We all suffer pain from time to time. Pain is an important signal which indicates that our body has been damaged in some way, and so attention is required to treat that damage. Pain can occur when one is sitting for a long time in the same posture, after an accidental hit, a fall etc.
Pain can be acute or short term, meaning that it comes suddenly and lasts for a limited time, or it can be chronic, that is persistent and long-lasting. Acute pain may only last a few minutes, but Chronic pain maybe for hours, days or weeks; and it could be caused, amongst many other things, by insect bites, burns or broken bones, arthritis, injuries during sport, fractures, wounds etc are also some basic examples of chronic or persistent pain.
Pain is unpleasant and uncomfortable, but when it becomes severe and chronic, it can also affect and destroy the quality of life. Coping mechanisms for chronic pain often involve the use of pain relievers, and various pain relievers are available which work in quite different ways from those pain relievers we would frequently use for the acute pain. Some non-medication treatments might also be helpful.
The patient support group, Chronic Pain Australia, has again organised National Pain Week to raise awareness of both the problems of chronic pain and some of the effective management strategies.
The Chronic Pain Australia website (www.chronicpainaustralia.org) states that one in three Australians live, directly or indirectly, with chronic pain. And almost two-thirds of these people suffering from chronic pain say it interferes with their daily activities. In another journal of the Australian Institute of Health and Welfare, one out of every five individuals aged around 45 is suffering from chronic pain. It worsened with the increase in age. Research says that this might be due to multiple disorders in the elderly age. Further studies provided evidence that the percentage of female sufferers was 1.8 times greater than that of male. Many people reported that chronic pain resulted in the limitation of daily routine work/tasks. A report published in 2018 stated that approximately $139 billion is the average yearly cost of chronic pain in Australia.
The leading cause of chronic pain is reported to be related to injury – possibly sports injuries or car, work or home accidents. But sometimes the cause is not so easy to identify.
Modern medicines work in several ways. They can prevent disease, cure disease or palliate (i.e., reduce the severity of) the symptoms.
The need for pain relief as a part of palliative care would seem quite obvious, but for many reasons, pain relief is neglected or not provided effectively.
In the past 10 years or so more attention has been focussed on the benefits of the so-called opioid type pain relievers such as morphine (morphine was first isolated in the early 1800s, although evidence exists that the raw material opium was in use several thousand years ago).
Most doctors and pharmacists have a very good understanding of the benefits of opioid pain relievers such as morphine. However, there are still misconceptions in the minds of many patients, their families and carers. The fact is, when used appropriately, they are both safe and effective.
Recently we have seen the development of several variations on the old morphine mixtures – preparations which are easier to take, more palatable and less likely to cause uncomfortable side effects. There are long-acting and sustained-release tablets and capsules, as well as patches and lozenges in doses which can be individually tailor-made.
Of course, opioid analgesics aren’t the only option – and not even the best choice on many occasions. Simple pain relievers like paracetamol or the non-steroidal anti-inflammatory medicines called NSAIDs are very effective when taken in the right dose. And medicines such as antidepressants, anti-epileptics, antispasmodics and steroids – medicines not normally associated with pain relief by patients and their families – are often the most appropriate choice.
There might also be the need for regular laxatives or occasional anti-nausea and possibly something for dry mouth caused by the side effects of some of the medicines.
The World Health Organisation (WHO) has a so-called Analgesic Ladder to help explain how pain relievers are best given. We can guide you through the steps so please come in and speak to one of our friendly pharmacists.
