Partnering with your Healthcare Professional

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Partnering with your Healthcare Professional to Prevent Pain: Information forPatients
搜索结果包含网站链接的网页搜索结果与你的保健人员预防疼痛2020 Global Year for the Prevention of Pain - IASP

Pain, a small word used by people around the world to describe a range of unpleasant feelings, affectsall of us at some point in our lives. Pain is a normal and necessary part of life. When a person has pain, itaffects them in many ways including physically, emotionally and socially. Pain which has started recentlyis known as acute pain. Acute pain is usually associated with tissue damage and generally eases as weheal. [6]. Acute pain is helpful as it alerts us to look after ourselves by protecting the area of injury untilit is healed. Chronic pain is different. Chronic pain is when the pain has been present for more thanthree months. Chronic pain is not usually associated with ongoing tissue injury, and can be a disease inits own right. It is also possible to have acute and chronic pain at the same time, for example if you havechronic pain, it is possible to injure yourself and you may then have acute pain which heals when theinjury no longer needs protection, but the chronic pain may continue. Attempts to treat chronic pain byrest and avoidance of activity are unhelpful and can perpetuate greater pain and loss of ability to takepart in your life. Chronic pain affects one in five children and adults, and is even more common amongvulnerable populations including the elderly, veterans and indigenous populations [1, 2]. Approximatelyone in twenty people are significantly limited by chronic pain in their daily activities (like being able to goto school or work or doing their household chores). In this fact sheet, we will discuss some key messageswhich people living with chronic pain and researchers working on chronic pain have identified as beinghelpful for preventing chronic pain.

Communication Is Important

When people are in pain and consult a health care professional, it is critically important that theyunderstand their diagnosis. Diagnostic uncertainty (or a perceived lack of explanation or incorrect labelto explain pain symptoms) is associated with mistrust of the medical system and potentially reducedengagement and benefit from treatment [2, 4]. Clear communication between patients and their healthcare professionals reduces the anxiety of being ill and in pain. Reducing anxiety is important whensomeone is living with chronic pain, as worry about pain can lead to greater suffering and decreasedfunctioning. Working with a health care professional who communicates clearly, gives the opportunityto ask questions and raise concerns makes a difference. Feeling engaged in your care can reduce painand improve your health outcomes.

When you are going to see a health care professional it can be helpful to follow these steps to takePARTrepare: write down specific questions which are worrying you with the most important at the top ofyour list

Ask questions and make sure you understand the answers.Repeat what has been told to you in your own words so that you can check that you have understoodcorrectly.Take action on what you need to do next [3].

There Are Different Kinds of Pain

Not all pain is the same. Acute pain is associated with actual or potential tissue damage. This is thenormal every day kind of pain which is helpful, and which motivates us to protect the painful area sothat it can heal. Acute pain needs to be distinguished from chronic pain, which is generally notprotective. Chronic pain occurs when the nervous system has become sensitive (the new term for thiskind of pain is nociplastic pain). This pain might have started as acute pain when there was an injury ortissue damage, but this is not necessary in all cases for chronic pain to develop. Chronic pain is nothelpful and protecting the area of the body which is painful does not help the body to heal, in fact itworsens chronic pain. Neuropathic pain is a type of chronic pain that occurs from disease or damage tothe nerves. This pain is not helpful, and protecting the painful area does not allow it to heal.Neuropathic pain and chronic pain require different treatments than acute pain, and these treatmentstypically emphasize the need to increase function across areas of life.

It May Be Safe to Move Even If There Is PainPain is not an accurate measure of tissue damage. When the body is injured, the healing processreleases chemicals which make our nerves very sensitive. This can increase your pain, even though theinjury is healing. Overall, it is important to start moving gradually after recovery from acute pain. Whentreating chronic pain, it is important to increase movement in a gradual way. This is done by first findinga baseline and progressing with small steps to increase how much activity you can tolerate withoutmaking pain worse. Emotional distress can make pain worse, as the areas of the brain involved inprocessing pain and emotions are very close to each other. If pain is not improving after an injury, or ifyou have chronic pain you may need to see a health professional, or even a pain expert. It is often safe,and necessary, to start moving and doing activities, and living life fully even if there is some pain.

It Is Important to Treat Our Emotions When We Have PainPain is almost universally aversive or unpleasant. Pain experience affects, and is affected, by ouremotions, thoughts, behaviours, and social environment including the people around us. High levels ofworry and low mood are common in people living with chronic pain [5]. Effective management ofchronic pain requires gaining an awareness and skills to manage other areas of your life that can beaffected by or are impacting your pain. Are you worried, anxious, depressed, angry, irritable, stressed?All of these emotions affect how our nervous system works. If these emotions are poorly managed, theycan increase the chances of developing chronic pain, and can also increase our suffering if chronic pain isalready present. Treating the whole person, not just the body, is important when we treat pain.

Summary

There is a lot you can do for yourself to reduce the impact of acute pain and to prevent developingchronic pain. Having knowledge and understanding about pain, having good communication with yourhealth care professional, keeping active and looking after your emotional health all reduce pain andreduce the risk of developing chronic pain. Actively engaging in your own health care and painmanagement makes a big difference to pain.

There are many resources available that can be used by people with pain to understand more abouttheir condition. A few we recommend are: For kids with pain: https://www.aboutkidshealth.ca/pain To learn about pain – Retrain Pain Foundation: https://www.retrainpain.org/ To learn about pain – Tame the Beast: https://www.tamethebeast.org/ Understanding pain in five minutes: https://www.youtube.com/watch?v=C_3phB93rvI Understanding Pain - Elliot Krane – The Mystery of Chronic Pain:https://www.youtube.com/watch?v=J6--CMhcCfQ Understanding pain in kids: https://www.aci.health.nsw.gov.au/chronic-pain/painbytes

REFERENCES

[1] Health NDo, Africa SS, Council SAMR, ICF. South Africa Demographic and Health Survey 2016. Pretoria, South Africa:National Department of Health Statistics South Africa South African Medical Research Council ICF 2019.[2] King S, Chambers CT, Huguet A, MacNevin RC, McGrath PJ, Parker L, MacDonald AJ. The epidemiology of chronic pain inchildren and adolescents revisited: a systematic review. Pain 2011;152(12):2729-2738.[3] Lorig KR, Holman HR, Sobel DS, Laurent DD, Gonzalez VM, Minor M. Living a Healthy Life with Chronic Conditions: SelfManagement of Heart Disease, Arthritis, Diabetes Boulder, CO: Bull Publishing Company, 2012.[4] Neville A, Jordan A, Beveridge JK, Pincus T, Noel M. Diagnostic Uncertainty in Youth With Chronic Pain and Their Parents.The journal of pain : official journal of the American Pain Society 2019;20(9):1080-1090.[5] Rayner L, Hotopf M, Petkova H, Matcham F, Simpson A, McCracken LM. Depression in patients with chronic pain attending aspecialised pain treatment centre: prevalence and impact on health care costs. Pain 2016;157(7):1472-1479.[6] Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, Cohen M, Evers S, Finnerup NB, First MB, Giamberardino MA,Kaasa S, Korwisi B, Kosek E, Lavand'homme P, Nicholas M, Perrot S, Scholz J, Schug S, Smith BH, Svensson P, Vlaeyen JWS, WangS-J. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification ofDiseases (ICD-11). PAIN 2019;160(1):19-27.

AUTHORSRomy Parker, PhDAssociate ProfessorDepartment of Anaesthesia & Perioperative MedicineUniversity of Cape TownCape Town, South AfricaFiona Campbell, BSc, MD, FRCAStaff, Department of Anesthesia and Pain MedicineDirector, Chronic Pain TeamCo-director, SickKids Pain CentreThe Hospital for Sick Children

Toronto, CanadaKathryn Birnie, PhD RPsychAssistant ProfessorDepartment of AnesthesiologyPerioperative and Pain MedicineUniversity of CalgaryPsychologist, Alberta Children’s HospitalCalgary, CanadaREVIEWERSMary Wing, Grad/Dip Chronic Condition ManagementPatient Educator/Advocate,Adelaide Pain Support NetworkMemberGlobal Alliance of Pain Patient Advocates (GAPPA)Adelaide, South AustraliaSaurab Sharma, MPT, PhD CandidateAssistant ProfessorDepartment of PhysiotherapyKathmandu University School of Medical SciencesDhulikhel, Kavre, NepalMichael Falcon, OTD, OTR/L, MHA, BSOccupational Therapist, ConsultantOregon, United States