Pain is a disease Pain is no stranger to everyone. We always feel various kinds of pain in our daily life for many reasons, and it is the earliest and most subjective internal sensation that we all experience in our lifetime. Preliminary statistics show that two out of every three outpatient visits are accompanied by various pain conditions or symptoms. For a long time, people do not understand pain, including a relatively one-sided understanding of pain, and the importance of pain and its harmfulness is far from adequate. For example, many people think that pain is only a symptom of disease and will not be life-threatening, and as long as the disease is cured, the pain will disappear, so people hold on to the mentality of enduring it and will not go to the hospital in time. A survey in the United States shows that pain is the most common and direct factor causing people’s reduced ability to work and reduced attendance. Young and middle-aged workers suffer a direct economic loss of up to $61.2 billion per year in lost labor time and reduced productivity due to pain. In today’s world, pain has become one of the major killers of human health. Not only does pain lead to aging of the patient’s face and strength, making the patient incapable of working and living from then on, but persistent pain can also shorten a person’s life span. When pain interrupts a person’s work and thus threatens the independence of the personality, the patient feels that life has lost its joy and meaning, which can lead to family break-up, suicide and even endanger society. It has been found that pain not only causes great suffering to the patient, but also directly leads to disorders in the function of various organs and systems of the body, impairs the immune system, and increases the chance of malignant diseases. Therefore, chronic pain has been compared to an “undead cancer”. Long-term chronic pain damages the nerve tissue and causes a plastic change in the nervous system, resulting in a very difficult to treat neuropathic pain, which seriously affects the patient’s quality of life. In 2001, the 106th Congress of the United States officially named the first decade of the new century as the “Decade of Pain Research and Treatment”, thus promoting the technology and research of pain medicine worldwide. In August 2002, at the 10th World Congress on Pain held by the International Academy of Pain (IASP) in San Diego, California, the experts reached a basic consensus that chronic pain is a disease. After breathing, pulse, temperature and blood pressure, pain is the “5th most important sign of human life”. In the United States, European countries and Japan, pain management is now a basic medical service in hospitals, and October 11, 2004 was the first World Analgesia Day initiated by the International Pain Society. The slogan “Pain relief is a basic right of patients” was proposed by the Society. The pain medicine community in China has responded to this initiative by designating October 11-17 each year as “China Analgesia Week” and calling on all pain management physicians in China to: take the initiative to ask each patient about their pain; focus on pain patient treatment, take the initiative to ask about pain, strengthen the standardized pain assessment of patients, and give active treatment. The goal is to raise awareness of pain in the medical community and in society as a whole. The aim is to raise the awareness of the medical community and society as a whole about pain. We should start now to create pain-free departments and pain-free hospitals to truly improve the quality of life of patients! Chronic pain must be taken seriously The International Academy of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience caused by real or potential tissue damage or similar conditions”. Some experts point out that pain is divided into good pain and bad pain, and only by treating pain correctly can we avoid harm. Acute pain is an alarming precursor to problems in the body organs, which not only suggests timely consultation, but also helps doctors determine the cause of the disease. Chronic pain usually refers to pain that persists for more than one month after the acute tissue injury has subsided, or pain that recurs for more than three months. Chronic pain can be a symptom of an internal organ disease or the main symptom of certain diseases. Common chronic pain includes more than 40 kinds of pains, such as myofascial strain, cervical spondylosis, disc herniation, trigeminal neuralgia, extremity arthralgia, osteoporosis, cancer pain, postherpetic neuralgia, migraine, frozen shoulder, tennis elbow, vasculitis, and post-amputation phantom pain. The causes and pathogenesis are intricate and complex. Although many people have experienced pain in one form or another, the best time to treat it is delayed because many people do not realize the severity of the pain and the possible consequences. The human body begins to gradually deteriorate at a certain age, with a decline in all physiological indicators. It’s like a slide that reaches a certain height and has to decline. The deterioration of physiological indicators is often accompanied by chronic pain, and the treatment of pain is to reduce the impact of pain on the body, so that the decline curve of the human body can slow down, so that people can live a healthier life. The first choice of pain medicine for chronic pain Nowadays, the standardized assessment, diagnosis and drug treatment level of analgesic treatment in China are greatly lacking. It is also common that medical workers do not understand pain medicine, and many people’s understanding of pain is still based on the old view that “pain is just a symptom”. Most of the pain treatment methods stay in analgesic drugs plus traditional massage, hot compresses, acupuncture and other methods, and there are not many techniques that can directly target the “root” of chronic intractable pain, resulting in the unique effect of pain medicine in treating intractable chronic pain has not been fully revealed. In tens of thousands of hospitals across the country, the pain department is really equipped with modern pain medicine theory and technology, especially the pain ward is not common. It is no wonder that many people misunderstand that the treatment of pain is only “treating the symptoms but not the root cause” and “not solving the problem”. Pain medicine developed in the 1930s as a clinical discipline specializing in the treatment of “painful diseases”, and neurology, anesthesiology, radiation intervention, orthopedics, physical medicine and other closely related, it is also the fusion of these disciplines of pain research branches into an emerging fringe discipline. Pain medicine and other adjacent disciplines for the treatment of “pain” both cooperate with each other, but also have a clear distinction between the division of labor. For example, anesthesiology focuses on pain relief during surgery and the treatment of acute pain; neurology and oncology focus on medication for pain-related conditions; and physiotherapy focuses on physical therapy. The treatment methods of pain medicine have shifted from simple drug treatment in the past to multidisciplinary comprehensive treatment, among which physical medicine has developed many electric and magnetic therapies to treat pain; the “imaging interventional minimally invasive neurotherapy” method has become the “nemesis” of pain because of its outstanding pain relief effect. The “imaging interventional minimally invasive neurotherapy” method has become the “nemesis” of pain because of its outstanding pain relief. The scope of pain medicine treatment is extremely wide, from medical medication to physical therapy to minimally invasive surgery. Any pain that cannot be solved by medical medication or surgery, pain that cannot be relieved after surgery, cancer pain, chronic pain of unknown origin and intractable neuralgia should be treated by pain medicine first. Through the professional and systematic treatment of pain department, 90% analgesic effect can be achieved and the chance of pain recurrence is very low. Currently, there is no pain department in our hospital, so you can choose the physiotherapy department first. Strategies for dealing with chronic pain A survey of self-medication habits of chronic pain patients, the first of its kind in Asia, published during World Pain Day 2010, showed that about 60% of chronic pain patients were using their own pain medication. Epidemiological findings show that 80% of people who experience pain, colds and other discomforts buy their own medication, and the most common medication they buy is painkillers. According to statistics, hundreds of millions of boxes of painkillers are sold through retail channels in China every year. There are many potential dangers of taking painkillers indiscriminately, and many pain patients end up with other diseases because of long-term use of painkillers. First is the stimulation of the gastrointestinal tract: painkillers, anti-inflammatory pain and other drugs may stimulate the gastric mucosa, causing serious gastrointestinal reactions, inducing gastric ulcers, and even gastric bleeding and perforation. Secondly, it leads to kidney damage: long-term use of painkillers may cause chronic interstitial nephritis, renal papillary necrosis, renal insufficiency, etc. The general principle of WHO for pain relief is “more benefit for the patient, not more pain”. The four objectives and principles of pain medication are: 1) to achieve maximum pain relief; 2) to minimize side effects; 3) to achieve maximum physical and psychological function; and 4) to restore the highest quality of life. The American College of Physicians recommends treatment with nonsteroidal anti-inflammatory drugs (e.g., fenbendazole, etc.), which not only have a rapid onset and efficacy, but also have a good safety record, with extended-release dosage forms providing 12 hours of continuous pain relief. However, the key depends on the doctor’s reasonable choice of NSAIDs. Experts pointed out that for minor headache, toothache, cold and body aches, etc., after clear reasons, you can buy the corresponding antipyretic and analgesic drugs by yourself. However, if the pain is not effectively relieved after 3 days of continuous use, you must go to the hospital for further examination. For mild pain, you can also choose topical medications, such as traditional topical creams and pain relief plasters. Topical medications are absorbed through the epidermis and have less impact on the organs. Professor Li Zhanguo, a famous rheumatologist in China, pointed out that when pain occurs in patients with neck, shoulder, back and waist pain, acute sprains and strains, osteoarthritis of the hands and knees, over-the-counter topical anti-inflammatory and analgesic drugs such as “Fotarine emulsion” should be considered first. Technically speaking, topical analgesics are comparable to oral analgesics, but with the advantages of direct access to the affected area, rapid onset of action and high safety, topical analgesics have a high rate of use abroad. In order to achieve a good therapeutic effect, the principle of “adequate amount, adequate frequency and adequate course” should be followed. Three levels of chronic pain treatment The conventional treatment for chronic pain relief can be divided into three levels: medication + physical therapy, nerve block therapy (including local closed injection) and minimally invasive treatment. For patients who do not have good results with medication alone or become dependent on medication, physical therapy and nerve block therapy can be used at the same time, etc. If chronic and intractable pain does not improve, minimally invasive therapy can be chosen from ——. The exact term is “imaging and electrophysiologically guided interventional minimally invasive neurosurgery”. Imaging and electrophysiologically guided intervention is a new technique for the treatment of neuropathic pain, which involves selective, destructive nerve blocks or precise focal treatment under X-ray or CT guidance with reference to the electrophysiological response of the target area, blocking the transmission of pain signals or relieving the compression of nerves. Spinal cord electrical stimulation therapy —— is currently the most advanced international treatment for the relief of chronic pain. The treatment system looks and works like a pacemaker, but it is a remote-controlled pain relief technology. In other words, electrodes are placed in the spinal canal of the human body through minimally invasive technology, and the spinal nerves are stimulated with pulsed current to block the transmission of pain signals to the brain through the spinal cord, so that the pain signals do not reach the brain and the patient does not feel pain, but a “tingling” sensation instead, thus reducing and relieving pain. It is also known as “green therapy” because it can avoid other side effects caused by drug analgesia. For patients with chronic neck, shoulder, back and leg pain, in addition to reasonable treatment, we must also pay attention to the relevant daily health care, patients can carry out simple and effective exercises for the neck, shoulder, back and other parts of the body in between work and spare time, and long-term adherence to a good working posture and lifestyle habits.