...Pain is subjective as such, and numerous factors may affect individual's pain experience. Huether and McCance (2012) stated, “interpretation of pain is influenced by many factors, including cultural preferences, male and female roles, and life experiences, including past painful experience and current expectation” (p.326). Therefore, sources of pain are physical, emotional, psychological, spiritual and cultural wounds, and the severity of pain depends on the individuals so is the effectiveness of the treatment; no one approach to pain is useful for all kinds of different pain experiences. While Physical pains could be easily treated with pharmaceutical approaches, emotional, psychological, spiritual and cultural pain are treatable solely with a...
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...prospect. Marijuana should be legalized as it provides many homeopathic benefits to a variety of people suffering from a wide range of conditions including chronic pain management, relief for autoimmune diseases and for treating mental health problems. Pain is the number one condition treated with cannabis in states where it is legal to use cannabis under state law if it is approved or recommended by a physician. In 1999, GW Pharmaceuticals, a British phytochemical company, developed several types of tinctures of cannabis to address the needs of multiple sclerosis patients for relief from muscle spasms and pain (Bearman, D. 2011). In 2000, the Center for Medicinal Cannabis Research (CMCR) was established at the University of California at San Diego School of Medicine. Studies from CMCR have shown that low-grade cannabis was capable of reducing daily pain by 34%. The findings were comparable to oral synthetic drugs used for chronic neuropathic pain. In the mid-1980’s, during the “AIDS Crisis”, the United States government encouraged the development and approval of a cannabis based synthetic drug called delta-9-THC, which is marketed under the trade name Marinol. Marinol has been effective in treating nausea in cancer patients and as an appetite stimulant for AIDS patients. Under a generic label, it has been used to treat pain, ADD, and other conditions. It is, so far, the only cannabis based FDA approved pharmaceutical on the market today. In the 1970’s and 1980’s studies were conducted...
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...(Background) Definition of neuropathic pain Neuropathic pain refers severe chronic pain, that originates from pathology of the nervous system, following imminent or actual damage to nerve tissue This process assists wound repair because any contact with the damaged part is avoided until healing has occurred Mechanism of neuropathic pain Advances in discovery of the mechanism of neuropathic pain has become clear by use of animal models, by placement of loose chromic ligatures on the sciatic nerve in rat brought, that brought about behaviour that appeared analogous to human neuropathic pain conditions (Bennett and Xie, 1988). The pathological mechanism behind neuropathic pain is thought to be spontaneous activity in damaged sensory neurones. Chahine et al (2005) found that the release of hyperalgesic pro-inflammatory agents can result in changes in either expression or inappropriate regulation of sensory Nav channels, suggesting that Nav channels have an important rcontribution to neuropathic pain Central neuropathic pain Experienced as a symptom of CNS disorders such as stroke and multiple sclerosis. Peripheral neuropathic pain Experienced as a symptom of disorders associated with peripheral nerve damage such as mechanical injury, diabetic neuropathy, (Usual Treatment) Anti-depressants 1) tricyclic anti-depressants 2) Selective Serotnin re-uptake inhibitors Anti-convulsants Ion channel blockers (anti-dysrythmics) (Structure/function...
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...Introduction Chronic pain is one of the most frequent diagnosis and the most common problem for which elderly patients in the clinical setting seek help. Chronic pain refers to an unpleasant, distressful and uncomfortable feeling. Studies have shown that chronic pain is often undertreated even when the prevalence rates and syndromes are well understood. The means of relief are within practitioners’ capabilities to provide care. With careful assessment and a comprehensive plan of care that addresses the various aspects of the patients needs; chronic pain can be controlled in the vast majority of cases. Thus, awareness and provision of basic and specialized interventions can ensure comfort and improve quality of life. However, chronic pain left untreated or undertreated may cause suffering. This will also cause disease-mediated symptoms such as pain, dyspnea, fatigue, and loss of mobility. Needless to say, there are accompanying emotional states such as depression, anxiety, and a sense of uselessness. This paper will explore the under treatment of chronic pain among the elderly, its defining attributes, the use of an analysis model and its relationship to the concept. Identify a nursing theoretical framework used to analyze and resolve the problem. Also, an attempt will be made to identify an evidence based practice and research to support strategies for the resolution of the problem. Problem Under treatment of Chronic Pain in the Elderly However, most often than...
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...A Caucasian man with Hip Pain The management of pain can be tricky as sometimes-healthcare professions struggle between objective pain and associating the subjective pain which is what the patient says, “It is.” Understanding the Pathophysiology of pain and the cause of acute pain that lead to chronic pain is an essential aspect of managing pain. The nociceptive pain pathway is series of neurons that detect noxious stimuli that end up with pain; however, the pathway starts at the peripheral to the spinal cord and the brain (Stahl 2013). Knowing the pain pathway will help the PMHNP to understand the use of certain psychological drugs for the manage pain like Selective norepinephrine reuptake inhibitors (SNRI) for depression (Mehalick et al. 2016). According to the case study, the patient suffered from right hip pain that has been going...
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...Pain one Definitions of pain from medical perspective There are different definitions and descriptions of pain due to different perspectives From medical perspective, pain can be defined as a bothering sensory feeling or emotional experience and is variably described as irritating, sore, stinging, aching, throbbing, or unbearable feeling (Patel 2010). In medical terms there are two categories of pain, including nociceptive and neuropathic (Macintyre &Schug 2007). Medically, according to Macintyre and Schug (2007) the first category of pain is nociceptive pain—a common category reported in clinical settings. This type of pain occurs due to trauma, tissue damage or inflammation that stimulates sensory nerve endings called nociceptors. Intense peripheral nociceptive stimuli will increase excitability of the nervous spinal cord, leading to central sensitisation in the presence of subsequent pain stimuli, increased intensity and lower pain threshold. Macintyre and Schug (2007) also described two types of nociceptive pain: somatic and visceral pain. Somatic pain may be experienced as sharp, hot or stinging pain that is localised to the area of injury. Visceral pain is dull, cramping or colicky pain that is poorly localised. Visceral pain can also be referred to other areas, with associated symptoms, such as nausea and vomiting. The second category is neuropathic pain. It results from serious injury such as in childbirth as stated by Wong (2004) or disease that affects the peripheral...
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...Injury or inflammation leads to profound changes in nociceptor processing. Discuss how nociceptors could contribute to the development of pathological pain responses under (1) inflammatory and (2) neuropathic pain conditions. Provide specific mechanisms under each condition and be sure to reference primary literatures in your answer. Please note that your answer should address both inflammatory and neuropathic pain conditions. Action on Transduction - A very logical mechanism to sensitize a nociceptor is to act on the stage of initial signal transduction, potentiating the process, and sensitizing the cell. A major receptor on primary afferents necessary for signal transduction is TRPV1, which inflammatory factors can act on, changing the gating...
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...Annotated Bibliography “What is the evidence of positive benefits with using T.E.N.S. (Transcutaneous Electrical Nerve Stimulation) unit for pain management?” Bi, X., Effects of transcutaneous electrical nerve stimulation on pain in patients with spinal cord injury: a randomized controlled trial. Journal of Physical Therapy Science 27: 23-25 (2014). Xia Bi, Department of Rehabilitation Medicine, Shanghai Gongli Hospital, China, focused his research on investigating the effectiveness with using transcutaneous electrical nerve stimulation on patients in pain due to a spinal cord injury. Bi states that there have been many clinical papers that have reported positive effects of TENS in pain management but controversy exists over which conditions can be treated using this method. He states that if TENS were shown to be effective method of alleviating pain in Spinal Cord Injury (SPI) patients, it would decrease medical costs and improve quality of life. Bi discusses how their results are consistent with those of previous studies (Celik EC, The effect of low frequency TENS in the treatment of neuropathic pain in patients with spinal cord injury) which reported the effectiveness of TENS in the pain relief of SCI patients. The study had several limitation which were mention in the paper stating that the sample size of subjects was insufficient for generalization of the results, a follow up was not performed, and lastly they did not compare the efficacy of low frequency TENS...
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...United States. (Chen et al. 2007) The number of patients with other neuropathies, such as autonomic, proximal, and focal, comprises the other 1 million diabetic neuropathy patients, most of whom suffer in pain from the dysfunction of the nervous system. (Chen et al. 2007) This disorder’s elusive nature is such that it can not only present in any part of the body but it can be completely without symptoms that the average patient would report to their physician. Since the patients themselves are less likely to naturally disclose their suffering through their assumption that their symptoms are not relevant to their diabetic condition, the physician’s role in the diagnosis and recognition of this disorder is even more critical. II. Definition and Types of Diabetic Neuropathy The most common type of diabetic neuropathy is peripheral, considered, more generally, sensorimotor. Peripheral neuropathy causes pain or loss of feeling in the toes, feet, legs, hands, and arms. (NIDDKD 2002) Specifically, distal symmetric polyneuropathy is the most common of peripheral types, causing nerve damage away from the center of the nervous system but equally on both sides of the body and in multiple places. Thus, the extremities are most affected. Peripheral neuropathy may cause not only pain but muscle weakness and early fatigue and loss of reflexes. Foot deformities, such...
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...2015 Assessment 2 In Women undergoing Mastectomy ± Auxiliary Node Dissection / Removal, how does the Pre-emptive administration of Gabapentin compared to Venlafaxine affect the incidence of post mastectomy pain syndrome at a 6 month post-surgery review date? Emma Burke 15086920 Elective and Acute General and Vascular Surgery (A4) Hawkes Bay District Health Board Pain Management Resource Nurse for A4 Goal to become Clinical Nurse Specialist in Pain Management Post Mastectomy Pain Syndrome (PMPS) affects between 20-60% of women who had a mastectomy [1-14]. “Poorly managed pain can slow recovery, create burdens for patients & their families, & increase costs to the healthcare system”[13] & taxpayer. If this can be significantly reduced, it has to be better for the women, their families & society. Each year in NZ there are >2800 women diagnosed with Breast Cancer, with the number increasing each year [14]. “PMPS is defined as a chronic pain. It is considered a neuropathic condition which arises after surgery for breast cancer PMPS is different from other painful syndromes as it is typically localised to the anterior or lateral region of the thorax, auxiliary&/or medial upper arm, causing burning pain, shooting pain, pressure sensation or numbness”.[15-20]. This report analysed over 45 different journal articles that looked at the incidence of PMPS & treatment options [1,2,4-15,21-51]. The use of Gabapentin & Venlafaxine...
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...Game instructions for one player Game instructions for multiple players Game requires two teams. How to play the game There are two sets of cards. Set 1 contains 5 cards with a description of a patients pain. Set two also contains 5 cards with a description of pain The goal is to match each card in set one with the correct type of pain in set two. Team 1takes game set 1cards with the description of a patients pain. Team 2 takes game set 2 cards with the type of pain. Goal: Team 2 will match each type of pain to the patient description by asking each member of team 1 questions about their pain and through this assessment will determine what pain type they are experiencing. The game ends when each game card in set 1 is matched to the correct game card in set 2. Game Card Set 1 Patient Profile Presenting Complaints and Symptoms o 19 year old male with complaints of dull pain around navel that has been getting progressively worse. Also has been experiencing nausea and occasional vomiting and constipation. Exam Findings o Abdominal guarding and rebound tenderness o Sudden onset and worsen with coughing Diagnosis: Appendicitis Game Card Set 2 Type of Pain Acute Pain Definition: Pain that starts suddenly and is very sharp. It can be a warning of a disease or from a result of trauma. It can also occur with certain events such as: Surgery Broken bones Dental work Burns or cuts Labor and childbirth ...
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...Treatment Types for Oncologic Pain James Skelton Mercy College of Health Sciences Treatment Types for Oncologic Pain Nearly all those who are diagnosed with cancer will have some kind of pain associated with the disease process. This pain may be visceral, neuropathic, procedural, or psychological in nature. This paper is a discussion of the different procedural guidelines that are currently used by the World Health Organization in the treatment of oncologic pain. This is also a look at alternative therapies that may be used in conjunction with the previously accepted pharmacological treatment of Western medicine. Article Summary One The article written by Fielding, Sanford, and Davis (2013) is a review of the current step-by-step guidelines the WHO has had in place for some time along with a comprehensive assessment of pain, the use of opioids and their adverse affects, the role of adjuvants, and non-pharmacological means of cancer pain treatment. The WHO bases its algorhythm on simplistic, broad categories such as mild, moderate, and severe pain. The article itself is geared towards nurses because they have a unique role in advocating for the patient. The WHO has had a three step analgesic ladder that it has used as a basis for cancer pain treatment for nearly 30 years now. Fielding, et al. (2013), stated that health professionals need to go beyond this three step ladder that focuses primarily on physical pain. Cancer pain is not just a physical but a biopsychosocial...
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...individuals perceive pain to a lesser degree or that sensitivity is diminished. Although pain is a common experience among individuals 65 years of age and older, it is not a normal process of aging. Pain indicates pathology or injury. Pain should never be considered something to tolerate or accept in one's later years. Unfortunately, many clinicians and older adults wrongfully assume that pain should be expected in aging, which leads to less aggressive treatment. Older adults have additional fears about becoming dependent, undergoing invasive procedures, taking pain medications, and having a financial burden. The most common pain-producing conditions for aging adults include pathologies such as arthritis, osteoarthritis, osteoporosis, peripheral vascular disease, cancer, peripheral neuropathies, angina, and chronic constipation. People with dementia do feel pain. The somatosensory cortex is generally unaffected by dementia of the Alzheimer type. Sensory discrimination is preserved in cognitively intact and impaired adults.1 Because the limbic system is affected by Alzheimer disease, current research focuses on how the person interprets and reports these pain messages.24 See further discussion on pain assessment with dementia on p. 170. Gender Differences Gender differences are influenced by societal expectations, hormones, and genetic makeup. Traditionally, men have been raised to be more stoic about pain and more affective or emotional displays of pain are accepted for women...
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...ANALGESICS Defining pain: * * PAIN: an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage * NOCICEPTIVE: activation of normal pain fibres in response to a noxious stimulus (e.g. injury, disease, inflammation); may be somatic (e.g. involving superficial structures such as skin and muscle) or visceral (e.g. involving deeper organs such as liver, pancreas) * NEUROPATHIC: injury or disease affecting the peripheral (e.g. diabetic neuropathy, phantom limb) or central (e.g. spinal cord injury, post stroke) nervous system or both (e.g. postherpetic neuralgia) * MIXED NOCICEPTIVE/NEUROPATHIC: e.g. cancer some cancer-related pain * BREAKTHROUGH PAIN: occurs between regular doses of an analgesic and reflects an increase in the pain level beyond the control of the baseline analgesia. This may just be an occasional natural fluctuation in pain or, if frequent, reflect inadequate baseline analgesia or management * INCIDENT PAIN: occurs with, or is exacerbated by, physical activity or an event such as a wound dressing. Inadequate stabilisation of a fracture or cough can also cause incident pain Classification of pain: | Nociceptive - superficial somatic | Nociceptive – deep somatic | Nociceptive – visceral | Neuropathic | Origin of stimulus | Skin, subcutaneous tissue, mucous of mouth, nose, sinuses, urethra, anus | Bones, joints, muscles, tendons, ligaments, superficial...
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...September 25, 2014 Herbal Medicine: Pain Relief With the advent of holistic traditions and research, people with chronic tissue or nerve pain, have found that herbal medicines are an effective resource to use early on and throughout life to aid in the reduction of pain and its cause. Herbal medicines are likewise alluded to as natural cures, home grown items, and phyto-medicines, which involve the utilization of plants and their parts, and have been used throughout history for pain relief and maintenance. Common examples of herbs that have been utilized for medication throughout the centuries include seeds, leaves, stems, bark, roots, blossoms, and concentrates. As science started to examine herbal cures, their uses became more refined and have been broken down into three different medicating classifications: tissue pain, nerve pain, and pain caused by inflammation. In continuation, I will explain the definitions for each classification detailing their relative herbal medications for relief and maintenance. Nociceptive pain also known as “tissue pain” is understood to be created by the progressing actuation of pain receptors in either the surface or profound tissues of the body. There are two sorts: "somatic" pain and “visceral" pain. Somatic pain is brought about by harm to the skin, muscles, bone, joint, and connective tissues. Visceral pain is explained as pain that starts from ongoing harm to the internal organs...
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