Revista de inmunología y terapia del cáncer

Abstracto

PAIN MANAGEMENT

Dalamagka Maria

When acute pain turns into chronic, then it is not a symptom of a disease, but it is a disease in itself. It lasts longer than the expected course of the disease or injury. Usual period of 3-6 months. In the past the answer to chronic pain was: "everything is in your mind". A useful definition by Margo McCaffrey is: "pain is what describes the person who experiences it and exists when he says he exists." The International Union for the Study of Pain says it is "an unpleasant aesthetic and emotional experience, combined with actual or potential tissue damage, or described in terms of such damage". Pain is transmitted through the body through the nervous system when nerve endings detect damage to a part of the body. Today, pain specialists can understand how pain is created: the way the nervous system, including the spinal cord, interacts with the brain to create the sensation of pain. Knowledge of the neurotransmitter system, the chemical messengers that transmit nerve signals, has paved the way for important new methods of treating pain. In recent years, scientists have learned how to manage these chemical messengers to change the way they interact with brain signals. This has led to the use of antidepressants and other drugs, which work with certain chemicals in the brain, such as which affect emotions and help in perceiving pain. There are now drugs that are very effective. And with advances in MRI, researchers can prove that the changes are very real in the brain. We can see exactly where the sensation of pain in the brain is created, when it is activated by a stimulus. We can see the effects of pain on a person's emotional state. There is also a new concept, a process called central awareness. If the initial pain from an injury is not treated properly, then these pain signals are sent repeatedly, resulting in changes in the central nervous system, which make it increasingly vulnerable. So over time, even normal stimuli can be perceived as painful. With this knowledge, pain specialists are now prescribing medications that attack moderate to severe chronic pain from different perspectives: innovative drugs, nerve-targeting techniques, and drug delivery pumps that offer strong nerve analgesia. Doctors also approve of the use of psychotherapy, relaxation techniques, hypnosis and alternative therapies, such as acupuncture, which rely on the growing evidence of a brainbody connection to relieve chronic pain.