Over 70% of adults choose to "endure pain" and not seek medical treatment.
10 On June 8th, the theme of World Analgesia Day and China Analgesia Week was released, and the Pain Medicine Week of China and Japan Hospital and the Congress of Pain Specialized Medical Association opened in Beijing. At the meeting, the theme slogan of "China Health Knowledge Dissemination Incentive Plan"-"Find pain, know pain, and solve pain" was released, calling on the public to know pain correctly.
It is understood that pain can be divided into acute pain and chronic pain. Acute pain refers to the pain that occurs suddenly in the near future and lasts for a short time. It is usually a symptom of many diseases, and is related to surgery, trauma, tissue damage or some disease states. Chronic pain lasts for a long time and is often a continuation of acute pain. Osteoarthritis, neck pain, low back pain, headache and cancer pain are all common chronic pains, which seriously affect the quality of life. The aging population, bad lifestyle and behavior habits and chronic diseases are the factors that lead to the continuous increase of pain diseases.
Professor Zhang Daying, Chairman-designate of Pain Branch of Chinese Medical Association and Director of Pain Department of the First Affiliated Hospital of Nanchang University, said that when we treat pain, we often regard it as a symptom or accessory of a certain disease. We expect it to fade with the recovery of the disease, and we will get used to "endure" it. Eliminating pain is the basic right of patients, so don't bear it in the face of pain. However, according to the research, more than 70% patients with pain "reluctantly" do not seek medical treatment, and only 28% patients seek medical treatment within 1- 10 days of their first pain.
Experts suggest that many patients only go to see a doctor when they can't stand the pain, or even "endure the pain" for a long time without proper treatment. Experts attending the meeting jointly called on the public to find the pain as soon as possible, correctly understand the pain, solve the pain as soon as possible and improve the quality of life.
Help you find the "initiator" of the pain.
Experts from the Health Education Institute of Beijing CDC said that severe pain can cause nausea, vomiting, dizziness, cold sweat, blood pressure drop and even shock. Chronic pain can lead to insomnia, constipation, loss of appetite, depression, irritability and so on. Refractory pain may cause limited physical activity, long-term inactivity or even disability, and the function is completely limited. Psychologically, pain may also cause depression, leading to emotions such as fear, anxiety and despair.
What causes pain? To sum up, there are the following categories:
1. Direct stimulation, such as knife cutting.
2. Inflammation, infection.
3. Some aseptic inflammation, such as inflammation caused by tissue infection.
4. Pain caused by lower limb ischemia, myocardial ischemia and arterial occlusion.
5. Metabolic diseases such as diabetes and gout. Diabetes can cause some pain-related diseases, one is diabetic peripheral neuropathy, which can cause numbness and pain in hands and feet. In addition, diabetes can also cause arteriosclerosis, and many people have insufficient blood supply to their lower limbs, leading to necrosis, and even amputation in severe cases.
6. Immune system diseases. Rheumatism, rheumatoid arthritis, scleroderma and other rheumatic immune diseases all affect the spine and joints, resulting in pain and limited function.
7. Geriatric diseases. Osteoarthritis is very common, and the problems occur in the neck, waist, chest and knee joint. In particular, elderly women are more likely to suffer from such diseases, because women's estrogen drops rapidly from old age, which is easy to cause osteoporosis, which in turn leads to fractures and osteoarthritis.
8. Some nervous system diseases.
9. Injuries caused by some operations.
10. The pain caused by mental problems.
Don't be a ninja for these diseases. Go to the pain department.
According to experts from the Health Education Institute of Beijing CDC, some soft tissue pain, headache, osteoarthropathy, disc herniation, pain caused by compression fracture, neuralgia, cancer pain, rheumatoid immune pain, chronic external ischemic diseases, etc., have certain treatment methods in the pain department. The general treatment of pain, that is, traditional treatment, mainly plays a certain role in relieving symptoms. For example, traditional massage, acupuncture, cupping and physical therapy all belong to the treatment methods of traditional Chinese medicine. At the same time, drug therapy is also very important, including all kinds of western medicines and Chinese patent medicines for promoting blood circulation and removing blood stasis, but it must be used under the guidance of a doctor, because some drugs are effective for one kind of pain and have no effect on the other. In addition, in the field of pain, minimally invasive interventional techniques have made great progress, including interventional treatment of cervical and lumbar disc herniation, interventional treatment of some intractable visceral pain and interventional treatment of some special neuralgia.
"What needs to be reminded is that there is a kind of pain emergency that must be taken seriously. What is a pain emergency? In fact, this kind of pain is a symptom, not a disease. It reflects the problems of your vital organs and is an alarm. " Experts say, for example, sudden myocardial infarction, pulmonary embolism in elderly patients, digestive tract perforation, aortic dissection and other severe pain. When this kind of pain occurs, you should go to the hospital as soon as possible. If you have a past history, you should go to the relevant department to see a doctor, so as not to go to the wrong place and delay the rescue time. For example, you have sudden chest pain and chest and back squeezing pain due to coronary heart disease. You should go to the cardiology department to do some tests to see if there is a myocardial infarction and do corresponding treatment.
Six misunderstandings about pain, don't catch a trick.
People usually have the following six misunderstandings about pain:
Myth 1: Pain can be tolerated, but if it can't be tolerated, it should be treated.
I can't stand the pain any longer. Once symptoms appear, active and effective treatment measures should be taken. Chronic pain should be treated as a disease. Pain will cause a series of pathophysiological changes, affect patients' emotional and mental health, lead to sleep disorders, anxiety and irritability, and reduce the compatibility with various treatments; Continuous pain stimulation can cause central sensitization. After central sensitization, the sensory threshold of neurons to pain stimuli decreases, which increases the intensity and duration of pain and greatly increases the difficulty of pain treatment. If the postoperative pain is not well controlled, it will affect the rapid recovery after operation. Especially after orthopedic joint surgery, patients are afraid of pain and refuse rehabilitation exercise, which leads to joint stiffness and muscle atrophy, thus affecting the surgical effect; In addition, patients with pain caused by osteoarthritis and rheumatoid arthritis, if their daily activities and functional exercises are affected by pain, will increase the risk of osteoporosis, muscle atrophy and so on, resulting in a vicious circle.
Myth 2: Pain is not a disease, so there is no need for treatment.
Pain can be an accompanying symptom of some diseases, such as headache secondary to hypertension and labor pain, or a painful disease, such as primary trigeminal neuralgia, postherpetic neuralgia and chronic low back pain. Acute pain is mostly a symptom of some diseases, while chronic pain is mostly a disease state. On the basis of treating the etiology of acute pain, symptomatic treatment is the main method; Chronic pain needs not only symptomatic treatment, but also comprehensive treatment according to the etiology and pathogenesis of pain.
For acute pain, this is usually a sign of physical damage or illness. Be sure to go to the hospital in time. For example, abdominal pain caused by acute appendicitis cannot be delayed, otherwise it may lead to serious consequences such as abdominal infection and sepsis. For chronic pain, it will aggravate, encourage and generalize, resulting in a vicious circle, which will further affect sleep, quality of life and psychology.
Myth 3: "Closing the door" can cure the symptoms but not the root cause.
"Blocking", that is, blocking therapy, is to inject local anesthetics or a small amount of hormonal drugs into pain points, joint capsules and other tissues. Local anesthetics can play a rapid analgesic role, and a small amount of local hormones can play a powerful anti-inflammatory role, which can eliminate inflammatory edema, promote inflammatory exudation and absorption, relieve muscle spasm, and improve the metabolism of diseased tissues. Therefore, blocking therapy can not only relieve temporary pain, but also treat diseases.
In addition, blocking therapy uses local anesthetics and is generally not addictive. Although long-term, repeated and high-dose use of hormones may lead to dependence, osteoporosis, femoral head necrosis and other adverse reactions, the dose of hormones used in block therapy is very small every time, so there is no need to worry too much. This is a safe and effective treatment. According to "Application of Glucocorticoids in Minimally Invasive Interventional Therapy of Pain-Domestic Experts' Knowledge" published on 20 17, in the treatment of epidural space and selective nerve root block, the medium and long-acting glucocorticoids should be used no more than 3 times and the short-acting effect no more than 5 times within 6 months; Intra-articular glucocorticoid is injected every three months for two years.
Myth 4: Analgesics are addictive, so try not to use them.
Some people think that taking analgesic drugs can be addictive. In fact, the "addiction" often mentioned here may be caused by disease dependence. Because of physical or disease reasons, patients really need to use analgesic drugs for a long time. For example, patients with rheumatoid arthritis need to take hormones for a long time. Medical "addiction" refers to mental dependence and addiction, which refers to people's periodic or persistent desire to take drugs in order to get satisfaction or avoid discomfort, and their compulsive drug use behavior.
After taking analgesics, the pain was obviously improved, and it recurred as soon as the drug was stopped. This situation is often due to the disease itself. For example, in some patients with degenerative arthritis or chronic low back pain, the pain will recur.
Tolerance refers to the adaptive response of the body to long-term drug use, which leads to the decline of drug efficacy, and the analgesic effect can still be exerted by increasing the dose. Opioid drugs (including morphine) are common addictive drugs that people are afraid of. Drug addicts are prone to addiction, but there are few cases of addiction to pain patients. It is worth noting that the application of analgesic drugs, no matter what kind of painkillers, should be applied under the guidance of doctors. Doctors will individually choose therapeutic drugs according to the primary disease, complications and medication history.
Myth 5: Analgesics have many side effects.
Analgesics commonly used in clinic include non-steroidal anti-inflammatory drugs, opioid analgesics, anticonvulsants and antidepressants. Different drugs have different mechanisms of action and adverse reactions, so we can't generalize them.
For example, non-steroidal anti-inflammatory drugs do have gastrointestinal adverse reactions, such as epigastric pain, nausea and indigestion. In severe cases, gastric and duodenal erosion, ulcers and life-threatening gastric and intestinal perforation and bleeding may occur. Patients with corresponding high risk factors should be cautious in using non-steroidal anti-inflammatory and analgesic drugs. If the condition requires long-term use of non-steroidal anti-inflammatory and analgesic drugs, pay attention to monitoring blood routine and fecal occult blood, and inform the doctor in time if you feel unwell.
The adverse reactions of analgesic drugs are not only related to the characteristics of drugs, but also related to personal physique, dosage, use time and whether there are risk factors for adverse drug reactions. Therefore, when choosing analgesic drugs, it is necessary to communicate with doctors about the patient's usual health status, including the past history of adverse reactions of analgesic drugs, accompanying diseases, drugs taken, etc. Doctors will choose appropriate drugs according to the patient's condition to minimize the occurrence of adverse reactions. At present, some analgesic drugs have also been genetically tested to predict the risk of adverse reactions of patients taking drugs, so as to reduce the occurrence of adverse reactions.
Myth 6: It is effective to completely eliminate pain.
Most acute pain can be completely relieved after removing the pathogenic factors, but chronic pain, such as diabetes, essential hypertension and other chronic diseases, is often incurable. The treatment of chronic pain often aims at symptomatic treatment, relieving pain, improving mood and improving quality of life. As a medical philosopher said, "Sometimes it can be cured, often relieved, and always comforted", it is unscientific to try to "radically cure" chronic pain through one or several treatment methods, which needs to be treated correctly.