Vol 2 | Issue 2 | Sep – Dec 2016 | page: 1-2 | Pinky Thapar
Author: Dr. Pinky Thapar
Chief Editor – International journal of surgical cases
Chief Consultant MIS, Gastrointestinal and Endocrine Surgeon
Course Director MUHS Fellowship in MIS
Jupiter Hospital Thane, Maharashtra, India.
Holistic Approach to management of Pain
Pain is perception of Agony internally. Though there are innumerable scientific definitions of pain, I have redefined pain by literally splitting the letters with a meaningful understanding P for perception(Perception), A (Agony) IN for (internally). The person who perceives pain is the sufferer. The two broad categories of pain can be physical and psychological. Physical pain which the perceiver bears can further be subdivided into inflammatory or spasmodic. Psychological pain is the after effect of physical pain. These two types of pain interchange their manifestations. The pain which starts as a physical problem may continue to linger psychologically and hamper routine activities. Similarly, psychological pain may manifest as disease of some or the other parts of the body. There are plenty of Pain scoring charts based on the perceivance of pain by the perceiver or sufferer. Intensity of pain varies from mild to moderate to severe. Further aspect in pain is acute short-lived pain, which gets treated promptly due to the presentation of severe agony by the sufferer. Source control plays a major pivotal role in relief of pain. Chronic pains are the one’s which persist beyond 2 to 3 weeks of onset of pain and may have acute exacerbations. It’s a mammoth challenge for a clinician to relieve the sufferer from chronic pain. Challenging part in pain management is the right understanding of chronic or intermittent Pains. These are often misunderstood by the treating clinician as stress and psychological problems. Thorough clinical examination and patient assessment of the complaints actually clinches the diagnosis. Immediate temporary measures (analgesics) help to alleviate the agony but they are not the solution for chronic pains. Though there are ample examples of chronic usage of analgesics to quieten the sufferer, it should not be considered as permanent solution. Physical pains may become chronic due to clinical and technical limitations in accurate identification of the cause of pain. This is further complicated in today’s era due to major dependency on investigations for correct diagnosis and pain management. Advanced tests done may be completely normal because the cause of pain is not due to gross anatomical alterations. In such circumstances, the clinicians err to suppress the pain by analgesics. The bearer is repeatedly counseled to bear the pain and get used to it, because we have not hit the cause and confidentially diagnosed the problem due to Stress”. These are the then labeled as stressed individuals. Yes, it’s partly true that these individuals are stressed, but the disability due to pain or persistence of pain is the cause of stress. This creates disharmony in the internal well being of the perceiver and forces him to seek help from different treatment modalities for relief of the suffering. A holistic approach is required for relief of pain. This approach is possible only if the clinician is sensitive towards patient care. Single most important tool is giving ample time in listening to patients view point on the cause of pain. The sufferer is in not at ease, is what is to be remembered by the clinician. (Dis-ease). By all or any means, if we can achieve ease in his daily activities, we have achieved the goal. It may not be possible to cure the disease in certain situations, but making him comfortable by multimodal approach is required. Eye to eye contact with the patient, building up confidence and faith that you are concerned and will take utmost care to relieve him of pain, assurance of pain relief helps in future healing process. Another simple practical tip is putting ourselves in his shoes and assessing the situation helps in optimum treatment. It’s the moral duty of each and every practitioner to alleviate the agony of the sufferer. Accurate correlation of simple tests with sound clinical knowledge is sufficient to pinpoint the cause of pain. A clinician ought to be a Radiologist too, vice a versa a radiologist needs to report the images after good clinical correlation. Awareness of self plays a major role in pain alleviation It’s the living being which bears pain. The bodily part which is the site of pain cannot suffer it unless the brain doesn’t register it. We bear pain as per our individual reaction and capacity to withstand the stress of pain. A novice lingers the stress of pain every moment, whereas thoughtful person acknowledges the pain, but tries to remain indifferent from it. Few masters bear pain in such a manner that it’s difficult to recognize by a common man whether they are actually suffering. This is the art of bearing pain by great masters who have conquered bodily pain. They are not ignorant about their pain, but they perceive it in a mature conscious manner. This art can be learnt by awareness of self as different from the body. This helps to decrease the internal agony of pain. It works at internal level and one needs introspection of the root cause of his or her suffering. Internal measures to cleanse the root cause help in understanding the cause of pain. No magic works here, multimodality approach helps to bring harmony and stability in mind to heal. Holistic approach is wholehearted wholesome approach looking at the problem from all angles. Let’s pledge to try our best to bring harmony in every sufferer who seeks our guidance.
|How to Cite this Article: Thapar P. Holistic Approach to management of Pain. International Journal of Surgical Cases 2016 Sep-Dec; 2(2): 1-2.