What pain is, how to determine its level, what you need to know about taking strong analgesics and what exercises exist to relieve pain-this is described in the chapter “What to do with pain” of the book “Next to the seriously ill”, released by the Vera Hospice Foundation. We publish this fragment.
Pain is not a necessary companion of the disease, but many diseases at different stages are accompanied by pain syndrome. Pain can take over the entire territory of life, preventing you from eating and sleeping, thinking and acting — the body loses the strength to fight the disease.
One of the most important tasks of both doctors and relatives is not to allow a person to suffer from pain. Painkillers do not cure the disease-the cause of pain, but they relieve the torment, giving strength to live.
Doctors can prescribe the right pain relief regimen, but without the help of caregivers, their efforts will be ineffective — so in this section we want to tell you about the types of pain and methods of dealing with it.
Your loved one should not tolerate pain!
According to the law, ” the patient has the right to pain relief related to the disease, condition and / or medical intervention, methods and medications, including narcotic drugs and psychotropic drugs.” This means that the patient has the right to be treated with any painkillers registered in Russia, which the doctor must prescribe in accordance with the clinical recommendations “Chronic Pain Syndrome (CBS) in adult patients who need palliative care for the treatment of chronic pain syndrome”adopted by the Ministry of Health in 2017.
Types of pain and causes of its occurrence
There are two types of pain: acute and chronic. Acute pain occurs suddenly. Its duration is usually limited. Chronic pain continues for a long time. A person who has been in pain for a long time does not behave like someone for whom pain is a new sensation. People who suffer pain for a long time may not moan, do not show motor anxiety, their pulse and breathing rate may be normal, but the patient’s restrained behavior does not mean that he does not experience pain.
Chronic pain: causes and manifestations
Algologist Andrey Danilov on why chronic pain is difficult to treat
The ways in which pain spreads and manifests itself are complex. Many components are involved in the formation of the sensation of pain. Feeling pain, waiting for it to increase, a person experiences not only unpleasant physical sensations, but also suffers mentally. Suffering is a mental reaction to pain or a psychological component of pain, and this component can often prevail over the true (physical) pain.
When a person experiences chronic pain, he is forced to constantly limit himself in something. Some of his usual actions become difficult or inaccessible.
It is not always possible to get rid of severe pain completely, but you can learn to reduce it to a tolerable level. When regulating pain, you should strive to bring it within reasonable limits and avoid emergencies when it becomes unbearable.
In most cases, the cause of chronic pain in seriously ill people is volume formations that change the structure and function of the organs and tissues involved in the painful process.
But there are other causes of pain. For example, abdominal discomfort may be the result of prolonged stoolage, exacerbation of chronic gastritis or stomach ulcers; joint pain may be caused by chronic arthritis; pain behind the sternum may be a manifestation of heart disease, etc. In other words, your loved one “has the right” to exacerbate their chronic and” acquire ” new diseases, one of the symptoms of which may be pain.
Often, the pain is the result of radiation therapy or surgical treatment. This is due to the traumatization of nerve fibers, their involvement in the inflammatory or scarring process, with pressure in the developed lymphostasis (edema) of the limb, etc.
As you can see, there are different types of pain with different localization. To identify the cause of each is the task of the attending physician.
The pain threshold is different for all people, so only the patient can determine how much pain he has.
It is very important that your loved one speaks openly about their pain. Some patients tend to cheer up, to downplay the power of pain, so as not to disturb loved ones. The effectiveness of further therapy depends on the correct assessment of the pain syndrome.
Therefore, we recommend that you use the world’s accepted pain assessment scales: numerological assessment (NOS), visual-analog (VAS), or the comprehensive pain assessment scale presented below.
The pain should be treated without waiting for it to go from mild to moderate, and even more severe. If painkillers do not help, call a doctor and ask to adjust the pain therapy.
Patients who are severely debilitated by the disease, suffer from dementia and other mental disorders, or are in a coma, can not talk about their pain and therefore often remain untreated. There is also a special scale for assessing pain in nonverbal patients (Figure 2), which is primarily intended for dementia patients, but can also be used for those who cannot describe their pain for other reasons.