What is Pain
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What is Pain

Pain is a very important symptom, not only because it is often the primary complaint for which the patient seeks relief but also because it provides the doctors and healthcare providers with critical diagnostic information.

Pain is a very important symptom, not only because it is often the primary complaint for which the patient seeks relief but also because it provides the doctors and healthcare providers with critical diagnostic information.

In taking a history from the patient with pain, there should be a careful interview or assessment in terms of nature, location and intensity of pain. The reaction to pain, a function of the higher centers is extremely variable and influenced by many factors depending upon the individual patient and the situation.

It is essential to determine, whenever possible, the primary cause and the pathogenesis of pain. The relief of pain is achieved by removal of the primary cause, neutralization of the effect of the stimulus and when these are not feasible, by dulling or obliteration of the sense of pain. The hazards of administering analgesics without first attempting to establish a diagnosis cannot be over emphasized. Analgesics, particularly narcotics, may mask the symptoms of serious acute or chronic illness.

Pain may be treated nonspefically with drugs; physical measures such as heat, cold, mobilization, or surgery. Acupuncture as a means of providing pain relief and even anesthesia, used for generations, is now proven to relieve pain particularly of chronic pain.

Transcutaneous electrical nerve stimulation is a simple and effective means of relieving well-localized acute and chronic pain in some patients. Hypnosis as a means of controlling various types of pain has a fluctuating history of acceptability and practice. Hypnosis may relieve sensory pain in some responsive patients through both tranquilizing and direct analgesic effects. The mechanism of pain relief in this instance, as with acupuncture and transcutaneous electrical nerve stimulation, evades current scientific explanation.

Psychic or emotional factors may greatly influence the pain threshold, it is important to consider the “placebo” role of all therapeutic measures for the control of pain. Pharmacologically inactive drugs such as placebo may be surprisingly effective in alleviating the pain of organic as well as functional disorders.

Current concern about the widespread use of addictive and abused drugs may lead to reluctance to prescribe narcotic analgesics when they are needed for pain relief. It must not be assumed that the average patient s addiction prone. Although the various narcotics may have different addictive potentials, it is unreasonable to believe that addiction can be circumvented by substituting less effective but nonetheless addicting synthetic narcotic analgesics.

Obviously, measures directed at correcting the cause of pain deserve first consideration. It may be necessary to give the narcotic on a one or two times or interim basis. When pain is severe and intractable, however as in the case of terminal malignancy, it is inhumane to permit unnecessary suffering. It does not suffice that the doctor alone be aware of these general concepts or attitudes; they should be known to all individuals responsible for administration of narcotic drugs.

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Comments (1)
Toni Star

Good and helpful article. Your words on pain are very interesting and informative...

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