WHAT IS PAIN?
Put simply, pain is your built in alarm that informs you something is wrong!
Pain is your body’s way of sending a warning to your brain. Your spinal cord and nerves provide the pathway for messages to travel to and from your brain and the other parts of your body. Pain travels along these nerve pathways as electrical signals to your brain for interpretation.
Receptor nerve cells in and beneath your skin sense heat, cold, light, touch, pressure, and pain. You have thousands of these receptor cells. Most sense pain. When there is an injury to your body, these tiny cells send messages along nerves into your spinal cord and then up to your brain.
In general, pain receptors are classified according to their location.
Receptors that respond to injury or noxious stimuli are termed nociceptors and are sensitive to thermal (heat), electrical, mechanical, chemical and painful stimuli. Each nociceptor is connected to a nerve that transmits an electrical impulse along its length towards the spinal cord and then, ultimately your brain.
It is your brain that informs you whether or not you are experiencing pain. Plus, your pain can plays tricks – especially when you suffer chronic pain.
Pain messages travel slower than other nerve stimulation
Nerves can also be categorised according to their diametre (width) and whether or not a myelin sheath is present.
Three types of nerves are concerned with the transmission of pain:
A beta fibres, which have a large diameter and are myelinated
A delta fibres, which have a small diameter and also have myelinated sheaths.
C fibres, which have small diameters and are non-myelinated (slowing their conduction rate) and are generally involved with the transmission of dull, aching sensations.
Nerves with a large diameter conduct impulses faster than those with a small diameter. The presence of a myelin sheath also speeds up the nerve conduction rate.
One method of easing your pain is to provide your nervous system with high speed “good feelings” such as rubbing your injured area. This is the same principle that a tens machine (pain relieving machines) utilises to provide pain relief.
Health professionals use different terms for different types of pain. Short term pain, such as a sprained ankle, is called ‘acute’ pain. Long-term pain, such as back pain, is called ‘persistent’ or ‘chronic’ pain. Pain that comes and goes, like a headache, is called ‘recurrent’ pain. It is not unusual to have more than one sort of pain, or to have pain in several places.
Many acute pains are a useful alarm signal that something is wrong. Most minor ones get better on their own or with simple treatment. Others may be a sign of something more serious, such as a broken leg. This pain is helpful because it means that you get treatment and rest your leg until the break has had a chance to heal. On the other hand, persistent pain appears to serve no useful purpose, but has a huge effect on the lives of many people.
WHAT IS PAIN MANAGEMENT?
More than one-third of the adult population in India suffers from some kind of chronic pain – pain that lasts longer than 3 months. Majority of these people are women and elderly. Untreated back and neck pain, arthritis, neuralgic pain, fibromyalgia, migraine and cancer related pain accounts for majority of these cases.
Why relieve Pain?
Unrelieved pain has major negative effects on one’s life and is associated with many physical, psychological and social changes which become a major health problem. Chronic pain can be excruciating and totally incapacitating. Chronic Pain is now recognized as a disease in itself and not just a symptom (as per WHO).
What is Pain Management?
Pain Management (also called Pain Medicine) is a branch of medicine employing a comprehensive approach for easing the suffering and improving the quality of life of those living with long standing pain. This involves a spectrum of treatment protocols starting from simple medications to varied interventional procedures supported by counselling and rehabilitative measures.
What is Interventional pain management?
Interventional pain management deals with treating pain using precision-guided injection techniques to deliver pain-relieving medicine to specific areas of your body. The injections are performed with X-ray or CT scan control. These are also done in the joints and the discs between the spine bones.
These injections can help us in avoiding spine surgeries in a vast majority of the patients.
What is a pain clinic?
A pain clinic is a specialized healthcare facility that focuses on the diagnosis and management of chronic pain. Pain clinics often use a multidisciplinary approach to help people take an active role in managing their pain and regaining control of their life. These programs are focused on the total person, not just the pain.
Pain clinics are ideal when a patient is looking at pain relief options which are minimally invasive and do not involve surgery. These treatment options are focused on relieving pain with minimal impact on life and with a short recovery time of a few hours (compared to recovery periods of 20+ days in case of surgeries).
What kinds of pain are treated?
Many different types of chronic pain problems are treated, but the most common are chronic lower back pain, sciatica, neck pain, joint pain, arthritis, headaches, neuralgic pain, post herpetic neuralgia, trigeminal neuralgia, fibromyalgia, migraine and cancer pain.
What types of procedures are done?
The most common procedures are X-ray guided injections to relieve inflammation in spinal structures caused by herniated discs. These procedures include epidural injections, percutaneous discectomies, facet and sacroiliac joint injections. Certain advanced procedures such as inserting electrodes in the spinal cord (spinal cord stimulator) and pumps which deliver painkillers into the spinal fluid (intrathecal pumps/spinal pumps) are also performed.
Are these procedures safe?
Some people are concerned about the safety and side effects of these procedures. When performed with precision by a skilled and experienced doctor, the procedures are safe and painless.
Are these treatments successful?
The treatments can be very effective when expertly performed using X-ray guidance. Following interventions, patient is put through a rehabilitation programme, which involves relaxation techniques, home-based exercises and lifestyle modifications. The long-term success rates in majority of cases are excellent.