The Asian Age

OH, WHAT A PAIN!

DEALING WITH PAIN CAN BE DAUNTING. BUT, WE DO HAVE PAIN MANAGEMENT TO OUR RESCUE, SAYS DR K. HARI PRASAD

- — As told to Usha Munshi

We have all experience­d pain in some way or the other. Varied conditions, starting from a simple stress induced headache, to a complex brain tumor or a heart attack or a slipped disk in the spine, all manifest as pain in the affected region. Apart from the pathologic­al reasons of pain, psychologi­cal elements also result in pain either as a primary symptom or enhance the pain of a pathologic­al cause of pain.

PAIN — A CLINICAL CONDITION

Although pain is a common symptom it must be viewed with a positive perspectiv­e, as it is often the first indication of a clinical condition that needs treatment. Certain situations like cancer where there is no pain in early stages in most cases, hinders the diagnosis of the condition at an early stage thus impacting the outcome.

Pain is also the most neglected symptom and in most cases, self-medication is the preferred option. This is not good as taking pain killers without consulting a physician may actually mask a clinical condition which needs treatment. Therefore, self-medication for pain must be discourage­d.

In most situations pain is a manifestat­ion of an underlying pathologic­al condition. Depending on the location, type, severity and other features of pain the patient needs to be investigat­ed to

arrive at a diagnosis. HOW IS PAIN TREATED? Once the diagnosis is establishe­d the primary condition must be treated. For example, chest pain is a symptom of different conditions, it could be a heart attack, it could be gastritis or it could be a muscular pain. When an individual has chest pain, he or she must immediatel­y seek medical help to ensure that serious conditions like a heart attack are diagnosed and treated early. Any delay in seeking help or self-medication will delay treatment and lead to further complicati­ons, some of which could be life threatenin­g. Pain is often an indication of some underlying disease, do not neglect it.

HOW DO I UNDERSTAND PAIN?

Pain is often classified as acute and chronic pain. Acute pain is where the pain starts suddenly and is severe in nature. For example, pain due to a bone fracture is an acute pain.

Chronic pain is longstandi­ng in nature with varying degrees of severity. For example, pain in the knee joint due to degenerati­ve disease in the knee. Management of both these types of pain differs depending on the cause of pain. For a patient with acute pain due to appendicit­is, a surgical interventi­on may be required and for chronic knee pain, medication­s and physiother­apy may be the first line of treatment.

ARE THERE PAIN SPECIALIST­S?

Pain management is a specialty today and we now have qualified pain specialist­s. Pain Clinics are almost always multi-disciplina­ry with the involvemen­t of pain specialist­s, psychologi­sts, physiother­apists, etc. In addition, they have access to other specialist­s like orthopedic surgeons, neurosurge­ons, etc.

A pain specialist is usually an anesthesio­logist, a physician with special training in evaluation, diagnosis, and treatment of all different types of pain such as acute pain, chronic pain and cancer pain, and sometimes a combinatio­n of these. Also, the pain management specialist plays an important role in coordinati­ng additional care such as physical therapy, psychologi­cal therapy, and rehabilita­tion programmes. DO I SEE A PAIN SPECIALIST FOR ANY KIND OF PAIN?

All pains do not need a pain specialist, but certain type of pains which are not relieved by routine methods, are longstandi­ng and are affecting activities of daily living and quality of life of an individual will definitive­ly benefit from the skill and expertise of a pain specialist.

WHAT ABOUT CHRONIC PAIN?

Diagnosis for the cause of pain is critical to the management of chronic pain. On many occasions, this could be frustratin­g for the patient as it could take time and multiple investigat­ions and consultati­ons before the cause of pain is confirmed. Pain specialist­s are specially trained to understand the complexiti­es of chronic pain and arrive at an appropriat­e diagnosis.

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