Break the cycle of long-term pain
Interview with Dr Periklis Zavrides
How is the concept of pain defined? Does it involve subjective or objective elements? Or both? Today, the concept of pain – albeit hackneyed – seems to be quite difficult to determine as to what exactly it may involve. This is mainly due to the fact that pain is a personal experience and not a simple ‘stimulus-response’ complex. Pain is a complex, unpleasant subjective experience with sensory, emotional and social aspects. The messages pain transmits to our brains are interpreted by each person in a different way according to his/her personal experience.
Are there different types of pain? If yes, what are these, and how are they classified? Pain is classified based on the mechanism involved (pain from stimulation of the nociceptors or neuropathic pain), the duration of pain encountered (acute or chronic), or even the point of the body affected by it (visceral pain, bone pain, etc).
What conditions do Pain Clinics manage? Chronic Pain Clinics manage patients suffering from migraines and headaches, intercostal neuralgia, trigeminal neuralgia, postherpetic neuralgia [from herpes zoster (shingles)], neck pain, osteoarthritis (knee and hip), phantom limb pain (following mastectomy, upper and lower-limb amputation), pain after thoracotomy and inguinal hernia repair, back pain and sciatica, sacroilitis (pelvic pain) and a number of other chronic pain conditions.
Are there any types of pain that are easier or harder to treat by Pain Specialists? Acute nociceptive pain (eg, postoperative pain) is easily treated with simple analgesics such as paracetamol (Panadol), nonsteroidal anti-inflammatory drugs (NSAIDs) (Diclac, Voltaren, Arcoxia), and opioids (pethidine, morphine). Neuropathic pain is more severe, persistent, resistant and not managed with the aforementioned painkillers. Effective medications for this type of pain include antidepressants, antiepileptics or other types of medication. Minimally Invasive Techniques such as peripheral nerve blocks, radiofrequency (RF) neurolysis, epidural injection of drugs, etc, also deliver excellent results.
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