Pain is something physically felt by an individual and it is quite harder to explain the level of pain verbally. As the popular phrase goes “putting oneself in other’s shoes”, the degree of pain, its perception and impact varies from person to person.
Perception of pain
Pain can be felt in any part of the body. External stimuli such as a needle prick causes pain in the affected area. Pain can also be felt in the internal organs due to physiological disorders. For example, stomach pain arising from digestive disorders.
Upon an event of external stimuli, pain receptors in the skin send signals across the nerves. This is a complex yet surprisingly fast process through which the signals reach brain cells. The person immediately feels pain in the affected area.
As far as the internal parts of the body are concerned, swelling, nerve damage etc can cause pain. Types of pain vary according to the causing factors and pain management depends upon the type of pain.
Types of pain
Acute pain occurs suddenly as a reaction to any painful event. For example, pain that originates from an accidental fall or injury due to a sharp object may cause acute pain. Pain due to surgical and dental procedures also come under this category. This pain lasts for a shorter period and the person feels recovery after the area gets healed.
Chronic pain originates as acute pain but may occur frequently and last longer than six months. Headache, back pain and joint pain are the common examples of chronic pain. Chronic pain often indicates the presence of an underlying condition such as arthritis. Long lasting chronic pain has the potential to cause depression and affect one’s daily activities and quality of life.
Other types of pain include Soft tissue pain, Phantom pain, Bone and nerve pain, Referred pain etc. Pain related to cancer is one of the major conditions, looking for future trends in pain management.
Pain management can be defined as the branch of medicine dealing with the treatment of pain and other associated conditions.
Types of pain management
Pharmacological treatment is the conventional way of treating pain with the help of drugs. Such “pain killer” drugs are known as Analgesics. Some types of painkillers such as nonsteroidal anti-inflammatory drugs (NSAID) work by reducing inflammation or swelling whereas other types such as opioids bind with receptors in the brain and mute the perception of pain. Morphine is one of the common examples of opioids.
Nonopioids are ‘over the counter’ medications with lesser side effects. Acetaminophen, Diclofenac, Ibuprofen etc are used as nonopioids. Drugs mostly named with ‘adol’ as a suffix are termed as weak opioids.
Non-pharmacological treatment for pain management include radiation therapy, application of heat to the affected area, lifestyle modifications etc. As pharmacological treatment is the conventional part of pain management, non-pharmacological ways of pain management have more scope for development in the future.
Future trends of pain management
Targeted molecular therapy – future replacement for Radiation therapy
Pain management plays an important role in the treatment of cancer. Traditionally Radiation Therapy is the common method of cancer treatment. Few limitations in Radiation Therapy may push the track of cancer treatment towards targeted molecular therapy.
Few challenges of Radiation Therapy are – targeting only the cancer cells without affecting healthy cells and missing very small cancer cells that might go undiagnosed. The next decade might look forward to the application of targeted molecular therapy as one of the future trends in pain management, especially for cancer treatment.
Targeted molecular therapy targets only the cancer cells with the help of specific drugs. As each type of cancer is different, this method is designed to suit the patient’s condition. Suitable drug is chosen depending upon the type of cancer, and upon administering, the drug binds with a protein involved in the growth of cancer cells. It interferes with the mechanism by which cancer cells spread. The drug also blunts the nature of cancer cells thereby allowing the body’s natural immune response to work upon.
Transcutaneous Electric Nerve Stimulation (TENS) – present mechanism and future trends
TENS is a small device used to relieve pain by passing electric current through the skin. This mechanism employs electric current to disrupt pain signals passing to the brain. Electrodes are placed over the affected area by using skin friendly adhesives. The TENS device sends electric current via attached electrodes and the patient could feel a tingling sensation. Mild to moderate pain can be relieved by this method and the patient can solely use the device by following the instructions.
TENS devices have a promising future for development. As they replace pharmacological treatment, it is one of the better ways to relieve chronic pain. Future TENS devices may evolve into wearable devices with sensors and artificial intelligence. As the digital world is expanding beyond imagination, TENS devices can also be developed to connect with smart phones via Bluetooth. Application of technology to modernize TENS can make this method of pain management easier to use and control.
Patient controlled analgesia (PCA) pump – Independent pain management in future
A PCA pump is a computerised device with a built-in syringe and prescribed medication. The pump has preset options to deliver a measured amount of medication. The patient can enjoy the benefit of self-administering the doses without the need to meet a healthcare provider or nurse for every dose. The syringe from the PCA pump delivers the medicine directly into the patient’s IV line.
As the future of pain management looks towards independent methods by which the patient can self-administer medications, novel inventions such as the PCA pumps can alter the path of traditional pain management. This could reduce the urge to visit clinicians for every onset of pain. For patients with chronic illness, PCA pumps come as a better option of pain management, provided the patients or their caregivers are well educated with its usage, benefits and risks.
These are some of the future trends in pain management that could become a working reality in forthcoming decades. As the world suffers with painful diseases, new innovations in the field of pain management keep on coming with the hope to cure painful diseases.
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