Man : Discomfort (Pain)

Pain

Pain is an experience of unpleasantness associated with the perception of harm or threat of harm to an individual.

It may be term as physical or mental. It comes in all form of degree of intensity:  mild to intolerable. The intensity of the suffering depends on the factors of time and frequency.

Pain is usually transitory, it will last only until the when the noxious stimulus is removed or the underlying damage or pathology has healed. But some painful conditions, such as rheumatoid arthritis, peripheral neuropathy, cancer and idiopathic  pain, may persist for years.

What is Pain?

Pain is 
       i.    the way your brain interprets information 
       ii.   about a particular sensation that your body is experiencing. 
       iii. Information (or "signals") about this painful sensation are sent 
      iv. via nerve pathways to your brain. 
The way in which your brain interprets these signals as "pain" can be affected by many outside factors, some of which can be controlled by special techniques.

Receptor nerve cells in and beneath your skin sense heat, cold, light, touch, pressure, and pain. You have thousands of these receptor cells, most of them being sense of pain and the fewest being sense of cold. When there is an injury to your body—for example, surgery—these tiny cells send messages along nerves into your spinal cord and then up to your brain. Pain medicine blocks these messages or reduces their effect on your brain.

Pain may sometime be just a nuisance, like a mild headache. At other times, pain may be extreme—even after taking medication— a sign of complications.

Character of Pain

Pain that lasts a long time is called chronic, and pain that resolves quickly is called acute. It is useful to distinguish between two basic types of pain, acute and chronic, and they differ greatly.

• Acute pain,

a.  Acute pain is of short duration, usually the result of an injury, surgery or illness. 
b.  This type of pain includes acute injuries, post-operative pain and post-trauma pain.

c.  It is a result from disease, inflammation, or injury to tissues. 
d. This type of pain generally comes suddenly: after trauma or surgery, and may be accompanied by anxiety or emotional distress. 
e.  The cause of acute pain can usually be diagnosed and treated, and the pain is self-limiting, that is, it is confined to a given period of time and severity. In some rare instances, it can become chronic.

• Chronic pain

a. Chronic pain is an ongoing condition, such as back and neck pain, headaches, complex regional pain syndrome Type 1 (reflex sympathetic dystrophy), neuropathic pain (nerve injury pain), musculoskeletal pain, and pain related to illness.

b. It is widely believed to represent disease itself. It can be made much worse by environmental and psychological factors. 
c. Chronic pain persists over a longer period of time than acute pain and is resistant to most medical treatments. It can—and often does—cause severe problems for patients.  
d.  A person may have two or more co-existing chronic pain conditions.  Such conditions can include chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, temporomandibular joint dysfunction, and vulvodynia.  It is not known whether these disorders share a common cause.

Traditionally, the distinction between acute and chronic pain has relied upon an arbitrary onset of time; most commonly used markers being 3 months and 6 months since the onset of pain,  though some from acute to chronic pain at 12 months

Others apply acute to pain that lasts less than 30 days, chronic to pain of more than six months duration, and sub acute to pain that lasts from one to six months. A popular alternative definition of chronic pain, involving no arbitrarily fixed time is "pain that extends beyond the expected period of healing." Chronic pain may be classified as cancer pain or benign.

Effects of Pain

Symptoms accompanying pain: nausea, headache, dizziness, weakness, drowsiness, constipation, diarrhea, perspiration. Emotional effects: anger, depression, crying, mood swings, irritability, suicidal feelings. Lifestyle changes: work, recreation, interpersonal relationships, ability to get around, self-care activities.

Facts about pain

Most of us suffer various forms of pain from time to time, and relieving it is vital so that we can carry on life with a minimum of discomfort and inconvenience. But there are certain basic facts about pain that we should always bear in mind.

·     Pain carries a message

Pain itself is not usually the real problem. The real problem is what is causing it. Pain is often a signal from the body through the nerve system, telling us something is wrong. Even the humble headache is sending us a message, perhaps that we had too much to drink last night, or that we are dehydrated or over-stressed, or getting flu.

·     Not fully understood

Scientists admit they don't understand everything about how pain works. Some pain has no obvious cause. And because our nerve system is quite complicated, we sometimes feel pain in a different part of the body from where the problem is. For example, people with spine problems often feel the pain elsewhere in the body. And some people have much higher tolerance for pain than others.

·     The search for cures

The human race has been seeking cures for pain since primitive times. Natural and herbal medicines were an early result of this historic search, based on trial and error. Some appear to work, but often with risky side-effects. In more recent times painkillers have become a huge focus of the pharmaceutical industry, and some modern remedies are extremely effective, although here again, there can be side-effects and risks of overdose. A third approach is the use of homeopathic remedies such as Palovin. These work on the well-researched principle that the body can be assisted to activate its own powers of self-remediation. Since the amount of active ingredient required is very tiny, there is no risk of side-effects.

·     Many types of pain

There are obviously many different types of pain, but they fall into several broad categories. And since pain itself is often not the real problem, simply killing it may not be the real solution. Understanding some basic points about pain can help us to manage and avoid it, particularly in the case of temporary pain, which can result from a multitude of everyday causes.

·     Injury pain

When we are injured, the body reacts with pain for two main reasons. Firstly to make us aware of the injury, which we might otherwise be unaware of, or want to ignore. And secondly it's a warning to us to avoid such injuries in future. The pain is unpleasant, so we learn to be more careful. Much the same applies if we get a stomach ache after eating something poisonous or contaminated. We will seek an appropriate remedy - and we will also be more careful about such food in future.

·     Chronic disease pain

Different type of pain is caused by diseases. Usually such pain will develop gradually in a matter of minutes, and will become chronic - that is to say, continuous or frequently recurring over a long period. To relief pain relief for longer periods, medical advice is essential to signify whether the pain has a deeper problem. Sometimes this deeper problem can be easily treated. Simply relieving the pain may just hide the true cause until it is too late to treat it.

·     Temporary pain

Fortunately, most of our aches and pains are temporary and we know from experience that it don't indicate a major problem. The commonest for most of us is the headache, although even this comes in a variety of forms and can have many, many causes. Another common type of temporary pain is due to over-exertion of muscles and joints. Generally if left alone, such types of pain will eventually be dealt with by the body itself, which over millions of years has developed incredible powers of self-remediation. The obvious and natural thing to do is usually to lie down and rest and have a drink of water. This generally works.

·     The need for relief

In this bustling world time is an essence but it takes time for the natural processes to remedy the pain. The need of fast relief so as we can carry on with our daily tasks. Palovin has been developed as a safe and simple relief for a range of common pains, which stimulates the body's inbuilt methods of self-remediation to work much faster than if simply left alone.

How is Pain Diagnosed?

There is no sure way to tell how much pain a person has. No test can measure the intensity of pain, no imaging device can show pain, and no instrument can locate pain precisely. Sometimes, as in the case of headaches, physicians find that the best aid to diagnosis is the patient's own description of the type, duration, and location of pain. Defining pain as sharp or dull, constant or intermittent, burning or aching may give the best clues to the cause of pain. These descriptions are part of what is called the pain history, taken by the physician during the preliminary examination of a patient with pain.

Physicians, however, do have a number of technologies they use to find the cause of pain. Primarily these include:

• Electro diagnostic procedures

It includes electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies. Information from EMG can help physicians tell precisely which muscles or nerves are affected by weakness or pain. Thin needles are inserted in muscles and a physician can see or listen to electrical signals displayed on an EMG machine. With nerve conduction studies the doctor uses two sets of electrodes (similar to those used during an electrocardiogram) that are placed on the skin over the muscles. The first set gives the patient a mild shock that stimulates the nerve that runs to that muscle. The second set of electrodes is used to make a recording of the nerve's electrical signals, and from this information the doctor can determine if there is nerve damage. EP tests also involve two sets of electrodes-one set for stimulating a nerve (these electrodes are attached to a limb) and another set on the scalp for recording the speed of nerve signal transmission to the brain.

• Magnetic resonance imaging or MRI,

It provides physicians with pictures of the body's structures and tissues. MRI uses magnetic fields and radio waves to differentiate between healthy and diseased tissue.

• Neurology

A neurological examination in which the physician tests movement, reflexes, sensation, balance, and coordination.

• Imaging

X-rays produce pictures of the body's structures, such as bones and joints.

Understanding Pain

Pain, be it acute or chronic changes many things in life, mostly invisible. There is the misconception of understanding chronic pain and its effects. The need to understand that chronic pain sufferers have attempted numerous alternative therapies and know what therapies have worked or not worked for them.

These are some things that can help you to understand, and help, people who suffer from often debilitating, chronic pain.

1. A human being.

Chronic pain sufferers spend the majority of their day in considerable pain. A chronic pain sufferer may be unable to enjoy things they used to enjoy. They remain aware, and desire to do what they used to perform. A feeling of being stuck inside a body in which they have little or no control, to enjoy work, family, friends, and leisure activities.

2. Intensity of pain.

Sufferers will often talk differently on the degree of their pain.  A pain scale of intensity for pain described by doctors to measure effects of treatments. Description of pain on a scale from 1 to 10, the 1 is "no pain at all, feel wonderful" and 10 is the "worst pain ever felt". A pain sufferer is always experiencing pain even when they look fine. They attempt to hide the pain due to lack of understanding of others to their predicament. Mere words may be inadequate to describe how the sufferer is feeling. Imagine recalling the time when you experienced pain, then multiply the intensity, twenty-four hours every day without relief.

3. "Happiness" and "healthy".

The occasional flu you suffer makes your life miserable. The sufferers have to bear and experienced the pain from months to many years. Pain has caused them to adapt with coping mechanisms in order to disregard the pain they feel.

• Respect that the person who is in pain is trying their best to bear it. When the chronic pain sufferer says they are in pain - they are! They are merely coping; sounding happy and trying to look normal.
• Signs of pain: grimacing, restlessness, irritability, mood swings, wringing of hands, moaning, sleep disturbance, teeth grinding, poor concentration, decreased activity, and perhaps even writing down suicidal thoughts or language. 

Making Pain Light

  1. Listen

1. Listen
To make light of their pain, the next best thing that you can do is to listen sincerely and earnestly, and using your listening skills to decode what they're hiding or minimizing. 

2. Understand and respect sufferer’s physical limitations.

Being able to stand up for ten minutes doesn't necessarily mean that the sufferer can stand up for twenty minutes, or an hour, or give you a repeat performance whenever. Just because the person managed to stand up for thirty minutes yesterday doesn't imply that they will be able to do the same today. With a lot of diseases, a person may exhibit obvious signs of immobility, such as paralysis, or total immobilization due to weakness, etc. With chronic pain however, it is confusing to both the sufferer and the onlooker, and their ability to cope with movement can be like a yo-yo. The sufferer may not know, from day-to-day, how they are going to feel when they wake up and each day has to be taken as it comes. In many cases, they don't know from minute to minute. That is one of the hardest and most frustrating components of chronic pain.

• Insert "sitting", "walking", "thinking", "concentrating", "being sociable" to steps in curtailment of a sufferer's ability to response to everything that you'd expect a person in good health to be able to do. That's what chronic pain does to its sufferers
 

 3.  Leave your "pep talk" mode for your kids and your gym buddies

Realizing that chronic pain is variable, keep in mind that pep talk can be aggravating and demoralizing for the chronic pain sufferer. It's quite possible (for many, it's common) that one day they're able to walk to the park and back, while the next day they'll have trouble getting to the next room. Therefore, it's vital that you don't fall into the trap of saying: "But you did it before!" or "Oh, come on, I know you can do this!" If you want them to do something, then ask if they can and respect their answer.

• Get over the need to give platitudes about the value of exercising and fresh air. For a chronic pain sufferer, "getting out and doing things" does not make the pain vanish and can often exacerbate the problems. Bear in mind that you don't know what they go through or how they suffer in their own private time. Telling them that they need to  exercise, or do some things to "get their mind off of it", may frustrate them to tears, and is not correct advice, especially if you're not medically trained and haven't got a clue. If they were capable of doing some things any or all of the time, they would.
• Pain sufferers are constantly working with doctors and striving to improve and do the right things for their illness. Statement that hurts, "You just need to push yourself more, try harder". Obviously, chronic pain can deal with the whole body, or be localized to specific areas. Sometimes participating in a single activity for a short or a long period of time can cause more damage and physical pain; not to mention the recovery time, which can be intense. You can't always read it on their face or in their body language. Also, chronic pain may cause secondary depression  (wouldn't you get depressed and down if you were hurting constantly for months or years?), but it is not created by depression.
 

              4. Never use throwaway lines. 

 Assuming you know best by making such statements as "Ah well, that's life, you'll just have to deal with it", or "You'll get over it eventually. Until then, you'll just have to do your best", or worst of all, "Well, you look well enough", etc., are lines that might make you feel done and dusted with the topic but they are both a form of distancing yourself from the person and making the sufferer feel worse and out of hope. Psychologist Mark Grant suggests that you throw lifelines rather than throwaway lines, by saying something like: "So how have you survived?"

• Admit it when you don't have answers. Don't paper over your ignorance with platitudes or bold allegations not based on fact. There is no harm in saying "I don't know" and then offering to find things out.

            5. Check your own patience 

If you're impatient and want them to "just get on with it", you risk laying a guilt trip on the person who is suffering from pain and undermining their determination to cope. They probably have the will to comply with your requests to go out and about with them but have neither the strength nor the coping capacity as a result of the pain.

• A chronic pain sufferer may need to cancel a previous commitment at the last minute. If this happens, please do not take it personally. If you are able, please try to always remember how very lucky you are, to be physically able to do all of the things that you can do.
• Be very understanding if the chronic pain sufferer says they have to sit down, lie down, stay in bed, or take these pills right now. It probably means that they do have no choice but to do it right now, and it can't be put off or forgotten just because they happen to be somewhere, or they're right in the middle of doing something. Chronic pain does not forgive, nor does it wait for anyone.
 

          6. Be sensitive when suggesting medicines or alternative treatments.

8. Prescription drugs, over-the-counter medicines and alternative therapies can have side effects and unintended consequences. Some may not appreciate suggestions, and it's not because they don't want to get well. They may have heard of it or tried it already or some may not be ready to cope with new treatment that can create an additional burden on their already over-burdened lives. Treatments that haven't worked carry the emotional pain of failure, which in and of itself can make the person feel even lower. Of course, if there were something that cured, or even helped people with a particular form of chronic pain, then they should be made aware of it. There is worldwide networking (both on and off the Internet) between people with chronic pain. Those can be good resources. Be sensitive in how you bring it up.

• On the other hand, never be afraid to ask them about how satisfied they are with their treatment. Mark Grant says that it is important to ask helpful questions about whether the chronic sufferer thinks their treatment is satisfactory or if they think their pain is bearable. He suggests that people rarely ask these open-ended "helpful questions" that would help the chronic sufferer to open up and really talk.
 

9. 7. Don't be put off if the chronic pain sufferer seems touchy.

If that's the appearance, it's probably because they are. It's not how they try to be. As a matter of fact, they try very hard to be normal. Just try to understand. They have been going through a lot. Chronic pain is hard to understand unless you have had it. It wreaks havoc on the body and the mind. It is exhausting and exasperating. Almost all the time, they do their best to cope with this, and live their lives to the best of their ability. Just accept them as they are.

11. 8. Be helpful.

The chronic pain sufferer depends a great deal on people who are not sick to support them at home or visit them when they're too sick to go out. Sometimes they need help with shopping, cooking, or cleaning. Others may need help with their kids. They may need help getting to the doctor, or to the store. You can be their link to the "normalcy" of life. You can help them keep in touch with the parts of life that they miss and desperately want to undertake again.

12. 9. Balance your career responsibilities.

If you are living with a chronic pain sufferer or supporting such a person on a regular basis, you need to maintain balance in your life. If you don't take care of your own needs, health, and work-life balance, being around the chronic pain sufferer can bring you down even though you're probably trying hard not to be. Avoid suffering from caretaker  burn-out by getting other people to help, taking time out, and curtailing your guilt trips. Care for this person as much as you're able but also care for yourself.

Excerpt and extracts taken with thanks from:

Wikipedia

David Garrison, MBD123, Kene, Martyn P and 22 others
http:// paincenter.stanford.edu/patient_care/pain.html