Everyone has experienced pain - a pounding headache, a throbbing toothache, an open wound, a sprained ankle or a stinging burn from touching a hot pan.
Pain is complex and frequently misunderstood, riddled with myths and misperceptions. Pain is a costly public health issue with an annual cost estimated to be more than $100 billion. It is the leading cause of disability in the United States and can compromise and interfere with everyday activities and enjoyment of life.
September has been designated by the American Pain Foundation as National Pain Awareness Month. In an effort to raise awareness about issues surrounding pain and a lack of access to pain care, Gov. Chet Culver has proclaimed September as Pain Awareness Month in Iowa.
There are hundreds of pain syndromes and pain is often a chief symptom of most chronic conditions, including cancer, diabetes and arthritis. For more than 76 million Americans living with chronic pain, pain persists and interferes with everyday activities and enjoyment of life.
At Trinity Regional Medical Center, pain is taken very seriously. Acute pain typically has a sudden onset, a short duration and subsides when the injured tissue heals. Chronic pain is a pain that persists after the usual healing time and/or more than three months duration.
In the past decade, the Trinity Pain Management Center has offered our community and the surrounding area numerous options for chronic pain management. We have a pain specialist, anesthesiologist, Dr. Andrzej Szczepanek or Dr. Andy, available to offer a variety of treatment options to the public. The supporting staff is specially educated in pain management and all believe in a multidisciplinary approach. They are dedicated to providing the best possible care at all times to all people.
Whereas pain affects an estimated 76.5 million people and is the leading reason for visits to health care providers; and
Whereas access to appropriate and effective pain care can be limited for many Americans; and
Whereas the cost of under treated pain drives up the cost of healthcare, extends the length of stay in hospitals, increases emergency room visits and contributes indirectly with lost wages and productivity of people in pain and their caregivers; and
Whereas the people of Iowa have the right to have pain assessed and treated by working with their health care providers to determine the most appropriate and effective pain management regime; and
Whereas the health care providers of the state of Iowa strive to increase the awareness of pain as a significant public health problem and make known the need for education and practical information to the citizens of Iowa;
Now, therefore, I, Chester J. Culver, governor of the state of Iowa, do hereby proclaim the month of September 2009 as Pain Awareness Month.
Successful pain management aims to lessen the pain, improve function and enhance quality of life. This is individualized to each person and requires a team of providers as well as support from family and friends. A combination of treatment options may include medication, psychosocial interventions, rehabilitative approaches, life style changes, complementary medicine, injection or infusion therapies and/or implantable devices and surgical procedures. Providers may range from primary care providers (physicians, nurse practitioners, and physician assistants), psychologists, counselors, physical and occupational therapists, chiropractors, acupuncturists, anesthesiologists, orthopedic specialists and neurosurgeons.
With all the above professional assistance, the individual with pain remains the most important member of the ''multi-modal'' or integrative approach. Trinity Pain Management staff believes the patient should be the most active member of the team; bringing in the family or support systems they have developed to aid them to reach their pain management goals. People with pain often have some aspect of depression, which can affect thinking, concentration and behavior and increase pain sensitivity and severity. There is evidence of a biological link between the regions of the brain involved with depression and pain regulation.
Recent studies have indicated that costs related to low back pain alone top more than $85 billion each year. The total cost for arthritis - the nation's leading cause of disability - is estimated at $128 billion annually. Arthritis in the spine can be particularly troublesome to people over the age of 65.
Growing older does not need to hurt. The most common cause of chronic pain in the older adults is musculoskeletal in nature, typically from osteoarthritis and other bone and joint disorders. Older adults often have multiple sources of pain, making the diagnosis and treatment of pain more difficult. Unmanaged pain can lead to depression, sleep disturbances, anxiety, fatigue, impaired ambulation, dementia, decreased socialization and contribute to the poor quality of life many older persons may experience.
''Pain is whatever the patient says it is, and exists whenever the patient says it does.'' (McCaffrey, 1968). Many patients have difficulty in precisely defining their pain symptoms. There is no device that exists to objectively measure a person's level of pain, such as a thermometer measures body temperature. For a complete picture of pain, patients are asked where the pain is, the intensity level, a description of the sensation, when does it occur, what makes it better, what makes it worse and how does it affect sleep, mood, appetite and activity.
Describing pain can use terms such as sharp, crushing, throbbing, shooting, deep, pinching, tender, and aching among others. A pain scale is a tool that helps describe the intensity of the pain and is found in numerical, verbal or visual forms. You may be asked to use numbers from 0 to 10 (no pain to the worse pain ever) or to use terms such as mild, moderate and severe. A visual scale that features facial expressions may be used for those who are unable to verbally describe their pain.
Chronic pain management is an ongoing process, not a one-time concern. Finding the right combination of therapies may take time. It is very important for you and your health care providers to work as a team to treat your pain effectively. Asking for help from those in specialized areas such as Trinity Pain Management Center enables your team to design a comprehensive pain management program. For those in pain the future cannot come fast enough.
Dr. Andrezej Szczepanek is a pain specialist and anesthesiologist. Pam Kennel is a registered nurse. Both are affiliated with the Pain Management Center at Trinity Regional Medical Center.