What is pain?
Pain is one of the most common reasons for visiting a physician. Pain is often experienced after an injury. Acute pain, which acts as an alarm, informs us of damage and disease, contributes to the healing process by forcing medical attention, and even protects us from possible dangers with our experience.
According to the view presented as “Revolution in Pain Theory” in recent years, there are structures related to pain in the brain and these structures called neuromatrix are in close relationship with each other. These structures, which consist of nerves that enable the body to perceive and feel pain, function like a network. This network, called the neuromatrix, is genetically structured in the brain beforehand, and is then shaped by past experiences, worries, and most importantly stress during life, and is perceived with its sensory, mental and spiritual dimensions. Finally, the information reaches the spinal cord.
2. What is chronic pain?
Chronic pain, whether it is an organic lesion or not, changes the neurobiology, decreases the quality of life by causing physical and emotional disorders, and impairs function by preventing work ability. Chronic pain, which has no role in the organism, prevents the person from normal life, and its treatment compels the physician. In particular, unorganized treatment efforts increase the use of hospitals and bring a socio-economic burden.
3. What causes chronic pain?
Although the mystery of why and how chronic pain, which was interpreted as a spell, trouble, devil, and evil spirit in the first civilizations, occurred in the last 20-30 years in nerve physiology, has not been fully understood until today. There are some things we do not understand in basic categories such as not only the occurrence of chronic pain, but also pain sensitivity, susceptibility to pain, the mechanism of action of some treatments that we know to be effective, and the fact that the response to treatments is different for everyone,
4. Can chronic pain be without a reason?
Today, it is known that genetic predisposition has a significant share (60%) in chronic pain, pathological changes in the sensory system are regulated by the immune system, and there is a mutual interaction between these two systems. In the light of this information, although we know the peripheral and spinal level in pain formation well, we have limited knowledge about what happens in the brain
5. What is neuropathic pain?
Neuropathic pain is pain associated with injury, dysfunction, or altered excitability of a part of the peripheral or central nervous system. Neuropathic pain can continue regardless of the injury or the severity of the damage, and may even worsen over weeks, months, or years. This situation is very different from pain due to tissue damage because pain due to tissue damage resolves rapidly after the stimulus is removed.
Neuropathic pain is a type of pain that the medical world does not know much about. The fact that it occurs due to a wide variety of diseases and the multitude of underlying mechanisms cause the diagnosis and treatment of neuropathic pain to be challenging.
6. Neuropathic pain symptoms?
Pain such as burning, electric shock, tingling, stabbing should remind us of pain due to nerve damage. Neuropathic pain occurs most commonly in diabetes and shingles. In addition to this, discomforts such as waist and neck hernia and nerve compression also cause this pain. In 79% of the patients, the intensity of pain is moderate or severe.” ) Treatment of neuropathic pain is difficult because many analgesics may not be enough to relieve these burning-stinging and burning pain. Antidepressants used in the treatment of depression are used as the first-line medicine in the treatment of neuropathic pain, as they make it easier to cope with this chronic pain.Anticonvulsants used in the treatment of epilepsy are preferred especially if the pain in the form of electric shock is at the forefront.
8. Pain Do relievers work for chronic and neuropathic pain?
It is 80-90% possible to treat chronic pain by following the step principle recommended by the World Health Organization. Paracetamol and similar drugs, which we describe as simple analgesics, may be sufficient for mild pain. If the pain is moderate, codeine and tramadol, which we define as weak opioids, can be added. In very severe pain, strong opioid drugs such as morphine come to the fore. In the treatment of neuropathic pain, antidepressants and anticonvulsants, which we describe as secondary analgesics, should be used in the front row.
9. Which pain do you think people complain about the most in Turkey?
40% of patients who applied to pain clinics complain of cancer pain and 60% of them complain of chronic non-cancer
pain. The majority of those who complain of chronic non-cancer pain are backache and headache.
10. Can pain cause psychological problems?
Chronic pain, that is, long-term persistent pain, whether it is an organic lesion or not, reduces the quality of life by causing physical and emotional dysfunction, impairs function by preventing work ability. For this reason, depression can be seen with the vicious circle created by this persistent pain in both the elderly and the patient with late pain. In addition, people with sensitive structures and who are exposed to stress may experience mild pain. As a result, both depression can lead to pain and pain can lead to depression.
