Wound Pain: The Exact Cause Of Lack Pain

“Pain is much more than a physical sensation caused by a specific stimulus. An individual's perception of pain has important affective (emotional), cognitive, behavioral, and sensory components that are shaped by past experience, culture, and situational factors. The nature of the stimulus for pain can be physical, psychological, or a combination of both.” (Potter, Perry, Stockert, Hall, & Peterson, 2014 p. 141) As stated by Potter et al, the different natures of pain are dealt with differently depending on many factors. Knowing this, treating pain can be very difficult as there is no single or clear cut way of measuring it; “Even though the assessment and treatment of pain is a universally important health care issue,

Pain is a complex and multidimensional phenomenon that is subjective and unique to each individual. Pain is difficult to describe and often hard to measure; however, most healthcare professionals agree that pain is whatever the patient describes it to be. Pain is one of the most frequently used nursing diagnosis and is the most common problem for which patients in the clinical setting seek help (Cheng, Foster, & Huang, 2003). Unrelieved pain can have a profound impact on the lives of both the patient and his or her family members. The subjective nature of pain makes pain difficult to assess; therefore, many patients do not receive adequate relief. The Joint Commission on Accreditation of Healthcare Organizations

Research has shown that there are several organizations and active advocates who are working on pain management problems to face this public health issue. The following establishments involve: The American Academy of Pain Medicine, Institute of Medicine, and American Pain Society and many for-profit and nonprofit organizations are also working at different level towards pain management. Most specifically, the IOM has been devoted to studying pain and its consequences on individuals, the healthcare system, as well as on government (IOM, 2011).

According to The World Health Organisation (1999), defined pain as an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain is traditionally described as acute or chronic pain. The prevalence of chronic pain (CP) is higher than of acute of pain, as it affects 7.8 million people of all ages in the UK (Chronic Pain Policy Coalition., 2006). The current leading cause of mortality that is accounting for 60% of all deaths is due to chronic diseases and is also a problem as causes an increasing burden on the health care service (World Health Organisation., 2007). CP can affect a person’s quality of life if managed poorly, statistics shows that 25% of people lose their job and 22% leads to depression. (Chronic Pain Policy Coalition.,

“Pain is a complex, multidimensional experience that can cause suffering. [While] pain is inevitable, suffering is optional” (Kinder, 2014, p. 114). The control of pain is, as Kinder puts it very complex, without appropriate measures it can be easily side stepped especially in the elderly. To ensure patient center care it is important that all aspect of one’s quality of life is address, this is emphasizing by pain being a component of vital signs. Being a vulnerable population the elderly is often under assessed as they minimized their problems so as not to be a burden in addition to the fact that they may believe that their pain is a normal part of aging.

Because severe pain is more difficult to control, Mrs R may become anxious and fatigued, and may also withdraw again from the regimen if there is no success in achieving pain relief; therefore, the preventive approach needs to be considered. (Wells, 2014). For an effective pain control pain, Mrs R should also keep a daily record of her pain. Writing a diary can help empower the patient in her own care, give her confidence and increase self-efficacy (Bastable, 2014). Also, a strategy of pain management is to combine opiods with non-narcotics, such as Tylenol, in order to enhance pain relief and to slowly decrease the use of narcotics overtime (Lewis, 2014). Mrs R was explained to always follow the right dosage of medication to optimize the narcotic results. A complete assessment of pain should be performed: PQRST. Pain is a subjective concept and the patient must describe the pain in order to provide an effective care plan (Jarvis, 2013). Responses to pain medication should be documented to facilitate communication between health care providers, therefore to maximise effective pain management strategies (Lewis, 2014). The use of non-pharmacological therapy for pain is also recommended to Mrs R because it helps reduce the dose of an analgesic/opiod required to control pain and helps to minimize analgesic side effects, and also promote the release of endorphins which inhibit pain signals (NCBI, 2010). Mrs R is encouraged to use distraction such as watching TV, listening to the radio/music, which redirect the attention on something and away of the pain. Imagery can also be proposed to divert the focus away from the pain by stimulating the client’s imagination to develop sensory images. Relaxation strategies can also be used to help Mrs R to be free of her anxiety and stress, and to reduce muscle tension (Lewis,

Another possible cause of neck pain that could have long-term implications, if not treated immediately, is pain caused by the onset of arthritis or other types of degenerative bone and joint diseases. When left untreated, this type of pain can expedite the degenerative process, hurrying the onset of limited mobility. Additionally, untreated degenerative joint disease that is left untreated will also lead to unbearable pain that worsens as time progresses, subsequently requiring the use of pain medications to help the individual to effectively manage their

Adequate pain assessment is essential for measuring the efficacy of treatment in clinical practice, provide patient with target pain treatment, and avoid the high number of non-responders.15 Clinically, valuable pain assessment would associate certain signs and symptoms that comprise the pain phenotype with underlying mechanisms.15 Methods such as quantitative sensory testing, functional imaging, skin biopsies and genetic screening are assessment tools provide valuable information regarding the neurobiology of pain.15 However, these tools are expensive, require technical expertise and not suitable for routine assessment of a patient’s pain.15 Therefore, the purpose of this study is to establish biopsychosocial pain profiling of multiethnic

Pain is subjective and identifying pain objectively is very complex. It can influence the patient’s behavior and can negatively affect the patient’s heart rate and blood pressure. When caring for these individuals and attempting to control their pain,

‘Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage’ (International association for the study of pain 2014). Pain can be made up of complex and subjective experiences. The experience of pain is highly personal and private, and can not be directly observed or measured from one person to the next (Mac Lellan 2006). According to the agency for health care policy and research 1992, an individuals self-report of pain is the most reliable indicator of its presence. This is also supported by Mc Caffery’s definition in 1972, when he said ‘Pain is whatever the experiencing patient says it is, existing whenever he says it does’.

Assessment of chronic pain first begins with understanding what chronic pain is. Chronic pain is any pain with or without obvious injury that lasts longer than the expected healing period. Like many chronic diseases, it has periods of remission, an absence of symptoms, and exacerbation, an increase in the severity of the symptoms. A recent study suggested that chronic pain affects about 80% of elders in nursing homes. (Pateinakis, 2013) Proper treatment of chronic pain begins with gathering subjective and objective data about the client’s pain.

Injury to the seven cervical (neck) vertebrae, including their associated discs, nerves, muscles and lymph nodes, can cause neck pain that only worsens without appropriate treatment. Holding the head rigidly in one position for an extended period, sleeping with the neck held in an abnormal position and pinched nerves are the most common reasons for neck pain.

Neck Pain can derive from many possible causes from the many parts that near or inside the neck: vascular, nerve, airway, digestive, and musculature / skeletal

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.

Pain is a basic mechanism in life that helps the body identify that something is wrong or dangerous. Without pain, the body would be severely damaged without realizing it. Pain can become an inconvenience when it spirals out of control; chronic pain, for example, leaves many miserable and unable to enjoy life to its fullest extent even with traditional medical intervention. Around 80% of people report chronic pain in their lifetime (Holtzman & Beggs, 2013). People afflicted by chronic back pain turn to modern medicine for relief, but even these alternatives are not always 100% effective.