2. Content
What is Pain???
Diagnosis of Pain
Types of Pain
Treatment of Pain
3. What is Pain???
Pain is an unpleasant sensation localized to any part of
the body.
Pain is the most common symptom in many of the
disease.
Often described in terms of a bodily or emotional
reaction (e.g., terrifying, nauseating, sickening) and/or
of a penetrating or tissue-destructive process (e.g.,
stabbing, burning, twisting, tearing).
4. Diagnosis of Pain
Self-report is the key to pain assessment.
In non-or pre verbal children
- Facial expression is the most valid indicator of pain;
therefore use faces pain scale to assess severity of the
pain.
- In children pain can be assessed by childs’ crying
voice, posture, movement and colour.
5. In Adults Pain should be assessed by:
- Duration
- Severity, e.g. does the patient wake up because of the
pain
- Site
- Character, e.g. stabbing, throbbing, crushing, cramp
like
- Persistent or intermittent
- Relieving or aggravating factors
- Accompanying symptoms
- Distribution of pain
6. Type of Pain
Acute and Mild Pain
Severe Pain
Chronic Non Cancer Pain
Cancer Pain
7. Treatment of Pain
Acute and Mild Pain-
a. Aspirin
b. Paracetamol
c. Non-steroidal Anti-Inflammatory Agents (NSAIDs)
These drugs are considered together because
they are used for similar problems and may have
a similar mechanism of action.
8. Severe Pain-
a. Tramadol
b. Morphine
c. Pethidine
Opioids are the most potent pain-relieving drugs
currently available. They have the broadest
range of efficacy, providing the most reliable and
effective method for rapid pain relief.
9. Chronic Non Cancer Pain-
It is a pain that persist for more than 4 weeks, pain
can arise from:
a. Tissue damage (nociceptive pain), e.g. arthritis,
fibromyalgia’s, lower back pain, pleurisy, cancer pain
etc
b. Injury to nerves (neuropathic pain) e.g. post herpetic
neuralgia (pain following shingles), trigeminal
neuralgia, diabetic neuropathy, HIV related peripheral
neuropathy, drug induced peripheral neuropathy or
phantom limb
c. Abnormal nerve activity following disease
10. Cancer Pain-
- The long-term use of opioids is accepted for patients
with pain due to malignant disease.
- Some degree of tolerance and physical
dependence are likely with long-term use.
Therefore, before embarking on opioid therapy,
other options should be explored, and the
limitations and risks of opioids should be
explained to the patient.