World Analgesia Day focuses on bone, joint and muscle pain
Since 2004, the International Academy of Pain Studies (IASP) has decided to designate October 11 as World Analgesia Day and suggested that the week of mid-October could be designated as “Analgesia Week” depending on the situation of each country. The aim is to raise scientific awareness of the need to prevent and treat pain in a timely manner. The Chinese Pain Society responded positively and designated October 11-17, 2004 as the first “Chinese Analgesic Week”. The theme of World Analgesia Day is “Pain Free is the Basic Right of Patients” to arouse people’s concern about pain. To continue to raise awareness about a number of pain disorders, each year IASP selects a different area of pain medicine for a year-long global campaign.
Past World Analgesia Day Themes
2004 World Analgesia Day theme: Freedom from pain is a fundamental right of patients
2005 World Analgesia Day theme: Freedom from pain – a fundamental right of patients and a sacred duty of physicians
2006 World Analgesia Day theme: Concern for pain in the elderly
2007 World Analgesia Day Theme: Concern for Women’s Pain
2008 World Analgesia Day Theme: Fighting Cancer Pain
I. Chronic pain is a disease
In daily life, many people think that pain is only a symptom of disease, and that it will disappear as long as the disease is cured. Experts point out that this is a misconception that must be corrected. From the medical point of view, pain is divided into two categories: one is acute pain, one is chronic pain. Acute pain is a symptom, chronic pain is a disease, and this disease is long-term unhealed, it is difficult to carry out treatment. Chronic pain as a disease has attracted a lot of attention worldwide, and the World Congress of Pain has recognized pain as the “5th vital sign of human beings” after breathing, pulse, temperature and blood pressure. Many pathological pain itself is a disease that seriously affects the quality of life and work of patients, people have gradually realized the importance of pain, and the World Health Organization proposed in 2000 that “chronic pain is a type of disease”.
The significance of acute pain is that it is a warning, and more than 50% of patients are seen for pain, so acute pain is called “good pain”. In contrast, chronic pain that lasts more than 3 months and is difficult to treat can only have a damaging effect on physical and mental health and quality of life, and is considered “bad pain” and should be eliminated. Most chronic pain cannot be seen as a symptom, but some chronic pain is a disease in itself. For example, there was a patient with head and facial pain, eating, washing, brushing teeth, talking, even walking vibration or wind blowing and other stimulation of the face or a point in the mouth, will immediately occur facial paroxysmal, knife-like lightning-like severe pain, frequent attacks every day. Due to the long-term impact on eating and sleeping, the body functions become exhausted. Patients are unable to work and live normally, making it painful to live. What is more undesirable is that due to the lack of timely and regular pain treatment, several teeth were extracted but the pain was still there due to the mistaken belief that it was caused by toothache, and a large amount of oral painkillers were taken for a long time, which led to stomach problems. The patient was diagnosed with trigeminal neuralgia, and with the help of experts, he was treated with regular nerve block and radiofrequency destruction of ganglion, which eliminated the pain, eliminated the need to take a lot of medication, recovered from stomach problems and restored his general health, and the patient claimed that he had “regained his life”. Similar to trigeminal neuralgia and post-herpetic pain, pain itself is a disease, and when the pain is cured, the disease is also cured. Therefore, the traditional concept of “tolerate back pain, it can’t be cured anyway” should be changed. At present, the development of science has led to an increasing number of means of treating pain, and the efficacy is getting better and better. At present, most of the chronic pain can be treated satisfactorily. With the development of economy and improvement of living standard, people with pain should take an active treatment attitude, and delaying the treatment will often make acute pain turn into chronic pain.
Second, the common diseases that cause bone and joint muscle pain: rheumatoid rheumatoid arthritis, cervical spondylosis, lumbar disc herniation, knee osteoarthritis, heel pain, temporomandibular joint dysfunction syndrome, degenerative osteoarthritis, etc. Acute and chronic lumbar sprain, lumbar muscle strain, supraspinous interspinous ligamentitis, lumbar dorsal myofasciitis, pear-shaped muscle syndrome, fibromyalgia syndrome, tenosynovitis, frozen shoulder, tennis elbow, osteoporosis, etc.
Third, the hospital has specialized institutions for pain treatment
Under the advocacy of the International Pain Society and Chinese Pain Society, it has reached a consensus that “dispensing with pain is the basic right of patients, and it is the sacred duty of medical and nursing staff to relieve patients’ pain as soon as possible by putting people first”. With the development of the economy and the improvement of the standard of living, it is the best policy to take an active treatment attitude when there is pain; delayed treatment often turns acute pain into chronic. According to the demand of patients, under the approval of the health administration, some general hospitals above the second level have opened pain clinics (or departments) one after another, and the main services they carry out (partially listed) are
1.Headache: migraine, cervicogenic headache, myotonic headache, post-traumatic headache and post-lumbar puncture headache, etc.
2.Neuralgia: trigeminal neuralgia, intercostal neuralgia, sciatica, acute herpes zoster, post-herpetic neuralgia, pain after nerve injury, central pain, phantom limb pain, stump pain, diabetic neuralgia, sympathetic nerve-related pain, complex local pain syndrome, etc.
3.Bone and joint pain: low back pain, cervical spondylosis, lumbar disc herniation, knee arthritis, heel pain, temporomandibular joint dysfunction syndrome, degenerative osteoarthritis, etc.
4.Tissue pain: acute and chronic lumbar sprain, lumbar muscle strain, supraspinous interspinous ligamentitis, lumbar dorsal myofasciitis, pear-shaped muscle syndrome, fibromyalgia syndrome, frozen shoulder, tennis elbow, soft tissue injury, etc.
5.Cancer pain: advanced cancer pain, bone metastatic pain, etc.
6.Analgesic service: painless abortion, painless endoscopy, etc.
The development of science has led to an increasing number of pain treatment methods and improving efficacy, and many chronic pains can now be treated satisfactorily. In professional treatment institutions, professional and technical personnel carry out consultation and treatment in accordance with the “Clinical Pain Treatment Guidelines” and “Clinical Pain Treatment Practice” compiled by the Pain Society of the Chinese Medical Association. Of course, sometimes the diagnosis and treatment of pain diseases are complicated, and multidisciplinary consultation of relevant departments is required for difficult diseases to clarify the diagnosis and develop treatment measures.
IV. How to introduce pain to doctors
When you get a little older, you will have a lot of pain that will haunt you and linger. In fact, pain is an alarm signal for your health. Only by staying away from pain can you improve your quality of life and truly enjoy the golden years of your life. Therefore, when you seek medical attention for pain, you should know how to present it to your doctor. It is recommended that when seeking medical attention you start by describing the time, location, and cause of your pain. You also need to use more vivid words to describe your pain, for example, “it hurts like pins and needles”, or “it hurts like thunder from far away to near, faintly”. This is the only way the doctor will know what your pain is like from what you say.
In your description, be sure to include the following points.
1. Site: Exactly where it hurts point out the specific area and use your hand to point out or circle the area of pain. For example: abdominal pain. So is it upper or lower abdomen, left or right abdomen.
2. Scope: Does it hurt at a certain point or a certain area, is it skin pain or bone pain, or internal organ pain.
3. Characteristics of spreading: Tell the doctor the pathway of the pain. Does it start from a certain area and then spread to other areas.
4 . Persistence: whether the pain is in bursts or constant.
5.Influencing factors: Does the pain get worse when you do something, does it hurt when you bend over to pick something up, does it get worse when you turn around, climb stairs, walk, or when you lie down or even when you eat something.
6, climate: cloudy or rainy days, whether it is easier to pain when the temperature rises or falls, try to pay attention to it.
7. Where the pain is likely to strike: Doctors need to know this because certain substances in the home or work environment may trigger the onset of certain pains.
8. Other bodily functions: Does the pain prevent you from doing certain things, for example, does it affect your ability to eat? Does your movement get restricted.
9, the impact on sleep: some pain can prevent sleep, once you fall asleep, the pain is no longer bother. If you have this situation, you should write it down.
10. Your pain history: Tell your doctor when you started having pain and what caused it. It is a good idea to describe what happened when a particular pain episode occurred. Also tell the doctor if the pain situation has changed from the beginning to now, the increase or decrease of the degree or the spread of the area, etc.
V. Principles of pain treatment and precautions to be taken during treatment.
Principle.
1.Block the nerve conduction pathway of nociception.
2.Block the vicious cycle of “pain → muscle tension and small-vessel smooth muscle spasm → local ischemia → tissue hypoxia, metabolite accumulation → increase in pain-causing substances → neuroplasticity reaction → increase in pain”.
3.Reduces sympathetic excitability, dilates blood vessels, improves blood circulation and tissue metabolism.
4.Anti-inflammatory effect, eliminating local non-bacterial and immune inflammation.
5.Improve the patient’s mood, adjust the psychological state, and improve the pain threshold.
Precautions.
1, should not be fasting or too full before treatment. Bathe or wash the affected area with warm water in advance, and notify the doctor if there is skin breakage or infection.
2. If there is dizziness, nausea, panic or discomfort during the treatment, inform the doctor in time.
3.Sometimes the local pain can be aggravated after treatment, which is a reaction to the drug and generally reduces to disappear within 24 hours.
4.After treatment, numbness, fever, sweating, abnormal sensation and other reactions may occur locally and in the corresponding area. This is the normal reaction of the drug, which can disappear after a few hours.
5.After treatment, you should rest for about 30 minutes as prescribed by the doctor before leaving the hospital. Do not bathe within 48 hours after treatment.
6.After treatment, pay attention to rest, avoid excessive exercise, and keep the injection site clean and dry for 48 hours.7
Patients with diabetes, hypertension, and coronary heart disease should come to the doctor after their condition has stabilized and take the initiative to tell the doctor during the visit.
VI. Bone and joint muscle pain, prevention is more important than cure.
In daily life, there are many patients with bone and joint muscle pain. Whether it is pain in the bone and joint itself, or pain in the soft tissues around the bone and joint, including pain caused by injuries to muscles, tendons, fascia and ligaments. We need to actively and effectively prevent them. Generally speaking, the more flexible the body is (such as the cervical and lumbar spine) and the more frequently used bone and joint areas, the more likely bone and joint pain and soft tissue pain will occur. How to avoid them?
According to life experience and expert advice, the following points should be noted.
1, plain need to prevent cold, keep warm, avoid bone and joint cold. Because cold can cause less blood flow into the bone and joint surrounding, muscle stiffness and poor compliance.
2.Avoid excessive exercise and inappropriate external force causing bone and joint and soft tissue damage. There should be a complete warm-up before exercise, which helps the muscles and tendons to accept the upcoming sports training. If there is no warm-up muscles are stiff and tense state, the flow of blood through the muscles is relatively low, the muscles are in a state of oxygen deprivation, which can easily lead to bone and joint and soft tissue injuries.
3, strengthen the muscles and tendons around the bones and joints of the forging. Strong muscles are effective in preventing such injuries, even if bone and joint pain and soft tissue pain have occurred, non-weight-bearing muscle exercises are still very necessary.
4, bone and joint mobility and flexibility is to prevent soft tissue injury and tear injury is very critical. If there is too much stiffness and tension in the muscles. This makes the muscles easily exceed their own range of motion, resulting in muscle tendon damage is inevitable. Therefore, a regular rhythm of muscle stretching and muscle flexibility training to prevent bone and joint pain and soft tissue pain is a very necessary measure.
5, the occurrence of acute injuries after the rest and rehabilitation is very important. Especially athletes or people with strong physical work. It is important to make sure that your muscles are rested, especially after heavy physical exercise. Prevent the joints and soft tissues that are recovering from causing new injuries, resulting in new injuries plus old diseases, the condition is prolonged and chronic pain is formed.