Accordingly to the reports of world health institutions, the pain is the main reason for seeking primary medical care and a symptom of up to 90% of diseases. Suffering, which lasts 12 weeks and longer, is defined as chronic and represents an actual medical and social problem, as it depletes the person's physical and emotional resources, leads to social and labor disadaptation.
Both researchers and clinicians around the world are now coming to a consensus that chronic pain is a disease in itself. An ache is not only an unpleasant sensation, but also a set of thoughts, emotions, and behavioral reactions of a person that arise in response to it. In connection with the high importance of the problem in some countries, the integral discipline - algology was developed.
The traditional treatment is reduced to a certain medication. These drugs act on the inflammatory component of ache. But their impact is temporary because after a few hours the medicine is removed from the body and you have to take a new dose. For successful healing of suffering, it is necessary to identify and influence the centers of its analysis and perception at the level of the spinal cord and brain.
Different Types of Pain Management
The development of medicine at the present stage implies an ever-increasing introduction of the so-called minimally invasive, that is, minimizing blood loss and damage to surrounding tissues when performing surgical interventions and manipulations. This allows patients to recover faster. Therefore, radical operational methods are gradually replaced by injection and implantation techniques:
- Blockade of nerves, roots, plexuses;
- Epidural injections;
- Radiofrequency ablation (RFA), cryodestruction and other selective physical effects on the conductors of pain and spine structures;
- Spinal electrostimulation;
- Implantable medicinal pumps.
Most interventions are performed in a day hospital, and after a few hours, the patient leaves the clinic. In general, the main tool of a specialist in pain management is an injection needle. Using special needles, X-ray navigation and knowledge of anatomy, you can block temporarily or forever any nerve, from head to toe. And then do not need to take painkillers daily.
Physical Approach to Pain Control
Blockades by infiltration of nerve conductors with solutions of local anesthetics can be diagnostic, therapeutic or dual-use. Diagnostic blockades are performed in order to clarify the path or its mechanism. The therapeutic one can provide temporary local anesthesia, as well as an anti-inflammatory effect with the administration of corticosteroids. An example of a blockade with a double goal is one of the sympathetic ganglion, which is performed both for the diagnosis of pain and for its relief.
In addition, we should highlight a group of methods aimed at restoring or remodeling the structures of the musculoskeletal system, which serve as sources of pain. For example, with back pain, it is puncture vertebroplasty and kyphoplasty, various techniques of decompression of intervertebral discs. It should also be mentioned radio frequency annuloplasty and cryoanalgesia for the treatment of pain by freezing a certain nerve.
These different types of pain management were developed and implemented as the accumulation of ideas about the pathophysiology of chronic pain. Currently, some methods occupy certain niches in clinical practice; others have lost relevance due to the emergence of new, more selective and safe interventions.
Psychological Approach to Pain Healing
To optimize the treatment of patients suffering from chronic pain, there are a number of factors contributing to the success of therapy. It is important to form correct ideas about the origin of the disease and various syndromes. To do this, work is carried out to explain the causes of the disease to patients through brochures or Internet sites.
Self-regulation of pain and its impact depend on how people adapt to it. External behavioral adaptation strategies include rest, the use of relaxation techniques or drugs. To the hidden strategies of psycho-physiological adaptation are various ways of self-distraction from pain: self-hypnosis, information search, and problem-solving. Techniques such as yoga, the method of mental imagination, biological feedback, virtual reality, have found application in rehabilitation programs for patients with chronic pain.
Among the key factors leading to patient disadaptation is a feeling of lack of control over pain. The latter is the ultimate goal of various types of psychotherapy. Certainly, positive emotions are a powerful factor in recovery. In this regard, in the typical pain management programs, an important role is given to increasing physical activity.
Specialists who study pain, in collaboration with providers of innovative medical technologies, have created so-called pain clinic. Usually, they function on the basis of universities, combining scientific and practical activities. An interdisciplinary, integrated approach helps to concentrate professionals with specific knowledge and experience, creates additional barriers to medical errors and allows finding the true causes of pain could be missed.
Thus, an integrated approach to pain therapy should include individual psychological support, the patient's realistic expectations of the results of treatment and the teaching of rational adaptive behavior changes in order to prevent anxiety, depression and the formation of a “painful personality.”