Every October 17 is celebrated as World Day Against Pain, an initiative of the World Health Organization whose aim is to highlight the urgent need to find a remedy to alleviate the physical and psychological suffering of those affected by diseases that cause pain. Dr. Fernando Torre Mollinedo, specialist in Pain Unit, explains what it consists of and what is the work of a Pain Unit.
Pain is an annoying and afflictive sensation in one or more parts of the body, caused by an internal or external cause. Within the World Day of pain we can raise different reflections.
World Day Against Pain: intention and functionality
The International Day of Pain is an initiative promoted by different Scientific Societies and the World Health Organization (WHO), whose objective is to highlight the urgent need to find a better relief for the physical suffering of diseases that cause pain.
At the same time, other objectives are set such as:
- To raise awareness among institutions, opinion leaders and the general public about the problems and enormous incidence of chronic pain.
- To highlight and recognize the work of those people who have dedicated their efforts and knowledge to improve pain treatments or disseminate its reality and magnitude.
- To give a voice to people suffering from chronic pain.
Pain Unit: what is it and how does it work?
Pain units emerged about 30 years ago to treat the symptom of pain in a more specific way, as an entity in its own right, and not as something that accompanies a disease.
Pain does not always fulfill a useful function for the individual; sometimes it becomes the only problem, persisting over time and conditioning the life of the patient and those around him. In this case, we would speak of chronic pain.
Pain units are specialized in the diagnosis and treatment of pain, where doctors with specific knowledge and experience study and evaluate, in a broad dimension, the problems of complex pain, whether acute or chronic, and propose the strategy to be followed in each case.
The patients who come to the pain units are patients suffering from complex chronic pain, i.e. pain that has not been relieved or cured by the usual treatments.
The objectives of the Spanish Pain Society (SED) are:
- To help improve the management of patients with acute or chronic pain.
- To attract the attention and interest of both basic scientists and physicians from other specialties to basic research and the therapeutic management of patients with pain.
- To promote and facilitate training and information on pain.
- To provide valid and uniform criteria for the treatment of the most common pain syndromes, through the recommendation of evidence-based therapeutic protocols and guidelines.
- To inform public opinion of the possible implications and consequences of different pain therapies.
What are the most common problems treated in a Pain Unit?
The most frequent pain syndromes are:
- Lumbalgias, lumbociatalgias or cervicalgias. These are patients who have undergone spinal surgery and in whom the surgery has not been able to reduce the pain.
- Given the aging population, more and more patients with advanced osteoarthrosis (gonarthrosis, coxarthrosis), osteoporotic vertebral crushing, canal stenosis… are treated.
- Myofascial pain and generalized pain syndrome such as fibromyalgia.
- Post-herpetic neuralgia, polyneuropathies, phantom limb or post-amputation pain, regional complex pain syndromes…
- We must not forget the pain caused by an oncological process, the Pain Units were originally created to treat these patients. Currently, the Oncology Services are responsible for alleviating this suffering, although in complicated cases, joint action is taken.
In the 2017 edition, World Pain Day is dedicated to postoperative pain. What does this pain consist of? How can it be improved?
The occurrence of pain after surgery is very common and has a high incidence and prevalence, especially after certain specific surgeries, such as inguinal hernia surgery, breast surgery, thoracic surgery, limb amputation, dental surgery, and cardiac surgery. Acute postoperative pain is followed by persistent pain in 10 to 50% of patients, and of this group of affected patients, 2 to 10% have severe chronic pain.
The diagnosis of chronic postoperative pain (CPOP) according to (IASP) is based on:
- Pain developed after a surgical procedure.
- Pain has a duration of at least three months.
- Other causes of pain must be ruled out
- The possibility that the pain is a continuation of a pre-existing problem must be excluded and ruled out beforehand.
CPOD occurs in approximately 30% of patients undergoing major surgeries and in 5% of minor surgeries. It is a frequent reason for consultation and can alter people’s quality of life.
With regard to treatment, as Dr. Concha Pérez -spokesperson for the Spanish Pain Society and Head of the Pain Unit at La Princesa Hospital in Madrid- points out, “when we talk about a good postoperative analgesic treatment, we are talking about a multimodal regimen, that is, using drugs that act at different levels, adapting them to each moment and acting with intense analgesia during the first few days and gradually reducing it”.
For more information on the International Day of Pain or on pain diseases, consult a pain specialist.