Generally speaking, anaesthetists are expected to know the medical background of their patients in deep detail so they can manage their anaesthetics safely. Being a professor in anaesthesia, I.C.U., I.C, as well as pain management, allowed me to build up a lot of experience with different diseases in different medical situations.
“Understand your illness” is a series of medical articles written in simple English and directed mainly to the patients and their relatives so they can understand their illness and cope with it in a better way. These topics will focus on the most common diseases, trying to analyse them in as simple a way as possible and finally give the patients relevant advice to help them be able to handle their medical situation a bit easier. The first article of this series will address chronic pain.
It is interesting to know that chronic pain is not just a symptom but it is a syndrome of more than one illness. Chronic pain has more than one aspect to it. It has physical, psychological, and social aspects. In other words, chronic pain affects patients’ physical and psychological health with a negative impact on his as well as the society socioeconomic status.
First of all, let us answer the question: what is chronic pain? Chronic pain is simply any pain that remains untreated for more than 12 weeks. It can be associated with an obvious reason, like history of serious physical injury, severe infection that was difficult to treat, a chronic disease like osteoarthritis, or may be cancerous in origin. However, having a chronic painful situation with an unknown cause is not uncommon.
Now, how common is chronic pain. You will be interested to know that more than 20% of the Western population suffers from chronic pain and less than 2% of them attend pain clinics and this costs the budget of national healthcare over £200bn in Europe and £150bn in the United States. Unfortunately, in the Middle East, including Egypt, there is no exact consensus regarding the above-mentioned problem. However, we believe that the number of patients suffering from chronic pain for different reasons in our culture is tremendous even if the exact figures were still unavailable.
In order, the most common types of chronic pain are: back pain, mainly the lower part of the patients back, headaches, neck, and arm pains. Treating chronic pain is not simple but could be quite complex and a long-term process. A multi-model pain management approach is the most common protocol in most pain clinics. This should include interventional, pharmacological, physical as well as psychological management, with the help of more than one clinician at the same time. Getting chronic pain patients back on track is usually the ultimate goal of their treatment. To help the patients to get to a satisfactory stage of their treatment so they can go back to their normal life as soon and as much as possible, these patients are expected to help their doctors by being understandable and co-operative.
Finally, and most importantly, chronic pain patients should be advised to try to remain as active as they can. This might be easy to say but difficult to do, but believe it or not, it is true and it really does help to slowly make things easier for everybody, including the patients, their relatives as well as their therapy assistants.
Essam Abdelrazek is a professor of anaesthesia, I.C. & pain management at Misr University for Science and Technology.