Aiming At Chronic Pain Management With Least Side Effects

Pain is often a transient phase associated with many medical and traumatic conditions. But there are many medical conditions in which pain is a chronic symptom that lasts long through the course of treatment. Here, chronic pain management is in itself a task. It must be performed seeking a balance between relief to the patient and the side effects that come with the treatment for pain.

The first step in the direction of securing an amicable pain relief to the patient is to identify the cause and nature of the pain. The origin of the pain may be nociceptive i.e. it may lie in muscles of the body or in the internal (visceral) organs. It may be neuropathic pain when the cause of pain is in the functioning of the nerves. The pain may be expressed in episodes in this case the cause of the pain may be cyclic in nature. If the exact source is properly identified by the physician, the treatment becomes easier and may not require continuous medication. The nature of pain must also be ascertained in context to its malignancy, acuteness and whether it is felt at the positions of rest or movement. In many complicated medical conditions the causes of pain may be mixed like neuropathic and nociceptive causes. 

Here a well defined strategy to differentiate the pains of different origins is a must. It must be noted that chronic pain may be affected regarding its intensity by non-pathological factors with psychological factors affecting it most.

The best approach to pain management can be a holistic approach in which all the features and factors associated, supposed or doubted to be associated with the pain must be discussed with the physician. These may include causes, intensity, cyclic nature or recurrence of pain, if present, its association with mood and disturbed sleeps, any psychiatric disorders should be mentioned. 

The physician is also expected to follow the most relevant system of measuring/scaling the pain and the improvement due to applying control measures. He is also required to introduce this system properly to the attendants of the patient, so they may cooperate to measure and report the effects back to the doctor. Last but not the least important point regarding getting the feedbacks is to know if there are any reasons that may inhibit the patient to report the pain properly. These may include religious reasons and subjective underestimation of the condition on the part of the doctor, nurse, or other health professionals. They need to be good listeners to the patients.

As of the treatment, oral medication makes the key part in resolving the pain troubles. The frequency for administering the oral drug should be carefully decided on investigating the underlying causes and the intensity of pain in detail. Psychological support is also a must for relieving pain. The patient may need antidepressant as well as cognitive therapy through sessions. The choice of drug is also extremely important in order to seek a perfect balance between the least side effects and most efficacy of the treatment offered.

Analgesics probably make the widest group among all the drugs. Anti-neuropathics, opoid analagesics, NSAID (non steroidal anti-inflammatory drugs), adjuvant drugs, co-analgesics and rescue medicines are all the kinds of analgesics in vogue today. These are further available in different formulations and combinations for administering through different routes by health-niche.

There is a wide range of surgical and behavioral techniques to treat pains apart from the medicines for pain. Acupuncture and other peripheral stimulation therapies rely on stimulating the nerve endings in a controlled manner. There may be required the psychological treatment supporting the basic medical or surgical treatment. This may include controlled ways of diversion and even employment of the patient in appropriate jobs depending on the nature of the case. 

In context to pain medication, opoids make for the most sensitive drugs. While it is generally not possible to treat server pain without using these, dependence, tolerance and successive withdrawl make sensitive issues demanding great care.

Identifying the root cause of pain and scaling its objective intensity are two essential elements in pain management to ensure the exact and balanced approach towards treatment.