Management of Chronic Pain

As reported by the Department of Health (DH), there are 15.4 million people in the United Kingdom living with LTCs and these numbers are expected to increase due to the ageing population and their unhealthy life style choices (2010). LTCs are more common in people from lower economic backgrounds, due to their financial difficulties, and according to research, the number of people with more than one LTC is expected to grow from 2008 by 1 million (The King’s Fund 2015). This issue caused the birth of the 2010-15 government policy on long term conditions, which aims for England to be one of the best countries in Europe at assisting patients with LTCs to live a healthy and

Until October 2014, it was illegal to dispose of opioids except to flush them down the toilet or transport them to a law enforcement agency. The DEA now allows disposal of unused or expired controlled substances at pharmacies and hospitals with special containers for safely storing the drugs. You can find these locations at http://www.DisposeMyMeds.org.

This assignment with look at long term conditions and the associated multiple pathology and the impact both physically and the financial burden placed on the NHS. It is reported that globally over 36 million deaths every year are accounted to long term conditions (World Health Organisation, 2013). The most common LTCs are reported to be Mental health problems, Diabetes, Hypertension, Musculoskeletal problems, Heart disease and Asthma. (Department of Health, 2012). The DH state that one third of the population are reported to have one or more long term conditions, these are described as conditions that cannot be cured but can be managed. (The Kings Fund, 2012)

Long-term conditions (LTC) are defined as “any ongoing, long-term or recurring condition that can have a significant impact on people’s lives” (National Health Committee NHC, 2007, p. 116). Two out of three adults within NZ have or have had a LTC, resulting in the most prominent cause for hospital admissions, premature deaths and an increase in health expenditure (Auckland District Health Board, 2013). This assignment will cover Olivia’s (pseudo name) experience of living with a LTC and how this has impacted her life. A reflection on learning about LTC will be included as well as a discussion on the implications I may encounter in my future practice when caring for a LTC patient will conclude the assignment.

The quality of healthcare provided in long term (LTC) conditions remains uneven despite improvements in equal access to healthcare since the last decade .While there have been substantial improvements in health over this period, health inequalities have been persistent and difficult to change . The enduing pattern of patients from deprived neighbourhoods receiving poorer care remains a problem , as socioeconomic disparities in overall health outcomes are superimposed upon on geographical areas, with burdens borne by the most disadvantaged groups . LTCs are not just a health

The first 48 hours of pain analysis and treating the pain of the patient to the hospice (or end-of-life patient in any other stetting) are crucial. However, the patient may be unable to speak and articulate his pain, or may be able to inadequately express the symptoms. One of the major concerns for those who are at the end of life is

Pain management in burn unit hospitals continues to be a major challenge for many hospitalized patients of all ages. Patients who are required to be hospitalized are usually ones who have moderate to severe burns that result in traumatic tissue damages. The topic of this research paper will be about pain management in patients with burns. The purpose of this paper is stated in following as a patient intervention comparison and outcome (PICO) format, in patients with severe burns who requires routine dressing changes, how does the combination of pharmacological and non-pharmacological pain management compare to using pharmacological pain management alone affect the patient’s overall pain experience?

Chronic pain in older adults is defined as ‘‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage, for persons who are either aged (65 to 79 years old) or very aged (80 and over) and who have had pain for greater than 3 months’’ (Lynch, 2000, p.270). The consequences of chronic pain may also be related to impaired activities of daily living (ADLs), physical disability, accidents, gait abnormalities, polypharmacy, and cognitive decline in older adults (Mantyselka et al., 2001; Kaye et al., 2010; Shega et al., 2010). Therefore, chronic pain has negative affects on older adults, their families, and social relationships.

“Chronic pain is even worse to live with than lung, cardiac or liver disease. Bad chronic pain is connected with the worst quality of life. People don’t realize that it is a disease on its own, not just a symptom.” (qtd in MacCallum par 1) Chronic pain is pain that lasts for longer than six months. It can affect different parts of your body and nervous system. (Blahd par. 1) Sometimes the pain is so severe that it is debilitating. That is where pain medication comes into play.

‘Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage’ (International association for the study of pain 2014). Pain can be made up of complex and subjective experiences. The experience of pain is highly personal and private, and can not be directly observed or measured from one person to the next (Mac Lellan 2006). According to the agency for health care policy and research 1992, an individuals self-report of pain is the most reliable indicator of its presence. This is also supported by Mc Caffery’s definition in 1972, when he said ‘Pain is whatever the experiencing patient says it is, existing whenever he says it does’.

Many of Americans have been diagnosed with chronic pain. In fact according to the Institute of Medicine 116 million United States adults live with chronic pain. The majority of these adults do not seem to receive the adequate treatment needed to help them to cope or to treat their pain. This is primarily due to the physicians not being able to efficiently diagnose their patients, and or the physicians lack the knowledge of the best ways to help manage the pain their patients are experiencing. This is why most people believe that Physicians are the main cause for the rise of prescription drug abuse (Garcia, 2013).

Assessment of chronic pain first begins with understanding what chronic pain is. Chronic pain is any pain with or without obvious injury that lasts longer than the expected healing period. Like many chronic diseases, it has periods of remission, an absence of symptoms, and exacerbation, an increase in the severity of the symptoms. A recent study suggested that chronic pain affects about 80% of elders in nursing homes. (Pateinakis, 2013) Proper treatment of chronic pain begins with gathering subjective and objective data about the client’s pain.

Chronic Pain is an interesting problem in society today. The exact cause of Chronic Pain is not the same in every patient. In fact most patients present with different symptoms and associated pathologies, such as the strong link with depression. Treatment of Chronic Pain is often performed a single practitioner whether that be a Medical Doctor, Chiropractor, Nutritionist, or an alternative health care professional. Chronic Pain is often extremely complex, because of this treatment needs to be multidimensional. Effective care of Chronic Pain requires the collective cooperation of health care professionals

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.

This paper is going to talk about how to deal with chronic pain. First of all, this paper will explain what chronic pain means by providing the foremost chronic pain encountered in life such as low back, joints, or other kinds. Next, this paper will cover why it is important to address conditions related to chronic pain, and will explore methods and strategies showing how to cope with continuing pain. Finally, this paper will share some predictable outcomes and a conclusion.