Pain is a sensation that almost everyone has experienced. Data shows that the global average prevalence of chronic pain in adults is about 30%, which means that on average, 3 out of 10 adults are afflicted by chronic pain. It is a serious disease that takes a toll on people’s minds and bodies and keeps the quality of life down.
Chronic pain afflicts hundreds of millions of people
Although no epidemiological survey has been conducted in China, the number of people suffering from chronic pain is significant, with as many as 100 million people suffering from chronic pain from osteoarthritis alone. If the incidence of neuropathic chronic pain is calculated at about 8% of adults abroad, there are at least 80 to 90 million such patients in China.
In China, I have seen too many patients suffering from pain since 1989, when I started to try outpatient pain treatment. They tell me about the unbearable suffering caused by pain and the changes it has made to their lives. Some are in so much pain that they roll around and bang their heads against the wall; some have to endure 2 to 3 pain attacks every hour; some are confined to bed and cannot get off the floor; some are in so much pain that they can’t sleep all night …… The pain has severely affected their quality of life and they feel hopeless. And side by side with this, many people’s awareness of chronic pain needs to be improved, and our pain science needs to be further developed.
If the pain is not relieved after 1 month or more, it is chronic pain. Many people think that pain is a complication caused by disease, and that if you have a disease, you will definitely have pain, and when you get well, you will naturally stop having pain. This understanding has a great limitation. In fact, modern pain medicine research found that chronic pain that lasts for more than a month can lead to dysfunction of the human system, reduced immunity and resistance, plant nerve disorders and other changes. In severe cases, it can also lead to “central sensitization”, or as the saying goes, “the brain hurts”, even if there is no external stimulation, the brain has a pain memory, will feel pain, or pain tolerance is reduced.
In recent years, the mainstream medical community at home and abroad has been calling for chronic pain to be a disease that requires timely treatment, which can be caused by other diseases or can be independent or co-exist with the primary disease. For example, after cancer is cured, many patients have more pain than before. This may be because cancer is like a trigger that “triggers” the pain switch and triggers new pain.
These pains are the most torturing
There are many different types of pain and different manifestations. However, broadly speaking, chronic pain can be divided into three major categories, which are also the most torturous.
Neck, shoulder, lumbar and leg pain. This is the most common pain, mainly including osteoarthritis, cervical spondylosis, frozen shoulder, lumbago, etc. Osteoarthritis mostly afflicts middle-aged and elderly people, often caused by strain and degeneration. Data show that the incidence rate of people over 65 years old is 60% to 70%, and the incidence rate of people over 70 years old is as high as 70% to 80%, and there are about 100 million osteoarthritis patients in China. Young people are often troubled by cervical spondylosis, frozen shoulder, etc.
Neuropathic pain. This is almost the most unbearable pain. “Heart-breaking, knife-like pain that makes the old man’s lips turn purple, his body shake, and his teeth clench” is how a netizen described his grandmother’s post-herpetic neuralgia. Neuropathic pain, including trigeminal neuralgia, known as the “number one pain in the world”, post-herpetic neuralgia, sciatica and painful diabetic peripheral neuropathy. It refers to the pain directly caused by the injury and disease of the somatic sensory nervous system, which may be spontaneous pain without any reason, “pain allergy” that can hurt for a week with a slight touch, or “pain hypersensitivity” that can be unbearable even when wearing clothes. It can also be a “pain allergy” that can hurt for a week at the slightest touch, or even a “pain hypersensitivity” that makes even putting on clothes unbearable. Neuropathic pain is not just pain, but its impact on life is often multidimensional, and many people cannot sleep or eat well, and are anxious and depressed as a result.
Cancer pain. Cancer is already a common disease, and data show that about 1/4 of new cancer patients are accompanied by cancer pain, and 75% of end-stage cancer patients will be tormented by cancer pain, but only 30%~40% of cancer patients in China receive regular anti-cancer treatment. At present, “anti-cancer” + “anti-pain” has become the mainstream of international oncology treatment, which is found to improve patients’ quality of survival and let cancer patients go farther and better.
The three most common misconceptions
In the clinic, I found that many patients have misconceptions about pain, the following three are the most common.
1. Enduring pain: “Enduring” is the way many people deal with pain, even if they can’t sleep well and sweat all over. But the idea that “if you are sick, you will be in pain, and when you are well, you will not be in pain” should be eliminated. Acute pain is a symptom, and most of the pain will go away when the disease gets better. The chronic pain itself is a disease, to be treated as a disease in a timely manner, in order to get good results.
2, indiscriminate pain relief: data show that hundreds of thousands of people in the United States lose their lives every year due to the abuse of painkillers. If it’s just an occasional toothache or stomachache and there is no related disease, it doesn’t matter much to take some painkillers, but if it doesn’t get better, you should go to the hospital in time. As long as the pain is caused by diseases, such as gastritis and gastric ulcer, even if the pain is occasional, painkillers should be taken under the guidance of a doctor. Clinically, there are patients who ate painkillers for toothache and had stomach bleeding. Some patients also use physical therapy, hot compresses and other methods to relieve pain, if effective can be adhered to, if several weeks in a row still do not work, then you should change the treatment method as soon as possible.
3, the treatment is also ineffective: If you turn back the clock to 30 or 40 years ago, in front of the pain, many times medicine is really powerless. But now, professional pain doctors have a lot of “weapons” to eliminate pain. Currently, there are hundreds of pain medications, and pain physicians know their indications and contraindications well enough to find the most beneficial and least damaging drugs for their patients; advances in minimally invasive interventional techniques have brought superior efficacy to pain treatment. In the case of spondylolisthesis, for example, there are many tools such as selective nerve blocks, nerve root pulsed radiofrequency, epidural lumpectomy and intervertebral foraminoscopic techniques. Through comprehensive treatment, pain can usually be relieved or even cured to a great extent.
To treat pain as a disease
Pain, after breathing, pulse, blood pressure and body temperature, has been listed as the “fifth vital sign”. When there is shortness of breath, high blood pressure, fever and other problems, we tend to pay great attention to it, but show great tolerance to pain. In the face of pain, we must remember the following points.
5 types of pain can be considered to see a pain department. If it is acute severe pain, you should go to the relevant department at the first time, such as chest pain to cardiology, abdominal pain to gastroenterology, etc. If it is a chronic pain for more than 1 month, you can choose to go to the pain department to receive treatment, mainly including the following 5 categories.
1. neck, shoulder, waist and leg pain, including cervical spondylosis, lumbar spondylosis, herniated disc, tennis elbow tendinitis, etc.
2, all kinds of neuralgia. such as trigeminal neuralgia, sciatica, intercostal neuralgia, residual limb pain, phantom limb pain, etc.
3, pain of unknown origin.
4, cancer pain, which can be treated with antinociceptive therapy during or after the completion of cancer treatment.
5.pain caused by spasm embolism of blood vessels and pipes.
Learn to say pain. When describing pain, be sure to tell the doctor in detail: How long have I been in pain? How often does it hurt? How does it hurt, is it pins and needles, cuts, tears, fire, or numbness like pain, etc.? Under what circumstances does the pain increase or decrease? Is there any other discomfort such as dizziness or nausea when the pain is present? In response to the doctor’s questions, describe the pain as accurately as possible.
Don’t put off an acute pain into a slow pain. Pain is not something that can be tolerated. We do not become more sturdy by tolerating pain, we only become more “fragile” and more pain intolerant. If you have pain, you must treat it in a timely manner. Don’t put off acute pain to become slow pain, or simple pain to become complex pain.
More activity can prevent pain. Lifestyle adjustments do not have much effect on neuropathic pain and cancer pain, but they have a preventive effect on the most common neck, shoulder, waist and leg pain. People should avoid sitting and standing for a long time and develop regular exercise habits to prevent cervical spondylosis, frozen shoulder, lumbago, etc. In autumn and winter, patients with osteoarthritis need to pay attention to keeping warm. And develop a healthier lifestyle under the guidance of a specialist.