What is Pain?
Pain cannot be seen and is in reality an abstract phenomenon. The international definition is:
“Pain is an emotional response to damage or to perceived damage”
This complexity can be seen as a blessing or a curse depending on your perspective. The fact that it does not just represent a signal going down a wire means it cannot just be turned off! However the fact that pain actually travels down a matrix of connections from the periphery, within the spinal cord and to the hind, mid and fore brain means there are many areas that we can influence.
Acute pain:
This is pain of an intensity and duration that would be considered normal for the severity of the injury. For example if you have appendicitis and have your appendix removed you could expect to have significant pain for a week or so. If this pain was still there 3 months later, something is wrong and you do not have acute pain.
The approach to treating acute pain is pretty simple. In general we use drugs of 3 or 4 types in combination and tailor the cocktail to suit the individual. Where the difficulty lies is in knowing what the patient’s response to both the injury and the drugs used to treat the pain will be. Here, knowledge of pharmacology and experience play an important role.
Chronic Pain
This is pain, usually of more than 3 months duration, that is often unrelenting and has a significant impact on the patient’s wellbeing.
The pain often causes physical, psychological and social misery. It can impact on the patient’s ability to work, mobilise, socialise and generally interact with the outside world.
Often the original source of this pain has long since gone, leaving the pain to exist alone in its wake. Also the unremitting nature of this pain means that it is more complex to deal with as it can affect the patient’s wellbeing in many ways.
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