I. History of pain medicine
As early as the 1920s, anesthesiologists opened pain clinics in the U.S. Since the 1950s, many foreign hospitals have opened pain departments and established pain research and treatment centers. With the establishment of the International Pain Society in 1976, it marked the beginning of a time when medical professionals who were passionate about pain medicine could independently research and develop methods for the treatment of pain disorders.
The development of pain medicine in China can be traced back to the 1950s, when acupuncture paralysis (acupuncture numbness) emerged in China to treat a variety of chronic intractable pain. 1989 saw the establishment of the Chinese branch of the International Pain Society, followed by the Chinese Medical Association Pain Society in 1992. With the rise of pain medicine in China and the opening of pain departments in major hospitals, on July 16, 2007, the Ministry of Health issued a notice on the addition of “pain medicine” to the list of medical institutions, and determined that “pain medicine” is the first level of clinical diagnosis and treatment subjects. On July 16, 2007, the Ministry of Health issued a notice on the addition of “pain medicine” to the list of medical institutions and established “pain medicine” as a first-class clinical treatment subject.
What is pain?
It is an unpleasant sensation and emotional experience associated with actual or potential tissue damage. It is a subjective feeling, the most primitive and widespread kind of human pain; it is listed as the fifth vital sign after whistle, pulse, blood pressure and body temperature.
Third, the scope of practice of pain department.
Diagnosis and treatment of chronic pain, mainly including
Headache: cervicogenic headache, migraine, occipital neuralgia, post-traumatic headache, etc.
Bone and joint pain: cervical spondylosis, cervical disc herniation, lumbar disc herniation, degenerative knee arthritis, gouty arthritis
Soft tissue pain: frozen shoulder, tenosynovitis, tennis elbow, acute and chronic lumbar sprain, supraspinous ligamentitis, lumbar dorsal myofasciitis, heel pain
Neuralgia: intercostal neuralgia, sciatica, acute herpes zoster, post-herpetic pain, trigeminal neuralgia, brachial plexus neuralgia, post nerve injury pain phantom limb pain, stump pain, diabetic neuralgia, complex regional pain syndrome
Ischemic pain: Raynaud’s disease, occlusive thrombotic vasculitis, thrombophlebitis, erythema limb pain
Cancer pain
Post-surgical scar pain, post-traumatic pain
Non-painful diseases: sudden deafness, acute facial palsy (facial neuritis), allergic rhinitis, intractable eruption, facial muscle spasm, insomnia, menopausal symptoms, early rehabilitation of ischemic-hypoxic encephalopathy
IV. Treatment features of pain department.
It is a new crossover discipline between traditional medical and surgical treatment, and its strengths and characteristics are minimally invasive interventional treatment methods.
Conventional treatment methods include: nerve block (peripheral nerve, cranial nerve, sympathetic nerve, visceral nerve), joint cavity and synovial bursa injection, soft tissue pain injection, joint skeletal muscle adhesion release, nerve radiofrequency, nerve electrical stimulation, intervertebral disc intervention (radiofrequency, ozone, chemical nucleolysis, plasma), intervertebral foraminoscopy, morphine pump implantation (intrathecal, epidural, intravenous), extracorporeal shock wave therapy, etc.
V. Understanding the connotation of modern pain medicine and correcting misconceptions about pain treatment
Influenced by traditional concepts and knowledge limitations, most patients, including some medical personnel do not understand the true meaning of pain medicine, and believe that pain treatment is only a symptomatic treatment, “treating the symptoms but not the root cause”. This idea is clearly and obviously outdated. In the last decade or so, the progress of pain medicine has benefited from the rapid development of modern social ethics, basic medical research on pain, development and improvement of analgesic drugs, diagnostic and navigation techniques in imaging, minimally invasive analgesic techniques, and computer technology, which have introduced numerous advanced minimally invasive interventional techniques that can nourish, under the precise guidance of CT, X-ray, ultrasound, and electrical stimulators, the nerves that have gone wrong For inflammatory pain of joints, tendons, tendon sheaths, etc., target injection of anti-inflammatory and analgesic treatment can be carried out; for pain of intervertebral disc origin, decompression, anti-inflammatory and relaxation treatments such as thermal coagulation and ablation can be used, thus cutting off the root cause of pain, treating the disease and playing the role of both the symptoms and the root cause. Therefore, asking the cause and choosing the prescription, removing the cause and relieving pain is the root of modern pain medicine in treating painful diseases.