Pain Treatment
Chronic Pain
Chronic pain treatment programs are mostly based on a behavioral science model of contingency management, where the focus of treatment is directed toward the psychological aspects of pain.
Chronic pain has captured the attention in the medical and health care profession and becoming a complex problem of major medical, social, economic, and personal proportion. The chronic pain sufferers do not face the pain itself but also the expensive costs that it brought because of various treatments.
Pain treatment options may involve a variety of interventions, including nerve blocks, surgeries, injections, therapy, and other appropriate medications. Chronic pain can be a life-defeating experience, where powerlessness, loss of control, emotional grief, and physical anguish are difficulties (2000).
Pain That Persists
Acute pain after surgery or trauma comes on suddenly and lasts for a limited time, whereas chronic pain persists. An acute pain is a direct response to disease of injury to tissue. Chronic pain goes on and on for months or even years and the experts advice that the first step in treating chronic pain is to identify the source of pain, if it is possible. But persistent pain should never be ignored because it could signal disease of injury that will worsen if left untreated.
The physical and emotional effects from any type of chronic pain can be devastating and treatment for chronic pain is much more than medication. It also involves stress relief and relaxation, physical therapy, improved sleep and nutrition habits, and exercise ( 2004).
Case 1: Pain from Amputation
Numerous complications of diabetes can be related to neuropathy. Those complications are the most common cause of early death among patients with diabetes. One of the familiar complications of diabetes in the society is the diabetic foot ulcer. The cumulative effects of neuropathy, deformity, high plantar pressure, poor glucose control, duration of diabetes, and gender are all contributory factors for foot ulceration ( 2000).
Amputation is the complete or partial removal of a limb or body appendage by surgical or traumatic means. Meanwhile, the neuropathy is a nerve dysfunction affecting sensory, motor, or autonomic fibers with varying degrees of impairment, symptoms, and signs.
The potential manifestation of diabetes is the limb removal when the diabetes is left untreated. Identifying the potential problems and treatment of foot disorders in a diabetic patient requires skills, integration of knowledge and experience to promote more effective treatment or improving outcomes and limiting the risk of amputations (2000).
Treatment of pain includes medications and other options. Medications used include opiods, anticonvulsants, antidepressants, and anesthetics, to name a few. Non-pharmacological management measures include TENS-devices, acupuncture, and electroconvulsive therapy.
Case 2: Abdominal Hysterectomy
Hysterectomy or the surgical removal of the uterus is the most commonly performed gynecological surgical procedure. Once the decision has been made to proceed with hysterectomy, the physician and patient must decide whether the procedure will be performed abdominally, vaginally, or with laparoscopic assistance. The route chosen depends upon the woman’s clinical circumstances and the surgeon’s technical expertise; the surgeon’s personal preference also plays a major role.
The reason for the hysterectomy, risks and benefits of the procedure, alternatives, and expectations for outcome should be discussed with the woman in detail. Since a number of the indications for hysterectomy are based more upon opinion than evidence from well-designed studies, informed consent with thorough exploration of patient preferences and expectations is particularly important. In the absence of a life-threatening emergency like uterine hemorrhage, the decision to proceed with hysterectomy is made mutually by the woman and her physician based upon her functional impairment, childbearing plans, response to medical therapy, discussion of alternatives, and perception that the risks of the procedure are outweighed by the expected benefits ( 2008).
Current therapeutic strategies for the management of acute pain are largely dependent on opioid analgesics and non-steroidal anti-inflammatory drugs. The preoperative administration of oral rofecoxib medicine provided a significant analgesic benefit and decreased the opioid requirements in patients undergoing abdominal hysterectomy. However, rofecoxib was not effective in preventing postoperative pain or reducing morphine consumption in patients after prostate surgery (2004).
Case 3: Chronic Headaches
Tension headaches are associated with muscle tension is a common type of pain. These are sometimes described as feeling like a tight band squeezing the head. Meanwhile, migraines are characterized by throbbing pain on one side of the head. Most people with migraines also experience nausea and sensitivities to light and sound.
In 1992 when the FDA approved Imitrex (sumatriptan), the first drug in a class known as triptans. This class of drugs marked a huge leap forward for headache sufferers. Unlike some previous drugs that dulled the perception of pain, triptans stop the pain by narrowing blood vessels in the brain and reducing inflammation (2004).
Most headaches can be successfully treated with over-the-counter pain relievers. But it is better if a person will seek professional help if the pain persists or get worse and keeps on keeping an individual from work and other activities.
It is easy for people to fall into an analgesic trap. A headache sufferer may take and benefit from a painkiller, then begins to use it more freely, perhaps even to prevent pain. As medication and headache pain increase together, the individual begins to find that the analgesic is less effective, so he or she takes more or tries new ones. In the end, the person gets a headache whenever the medicine is not being taken.
The first step in treatment is to get the person to withdraw from the analgesics, which sometimes requires inpatient care. Complete treatment, however, includes finding a medication that will serve to prevent the pain and reduce the frequency of headaches. Finally, adequate, psychological support should be provided, including behavior modification, relaxation therapy, emotional support, and education ( 1993).
Credit:ivythesis.typepad.com
0 comments:
Post a Comment