Assessing pain, the pain patient & pain games

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Assessing pain, the pain patient & pain games
ASSESSING PAIN, THE PAIN PATIENT & PAIN GAMES
One of the greatest challenges facing medicine today is not how to practise acupuncture or cure cancer or osteoarthritis. Rather, it is a careful and objective evaluation of Western medicine. How is the Hippocratic requirement satisfied that treatment must, first of all, cause no harm?
Pain is the most common symptom confronting the doctor. Yet, curiously, it has no standard definition. Why do some respond well while others repeatedly return to haunt their doctor because their pain shows little improvement?
Pain can occur without injury — and injury without pain. Pain is not just a function of the amount of bodily damage alone. The amount, and quality, of the pain we feel is also determined by our previous experiences and how well we remember them. Our ability to understand the causes of pain and to grasp its consequences, as well as our cultural values, all play an important role in the way we perceive and respond to pain.
Pain cannot be measured. The doctor must rely entirely on the patient's description in trying to understand what the patient experiences. There are several thresholds related to pain. Typically, thresholds are measured by applying a stimulus such as electric shock or radiant heat in the small area of skin and actually increasing the intensity.
Complex assessment
A reason for the hitherto lack of accurate assessment of the causes of chronic pain is that the condition involves complex combinations of sensory, perceptual, psychological, psycho-social and environmental factors.
Thus often a concerted effort has to be made by a closely knit team of interested practitioners to make the correct diagnosis and develop the most effective treatments. This team approach which is the basis of pain clinics is now gaining popularity. Chronic pain sufferers can only rejoice.
But let's have a burst of refreshing honesty here. Doctors aren't gods. They don't know everything about everything! There is still much to be learned. And while many patients can be helped, it is impossible to help everyone.There are no magic cures. No magic wands. What has to be stressed is more effective pain management. That simply means the patient must be helped to cope with pain which is likely to persist for indefinite periods even if its severity cannot be totally relieved.
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