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What is pain?
Pain is a complex phenomenon, and the experience of pain is
unique for each individual. It has been described in many ways:
An unpleasant sensory and emotional experience associated with
actual or potential tissue damage, or described in terms of such
damage.
(Classification of chronic pain. Descriptions of chronic pain syndromes
and definitions of pain terms. Prepared by the International
Association for the Study of Pain, Subcommittee on Taxonomy. Pain
1986 (Suppl 3): S1-226)
An experience that affects, and is affected by, both the mind and
the body. It involves the perception of a painful stimulus by the
nervous system and the reaction of a person to this.
(Stannard C and Booth S.(2004) Pain. Churchill Livingstone. 183-6)
Pain is what the patient says hurts.
Chronic Pain
Chronic pain - persists over weeks or months and
may be associated with significant changes in
lifestyle, functional ability and personality.
Management is challenging as it requires careful
assessment, not only of the nature and intensity
of pain, but also of the degree of psychological
distress.
It is a significant and costly problem,
(Doyle D et al.2004.Oxford Textbook of Palliative
Medicine 3rd ed: 299)
Cancer Pain
Cancer pain is often very complex, but the most intractable pain
is often neuropathic in origin, arising from tumour invasion of the
meninges, spinal cord and dura, nerve roots, plexuses and
peripheral nerves.
Multimodal therapies are necessary.
The management of cancer pain can and should be improved by
better collaboration between the disciplines of oncology, pain
medicine and palliative medicine. This must start in the training
programmes of doctors, but is also needed in established teams
in terms of funding, time for joint working and the education of all
healthcare professionals involved in the treatment of cancer pain.
Cancer Pain
(Grisell Vargas-Schaffer. 2010. Is the WHO analgesic ladder still valid? Twentyfour years of experience. Canadian Family Physician Le Mdecin de famille
canadien Vol 56: june 2010)
Bruary March)
Conclusion
Chronic pain management involving
multidisciplinary, multiple approach
and modalities could be more
beneficial and cost effective in long
term.
Thank You