrally. There are some areas in the spinal cord where the changes are much more pronounced than others. The pain signals are exacerbated to the extent that in some conditions even a non-painful stimulus ends up as a painful stimulus. This is very typical of nerve (neuropathic) pain.
According to Pain in Europe: A Report (2000)
Effect on Patient’s Quality of Life
• 26% reported impact on their jobs
• 43% said feeling pain made them feel helpless
• 16% said that some days their pain was so bad that they wanted to die
Chronic pain is not difficult to manage. It just needs a different approach. While acute pain is managed mainly with medications chronic pain needs a proper multi-modal approach. The latest evidence suggests chronic pain patients do better with a holistic approach using the Bio-Psycho-Social model of pain management. This model of treatment is advocated by international bodies including British Pain Society.
Pain Medicine is a modern super specialty of medicine requiring a deep understanding and knowledge on the subject with sophisticated training in the intervention methods. Chronic pain affects not only your body but also your mental well being. So you need to see a Consultant in Pain medicine, who is specifically trained in the Bio-Psycho-Social model of pain management. It needs a thorough assessment and proper evidence based approach keeping in mind the individual patient needs.
By Dr. Senthil.K.Vijayan
MBBS, FRCA(Lon), FFPMRCA(Lon), CCT(UK), MFMLM(Lon)
Consultant and Head
Department of Interventional Pain Medicine
Disclaimer: The views expressed in this article are of the writer and not of the hospital.
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