Top misconceptions about pain management

  1, pain is not a disease, can endure it.  ”Pain” is the earliest and most subjective sensation experienced by every person in his or her life, and is the main signal of damage to human tissues and organs. It serves as a protective signal that makes people avoid danger or go to the doctor. For chronic pain that is still tolerable, many people do not take it seriously and tolerate it as long as they can. In fact, pain not only causes mental suffering, loss of labor force and quality of life, but also causes disorders in the function of various organs and systems, low immunity and various complications, which greatly shorten the life span of people. The World Health Organization has clearly put forward: “Acute pain is a symptom, chronic pain is a disease”. The Department of Pain is precisely the professional department to solve various chronic pain, chronic pain disease should be timely to the Department of Pain.  2, no matter what method is used, stop the pain first.  The “headache to cure the head, the foot to cure the foot” is the extreme wrong method. Therefore, the correct treatment of chronic pain is: on the basis of a clear cause, through the treatment of the cause, remove the inflammatory metabolites, effectively improve the local blood circulation disorders, interrupt the vicious cycle of pain, to achieve long-term perfect analgesia. If the pain is injected with dulcolax indiscriminately, the condition will be delayed because the pain is temporarily covered up, which will surely cause serious medical accidents, so the correct method of analgesia must be adopted.  3. Cancer patients can only rely on medicine and injection to relieve pain.  For cancer pain patients, with the development of the disease, the traditional oral and injectable drug delivery methods may have disadvantages such as incomplete analgesia and large side effects. The latest pain interventional treatment-subarachnoid programmable morphine pump implantation-brings light to patients with cancer pain and chronic intractable pain. This technique has been widely performed in Europe and the United States and other countries with convincing results. The subarachnoid programmable morphine pump enables the release of very small amounts of morphine in the subarachnoid space at a uniform rate, and the amount of morphine release can be adjusted at any time by means of in vitro programming, which greatly improves the analgesic effect of morphine and reduces adverse effects. The biggest advantage of this method is significant and long-lasting efficacy, less patient pain and less adverse drug reactions.  4.Cervical spondylosis and lumbar spondylosis can only be operated when conservative treatment is ineffective.  The vast majority of people have a fear of surgery, a fear of surgery trauma; two fear of risk, in case the pain is not cured, but aggravated or paraplegic how? This fear is understandable. In fact, there are many interventional procedures for pain management that do not require an incision. Under the guidance of imaging, a very fine puncture needle is used to reach the lesion and selectively block the nerve or dissolve the nucleus pulposus to treat spinal neuralgia or herniated discs in a physical or chemical manner, which is more than 90% effective, less invasive and less risky, and is currently advocated as a green treatment. Of course, not all spinal lesions can be used in this way, and some serious people should be operated.  5, after the wind back pain is only the wind and cold, my lumbar spine itself is not a problem.  Inappropriate posture or cold is the triggering factor of low back pain, but often has its underlying disease – small joint disorders are the main cause of local nerve compression, producing inflammatory edema. X-rays of such patients are often normal, but do not indicate that there is no problem in the lumbar spine, because early inflammation of the compressed nerve does not always show up on imaging. Medication, physical therapy, and nerve blocks can relieve pain and eliminate inflammatory edema. Such patients should usually pay attention to the protection of the spine: avoid prolonged sitting, so as not to increase the burden on the lumbar spine; appropriate calcium supplementation, the choice of easily absorbed calcium supplement products; pay attention to warmth.  6, morphine, dulcolax is the highest stage of treatment of all pain.  In fact, it is not. Central pain caused after head spinal cord injury, local complex neuralgia caused by peripheral neuropathy, phantom limb pain, etc. The effect of opioid painkillers is not ideal: the negative effect brought by high dose morphine is much greater than its positive effect. The mechanisms of pain are complex and not all of them can be explained by opioid receptor mechanisms, and for these pains must be treated from the central stage. The most advanced international deep brain electrical stimulation and spinal cord electrical stimulation have many successful cases in the treatment of these diseases. Mr. Liang is the general manager of a large enterprise. Twenty years ago, a traffic accident caused a brachial plexus nerve injury, which resulted in frequent severe pain in the left arm, diagnosed as complex localized pain syndrome type I. He relied on high-dose morphine for analgesia for years, and his quality of life was extremely poor. He had been transferred to the neurology, orthopedics and pain departments of several large hospitals in Beijing and Shanghai, but all returned in frustration, and his family was worried. After permanent spinal cord electrical stimulation placement was given, the pain was immediately and completely relieved, no more pain medication was used, and Mr. Liang returned to work with a smile on his face. (CCTV and many domestic newspapers have reported on this) 7. How can you still have pain after the primary disease has been cured.  Some people are cured of herpes zoster, but months or years later the original herpes area occurred stubborn severe pain, especially the elderly and frail or those with chronic diseases are more likely to occur, this is called postherpetic neuralgia, is a kind of sequelae pain, is due to nerve cell degeneration damage. To avoid this, regular antiviral and timely analgesic treatment must be administered during the acute outbreak phase to avoid permanent and irreversible damage to the nerves due to virus latent at the nerve roots. In addition, immunity must be enhanced and comorbidities controlled.  8. The surgery was successful and the imaging was normal, how come the pain is still there.  It is true that many patients after spine surgery or cranial surgery have this narrative. Modern medicine believes that health is not only about normal body morphology, but also about normal function, and this concept must be established. Pain medicine is the science that addresses function. To give a simple example, if an elderly person has degenerative changes in the spine that cause nerve compression and produce inflammatory edema and pain, if the nerves can be nourished or blocked in the easiest and most effective way, the pain will naturally be relieved. If the bones are revised in a major way, new pain may arise before the old one is resolved, which is undesirable.