| Global Day against Pain |
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| Shu-yam Wong, M.D., Director, Division of Obstetric and Pediatric Anesthesia,
Assistant Professor Department of Anesthesiology,
Linkou Chang Gung Memorial Hospital |
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The causes of pain are multiple and it is a warning at times that there is damage, inflammation or pathology in our organs. The definition of pain as stated by The International Association for the Study of Pain (IASP) in 1979 is: An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is often subjective and the sensation experienced, together with the pain threshold and pain tolerance level differs among each individual. Each person in a different environment, different state of mind or body will experience a different kind of pain. In each of us, pain is something that we all experience at some time or the other. About 50% of us have experienced headache, backache, shoulder or neck pain, joint or digestive discomfort, muscle aches, external wound pain, delivery pain, chest pain or pain from amputation or cancer etc. Pain may also be classified into acute or chronic. When severe, pain may be so unbearable, that even with Chinese or Western Medicine, only partial relief can be obtained causing tremendous trouble.
In modern medicine, apart from the traditional vitals signs monitored pre- and post -operatively such as blood pressure, pulse, respiratory rate, temperature, pain has become the 5th important vital sign. More attention is now given to this important physiological response and the appropriate management given.
In 2003 the European Week against Pain was launched with the aim to create more awareness of the importance of pain prevention. The IASP responded highly to this initiative and decided to promote this globally and so since the year 2004, each 11th of October has been set as the Global Day against Pain. The Taiwan Pain Society started this activity in 2011 and in 2012 which has been in keeping with the IASP theme of global Visceral Pain; a series of media promotions and educational reports have been issued with the aim of educating the public that pain relief should be a human right. The causes of pain are multiple, as doctors we should search for the root of the pain and given the appropriate treatment. Sometimes physical therapy may be enough, at other times analgesia may be required and sedatives, tricyclic antidepressants or even morphine needed. Some patients require surgery to cure the problem. The World Health Association has made some recommendations regarding the treatment of pain. 1) Oral medicines are among the key components of pain management, aim to administer medication orally if possible 2) treat in accordance to the three-step "ladder" for pain relief in adults. If pain occurs, there should be prompt oral administration of drugs in the following order: nonopioids (aspirin and acetominophen); then, as necessary, mild opioids (codeine); then strong opioids such as morphine, until the patient is free of pain. 3) Recognize that therapeutic regimes need to be individualized with attention to detail and combined with psychological support e.g. cognitive behavioral techniques. It is also necessary to monitor and evaluate for therapeutic and unwanted effects. If the above recommendations are followed, 90% of patients will have their pain resolved.
To not have to suffer from pain is one of the aims in life. There are ways to decrease the discomfort associated with procedures such as bronchoscopy, upper gastrointestinal endoscopy, colonoscopy and post operative pain etc. These methods may not be covered under the national insurance so enquires should be made to know what options exist to in order to decrease pain. |
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| Cover Story |
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| News Summary |
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| Medical Briefing |
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