Dr Ramavtar Sharma
Medical science has grown exponentially after World War 2 but one puzzle is yet to be solved and remedy found to perfection. Attainment of cure from pain is still an enigma and there appears nothing on horizon to claim a cure. This is specifically true for chronic, nagging pain. Headache, knee joint pain, toe or shoulder pain and most frequently the back pain are part of normal human sufferings. Despite its commonality, pain is a complicated thing. We need to understand it so that we can make a sense of it. If we are unable to do so we would be unable to get a handle on it.
Pain is complicated because it stops or significantly alter thinking. It stops you from doing or engaging. Pain may even delay your recovery from sickness or operation. Long lasting or perpetual pain may even alter they way you mould yourself . When you have to combate pain for a prolonged period of time, the very purpose of life is lost as you stop feeling joy and happiness. If these points are taken into consideration then pain management should be a national issue requiring widespread discussion amongst medical and allied professionals and policymakers.
Sports medicine, physiotherapy and to a limited extent anesthesiology are focused on long duration pain management but the results so far have been much below expectations. That means pain is not totally about the physical body alone but emotional and psychological stimuli also play some very significant role which is yet to be understood and applied to practice for better pain management. Treatment of pain is mainly based on tissues hence, remains one dimensional whilst pain is multidimensional. It is not only about tissues, it is about people. Clinicians might not find anything which can cause pain but that shouldn't be inferred as fake or illusion. Pain can still be there even without any obvious cause.
Pain of heartbreak is very real but you can not find any investigative proof for it. Similar is the case with migraine and fibromyalgia. Functional MRI in these cases show altered activities in specific brain areas. This should be proof that the pain is real and its management requires more than medicines. Acute pain is mostly well managed as it is caused by inflammation as a result of trauma or surgery. Healing process in such cases is completed by three months depending upon severity of trauma. Any pain which stays beyond three months is considered chronic pain. It is this type of pain which might prove to be Waterloo for even the best pain management professional.
About 40 percent of people visiting their general practitioner complain about some sort of bodily pain with women complaining more than men. Every fifth patient complains of suffering from mild to moderate pain for years. This should sensitize doctors about the enormity of the problem as medicines mostly fail to provide a cure and are toxic as well. According to Prof Romi Parker of University of Cape Town, South Africa we need emotional, psychological, cultural and religious effort to alleviate chronic pain. Training dedicated professionals and volunteers with above mentioned inputs and philosophical attitude would go a long to make life manageable for a huge number of people. Our awareness and attitude towards chronic pain needs to be changed so that more and more people can live a life sans pain and silent suffering.
Email: ramawatarf132@gmail.com
