Managing the Pain

Injury, surgery, and certain medical conditions like arthritis, back problems, and cancer are the most common causes of pain in adults, and headache and back pain, along with pain in the neck, limbs, and shoulders, are the ones that are most commonly reported. Pain is a complex protective mechanism that protects the body from harm. Pain receptors attached to two main types of nerves extremely sensitive to danger and harm relay messages in two ways—one does so immediately, resulting in a sudden, sharp pain, while the other type relays messages much more slowly, resulting in a dull and throbbing pain. The number of such receptors varies throughout the body; for instance, there are numerous receptors on the skin, and very few in the gut. That is why it is easy to discern site of pain in the former, and very difficult to determine the exact location of pain in the latter.

Here’s how it works—suppose you touch something hot or sharp. The skin’s pain receptors send signals to the thalamus, a part of the brain, via the spinal cord. The signals are analyzed by the thalamus and forwarded to parts of the brain involved with physical response, thought, and emotion. Sometimes, on receiving signals from the receptors, a reflex action occurs, whereby the spinal cord immediately sends a signal back to the muscles, which then contract. This reflex action moves the affected part away from the source of danger, preventing further harm, and in such cases the pain may come later.
Types of pain

Broadly speaking, the different types of pain are:
1. Acute pain, a sudden, sharp, usually short-term pain caused by things like a broken bone, an infection, or an operation.
2. Chronic pain, lasting for a longer time, usually caused by a cancer, or sometimes due to the long-lasting effects of cancer treatment.
3. Breakthrough pain, a sudden pain that can occur between scheduled in-take of painkillers, could also occur suddenly by an activity, such as coughing or moving.
4. Bone pain, due to cancer affecting a bone, manifests as a dull, persistent ache that refuses to go away.
5. Soft tissue pain (visceral pain) is due to damage or inflammation in the muscles, tissues, or organs.
6. Nerve pain (neuropathic pain) occurs because of nerve damage. It can occur at intermittent intervals and cause the pain area to feel numb or extra sensitive. This pain can manifest as a tingling, shooting, stabbing, or burning sensation.
7. Referred pain refers to pain felt in another part from where the pain originated. For instance, pain felt in the right shoulder due to liver damage.
8. Phantom pain, pain in a part of the body that has been removed, such as after amputation or breast surgery. It may manifest as a burning, stabbing, or cramping, sensation.
9. Total pain, when factors like social, emotional, and spiritual factors are involved.
(Everyday Health, https://urlzs.com/rQdbJ)

The management of pain
The International Study of Pain (IASP) defines pain as, “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” It is also noted, “The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. Pain is always subjective. … Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons.” (https://urlzs.com/JZqij)
Thus, pain is measured and specific to an individual based on their perception of the pain, which is why pain is different for different people. As far as children are concerned, the Faces Pain Scale, a self-report measure of pain intensity, is used to measure pain. It requires no equipment, except for six drawings of faces that show more and more pain and are scored as 0 (no pain), 2, 4, 6, 8, and 10 (very much pain).
(International Association for the Study of Pain, https://urlzs.com/YzNsB)
The World Health Organization (WHO) has recently raised concerns about the harm due to misuse of pain management medications, including opioids, which to lead to dependence, overdose, and accidental death. WHO also points out that acute and chronic pain have to be differentiated and managed in different ways, and also that, many strategies besides drug treatment only have also been identified. That is why WHO is reviewing and updating its guidelines regarding pain management.
Currently, the different kinds of medication for pain include:
• Non-steroidal anti-inflammatory drugs (NSAIDs): Reduce pain, decrease fever, prevent blood clots, and decrease inflammation (in higher doses). Some common examples of NSAIDs: aspirin, diclofenac, ibuprofen, indomethacin, naproxen, etc.
• Paracetamol (acetaminophen): Commonly used for headache, backache, toothache, muscle ache, arthritis, cold, and fever.
• Antidepressants: Used to treat anxiety disorders and major depressive disorders, they may also be used to relieve some chronic pain conditions. According to a study, the most efficacious antidepressants for neuropathic pain may be the tertiary-amine tricyclic antidepressants (TCAs), such as doxepin, imipramine, amitriptyline, etc. (Pain, Pain, Go Away, https://urlzs.com/ooc6y)
• Anti-seizure medications: Their nerve-calming qualities may be effective in treating pain related to nerve damage or injury, such as neuropathic pain, fibromyalgia, back pain, and migraine. Recent studies have reported that gabapentin and pregabalin are the most effective anti-seizure medications for conditions like fibromyalgia, central neuralgic pain, postherpetic neuralgia, and painful diabetic nephropathy. (Cochrane, https://urlzs.com/bEomZ)
• Corticosteroids: Alleviate inflammation and pain. While the use of oral corticosteroids in pain management is a controversial subject, they do reduce pain and result in higher functional levels in patients suffering from painful conditions like mixed connective tissue disease, skin diseases, and rheumatoid arthritis. Injectable corticosteroids are more common in the management of pain, particularly for peripheral neurological and musculoskeletal pain conditions. (Practical Pain Management, https://urlzs.com/JzNXu)

The management of pain
The International Study of Pain (IASP) defines pain as, “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” It is also noted, “The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. Pain is always subjective. … Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons.” (https://urlzs.com/JZqij)
Thus, pain is measured and specific to an individual based on their perception of the pain, which is why pain is different for different people. As far as children are concerned, the Faces Pain Scale, a self-report measure of pain intensity, is used to measure pain. It requires no equipment, except for six drawings of faces that show more and more pain and are scored as 0 (no pain), 2, 4, 6, 8, and 10 (very much pain).
(International Association for the Study of Pain, https://urlzs.com/YzNsB)
The World Health Organization (WHO) has recently raised concerns about the harm due to misuse of pain management medications, including opioids, which to lead to dependence, overdose, and accidental death. WHO also points out that acute and chronic pain have to be differentiated and managed in different ways, and also that, many strategies besides drug treatment only have also been identified. That is why WHO is reviewing and updating its guidelines regarding pain management.
Currently, the different kinds of medication for pain include:
• Non-steroidal anti-inflammatory drugs (NSAIDs): Reduce pain, decrease fever, prevent blood clots, and decrease inflammation (in higher doses). Some common examples of NSAIDs: aspirin, diclofenac, ibuprofen, indomethacin, naproxen, etc.
• Paracetamol (acetaminophen): Commonly used for headache, backache, toothache, muscle ache, arthritis, cold, and fever.
• Antidepressants: Used to treat anxiety disorders and major depressive disorders, they may also be used to relieve some chronic pain conditions. According to a study, the most efficacious antidepressants for neuropathic pain may be the tertiary-amine tricyclic antidepressants (TCAs), such as doxepin, imipramine, amitriptyline, etc. (Pain, Pain, Go Away, https://urlzs.com/ooc6y)
• Anti-seizure medications: Their nerve-calming qualities may be effective in treating pain related to nerve damage or injury, such as neuropathic pain, fibromyalgia, back pain, and migraine. Recent studies have reported that gabapentin and pregabalin are the most effective anti-seizure medications for conditions like fibromyalgia, central neuralgic pain, postherpetic neuralgia, and painful diabetic nephropathy. (Cochrane, https://urlzs.com/bEomZ)
• Corticosteroids: Alleviate inflammation and pain. While the use of oral corticosteroids in pain management is a controversial subject, they do reduce pain and result in higher functional levels in patients suffering from painful conditions like mixed connective tissue disease, skin diseases, and rheumatoid arthritis. Injectable corticosteroids are more common in the management of pain, particularly for peripheral neurological and musculoskeletal pain conditions. (Practical Pain Management, https://urlzs.com/JzNXu)

Pain management through therapy
• Physical therapy is very important in the management of pain. While pain can be worsened by incorrectly done exercise, proper exercise builds tolerance and reduces pain.
• Cognitive behavioral therapy is a kind of talk therapy that helps to change negative thoughts and behaviors, thus developing better coping skills to deal with pain.

Some other pain management options include meditation and other relaxation techniques, heat and cold therapy, massage, etc. One technique, known as transcutaneous electrical nerve stimulation (TENS) therapy, uses low-voltage electric currents to block signals from pain receptors to the brain.

WHO Guidelines for the management of cancer pain
Fifty-five percent of patients undergoing anti-cancer treatment experience pain, as do 66% of patients with advanced or terminal disease. WHO has developed certain guidelines for pharmacologic and radiotherapeutic management of cancer pain in adults and adolescents, focusing on three focus areas:
• Analgesia of cancer pain: This addresses the choice of medicine, as well as the choice of opioid, for pain relief maintenance, along with optimization of rescue medication, administration route, and rotation and cessation of opioid use.
• Adjuvant medicines for cancer pain: This addresses the use of anti-seizure medication, antidepressants, and corticosteroids as adjuvant medicines for cancer pain relief.
• Management of bone metastases-related pain: This addresses the use of bisphosphonates and radiotherapy in the management of pain secondary to bone metastases.
WHO, https://urlzs.com/wFMQT

The management of pain
The International Study of Pain (IASP) defines pain as, “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” It is also noted, “The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. Pain is always subjective. … Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons.” (https://urlzs.com/JZqij)
Thus, pain is measured and specific to an individual based on their perception of the pain, which is why pain is different for different people. As far as children are concerned, the Faces Pain Scale, a self-report measure of pain intensity, is used to measure pain. It requires no equipment, except for six drawings of faces that show more and more pain and are scored as 0 (no pain), 2, 4, 6, 8, and 10 (very much pain).
(International Association for the Study of Pain, https://urlzs.com/YzNsB)
The World Health Organization (WHO) has recently raised concerns about the harm due to misuse of pain management medications, including opioids, which to lead to dependence, overdose, and accidental death. WHO also points out that acute and chronic pain have to be differentiated and managed in different ways, and also that, many strategies besides drug treatment only have also been identified. That is why WHO is reviewing and updating its guidelines regarding pain management.
Currently, the different kinds of medication for pain include:
• Non-steroidal anti-inflammatory drugs (NSAIDs): Reduce pain, decrease fever, prevent blood clots, and decrease inflammation (in higher doses). Some common examples of NSAIDs: aspirin, diclofenac, ibuprofen, indomethacin, naproxen, etc.
• Paracetamol (acetaminophen): Commonly used for headache, backache, toothache, muscle ache, arthritis, cold, and fever.
• Antidepressants: Used to treat anxiety disorders and major depressive disorders, they may also be used to relieve some chronic pain conditions. According to a study, the most efficacious antidepressants for neuropathic pain may be the tertiary-amine tricyclic antidepressants (TCAs), such as doxepin, imipramine, amitriptyline, etc. (Pain, Pain, Go Away, https://urlzs.com/ooc6y)
• Anti-seizure medications: Their nerve-calming qualities may be effective in treating pain related to nerve damage or injury, such as neuropathic pain, fibromyalgia, back pain, and migraine. Recent studies have reported that gabapentin and pregabalin are the most effective anti-seizure medications for conditions like fibromyalgia, central neuralgic pain, postherpetic neuralgia, and painful diabetic nephropathy. (Cochrane, https://urlzs.com/bEomZ)
• Corticosteroids: Alleviate inflammation and pain. While the use of oral corticosteroids in pain management is a controversial subject, they do reduce pain and result in higher functional levels in patients suffering from painful conditions like mixed connective tissue disease, skin diseases, and rheumatoid arthritis. Injectable corticosteroids are more common in the management of pain, particularly for peripheral neurological and musculoskeletal pain conditions. (Practical Pain Management, https://urlzs.com/JzNXu)

Pain management through therapy
• Physical therapy is very important in the management of pain. While pain can be worsened by incorrectly done exercise, proper exercise builds tolerance and reduces pain.
• Cognitive behavioral therapy is a kind of talk therapy that helps to change negative thoughts and behaviors, thus developing better coping skills to deal with pain.

Some other pain management options include meditation and other relaxation techniques, heat and cold therapy, massage, etc. One technique, known as transcutaneous electrical nerve stimulation (TENS) therapy, uses low-voltage electric currents to block signals from pain receptors to the brain.

WHO Guidelines for the management of cancer pain
Fifty-five percent of patients undergoing anti-cancer treatment experience pain, as do 66% of patients with advanced or terminal disease. WHO has developed certain guidelines for pharmacologic and radiotherapeutic management of cancer pain in adults and adolescents, focusing on three focus areas:
• Analgesia of cancer pain: This addresses the choice of medicine, as well as the choice of opioid, for pain relief maintenance, along with optimization of rescue medication, administration route, and rotation and cessation of opioid use.
• Adjuvant medicines for cancer pain: This addresses the use of anti-seizure medication, antidepressants, and corticosteroids as adjuvant medicines for cancer pain relief.
• Management of bone metastases-related pain: This addresses the use of bisphosphonates and radiotherapy in the management of pain secondary to bone metastases.
WHO, https://urlzs.com/wFMQT

The management of pain
The International Study of Pain (IASP) defines pain as, “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” It is also noted, “The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. Pain is always subjective. … Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons.” (https://urlzs.com/JZqij)
Thus, pain is measured and specific to an individual based on their perception of the pain, which is why pain is different for different people. As far as children are concerned, the Faces Pain Scale, a self-report measure of pain intensity, is used to measure pain. It requires no equipment, except for six drawings of faces that show more and more pain and are scored as 0 (no pain), 2, 4, 6, 8, and 10 (very much pain).
(International Association for the Study of Pain, https://urlzs.com/YzNsB)
The World Health Organization (WHO) has recently raised concerns about the harm due to misuse of pain management medications, including opioids, which to lead to dependence, overdose, and accidental death. WHO also points out that acute and chronic pain have to be differentiated and managed in different ways, and also that, many strategies besides drug treatment only have also been identified. That is why WHO is reviewing and updating its guidelines regarding pain management.
Currently, the different kinds of medication for pain include:
• Non-steroidal anti-inflammatory drugs (NSAIDs): Reduce pain, decrease fever, prevent blood clots, and decrease inflammation (in higher doses). Some common examples of NSAIDs: aspirin, diclofenac, ibuprofen, indomethacin, naproxen, etc.
• Paracetamol (acetaminophen): Commonly used for headache, backache, toothache, muscle ache, arthritis, cold, and fever.
• Antidepressants: Used to treat anxiety disorders and major depressive disorders, they may also be used to relieve some chronic pain conditions. According to a study, the most efficacious antidepressants for neuropathic pain may be the tertiary-amine tricyclic antidepressants (TCAs), such as doxepin, imipramine, amitriptyline, etc. (Pain, Pain, Go Away, https://urlzs.com/ooc6y)
• Anti-seizure medications: Their nerve-calming qualities may be effective in treating pain related to nerve damage or injury, such as neuropathic pain, fibromyalgia, back pain, and migraine. Recent studies have reported that gabapentin and pregabalin are the most effective anti-seizure medications for conditions like fibromyalgia, central neuralgic pain, postherpetic neuralgia, and painful diabetic nephropathy. (Cochrane, https://urlzs.com/bEomZ)
• Corticosteroids: Alleviate inflammation and pain. While the use of oral corticosteroids in pain management is a controversial subject, they do reduce pain and result in higher functional levels in patients suffering from painful conditions like mixed connective tissue disease, skin diseases, and rheumatoid arthritis. Injectable corticosteroids are more common in the management of pain, particularly for peripheral neurological and musculoskeletal pain conditions. (Practical Pain Management, https://urlzs.com/JzNXu)

Pain management through therapy
• Physical therapy is very important in the management of pain. While pain can be worsened by incorrectly done exercise, proper exercise builds tolerance and reduces pain.
• Cognitive behavioral therapy is a kind of talk therapy that helps to change negative thoughts and behaviors, thus developing better coping skills to deal with pain.

Some other pain management options include meditation and other relaxation techniques, heat and cold therapy, massage, etc. One technique, known as transcutaneous electrical nerve stimulation (TENS) therapy, uses low-voltage electric currents to block signals from pain receptors to the brain.

WHO Guidelines for the management of cancer pain
Fifty-five percent of patients undergoing anti-cancer treatment experience pain, as do 66% of patients with advanced or terminal disease. WHO has developed certain guidelines for pharmacologic and radiotherapeutic management of cancer pain in adults and adolescents, focusing on three focus areas:
• Analgesia of cancer pain: This addresses the choice of medicine, as well as the choice of opioid, for pain relief maintenance, along with optimization of rescue medication, administration route, and rotation and cessation of opioid use.
• Adjuvant medicines for cancer pain: This addresses the use of anti-seizure medication, antidepressants, and corticosteroids as adjuvant medicines for cancer pain relief.
• Management of bone metastases-related pain: This addresses the use of bisphosphonates and radiotherapy in the management of pain secondary to bone metastases.
WHO, https://urlzs.com/wFMQT

The management of pain
The International Study of Pain (IASP) defines pain as, “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” It is also noted, “The inability to communicate verbally does not negate the possibility that an individual is experiencing pain and is in need of appropriate pain-relieving treatment. Pain is always subjective. … Many people report pain in the absence of tissue damage or any likely pathophysiological cause; usually this happens for psychological reasons.” (https://urlzs.com/JZqij)
Thus, pain is measured and specific to an individual based on their perception of the pain, which is why pain is different for different people. As far as children are concerned, the Faces Pain Scale, a self-report measure of pain intensity, is used to measure pain. It requires no equipment, except for six drawings of faces that show more and more pain and are scored as 0 (no pain), 2, 4, 6, 8, and 10 (very much pain).
(International Association for the Study of Pain, https://urlzs.com/YzNsB)
The World Health Organization (WHO) has recently raised concerns about the harm due to misuse of pain management medications, including opioids, which to lead to dependence, overdose, and accidental death. WHO also points out that acute and chronic pain have to be differentiated and managed in different ways, and also that, many strategies besides drug treatment only have also been identified. That is why WHO is reviewing and updating its guidelines regarding pain management.
Currently, the different kinds of medication for pain include:
• Non-steroidal anti-inflammatory drugs (NSAIDs): Reduce pain, decrease fever, prevent blood clots, and decrease inflammation (in higher doses). Some common examples of NSAIDs: aspirin, diclofenac, ibuprofen, indomethacin, naproxen, etc.
• Paracetamol (acetaminophen): Commonly used for headache, backache, toothache, muscle ache, arthritis, cold, and fever.
• Antidepressants: Used to treat anxiety disorders and major depressive disorders, they may also be used to relieve some chronic pain conditions. According to a study, the most efficacious antidepressants for neuropathic pain may be the tertiary-amine tricyclic antidepressants (TCAs), such as doxepin, imipramine, amitriptyline, etc. (Pain, Pain, Go Away, https://urlzs.com/ooc6y)
• Anti-seizure medications: Their nerve-calming qualities may be effective in treating pain related to nerve damage or injury, such as neuropathic pain, fibromyalgia, back pain, and migraine. Recent studies have reported that gabapentin and pregabalin are the most effective anti-seizure medications for conditions like fibromyalgia, central neuralgic pain, postherpetic neuralgia, and painful diabetic nephropathy. (Cochrane, https://urlzs.com/bEomZ)
• Corticosteroids: Alleviate inflammation and pain. While the use of oral corticosteroids in pain management is a controversial subject, they do reduce pain and result in higher functional levels in patients suffering from painful conditions like mixed connective tissue disease, skin diseases, and rheumatoid arthritis. Injectable corticosteroids are more common in the management of pain, particularly for peripheral neurological and musculoskeletal pain conditions. (Practical Pain Management, https://urlzs.com/JzNXu)

Pain management through therapy
• Physical therapy is very important in the management of pain. While pain can be worsened by incorrectly done exercise, proper exercise builds tolerance and reduces pain.
• Cognitive behavioral therapy is a kind of talk therapy that helps to change negative thoughts and behaviors, thus developing better coping skills to deal with pain.

Some other pain management options include meditation and other relaxation techniques, heat and cold therapy, massage, etc. One technique, known as transcutaneous electrical nerve stimulation (TENS) therapy, uses low-voltage electric currents to block signals from pain receptors to the brain.

WHO Guidelines for the management of cancer pain
Fifty-five percent of patients undergoing anti-cancer treatment experience pain, as do 66% of patients with advanced or terminal disease. WHO has developed certain guidelines for pharmacologic and radiotherapeutic management of cancer pain in adults and adolescents, focusing on three focus areas:
• Analgesia of cancer pain: This addresses the choice of medicine, as well as the choice of opioid, for pain relief maintenance, along with optimization of rescue medication, administration route, and rotation and cessation of opioid use.
• Adjuvant medicines for cancer pain: This addresses the use of anti-seizure medication, antidepressants, and corticosteroids as adjuvant medicines for cancer pain relief.
• Management of bone metastases-related pain: This addresses the use of bisphosphonates and radiotherapy in the management of pain secondary to bone metastases.
WHO, https://urlzs.com/wFMQT

• Physical therapy is very important in the management of pain. While pain can be worsened by incorrectly done exercise, proper exercise builds tolerance and reduces pain.
• Cognitive behavioral therapy is a kind of talk therapy that helps to change negative thoughts and behaviors, thus developing better coping skills to deal with pain.

Some other pain management options include meditation and other relaxation techniques, heat and cold therapy, massage, etc. One technique, known as transcutaneous electrical nerve stimulation (TENS) therapy, uses low-voltage electric currents to block signals from pain receptors to the brain.

WHO Guidelines for the management of cancer pain
Fifty-five percent of patients undergoing anti-cancer treatment experience pain, as do 66% of patients with advanced or terminal disease. WHO has developed certain guidelines for pharmacologic and radiotherapeutic management of cancer pain in adults and adolescents, focusing on three focus areas:
• Analgesia of cancer pain: This addresses the choice of medicine, as well as the choice of opioid, for pain relief maintenance, along with optimization of rescue medication, administration route, and rotation and cessation of opioid use.
• Adjuvant medicines for cancer pain: This addresses the use of anti-seizure medication, antidepressants, and corticosteroids as adjuvant medicines for cancer pain relief.
• Management of bone metastases-related pain: This addresses the use of bisphosphonates and radiotherapy in the management of pain secondary to bone metastases.

WHO, https://urlzs.com/wFMQT

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