Data show that there are more than 300 million patients with chronic pain in my country, but the awareness rate, low consultation rate, and complete remission rate are low. Living with pain has reduced the quality of life of patients. Experts say it is crucial to strengthen pain management and national pain awareness education in our country.
Cartography by Cheng Shuo (published by Xinhua News Agency)
Everyone is afraid of pain, but not everyone understands pain. When pain strikes, do you endure it and let it pass? Does the ability to tolerate pain increase the longer you endure pain? I heard that painkillers have serious side effects, so why don’t you take them if you can?
In response to these questions, the “Raise Prevention Awareness and Stay Away from Severe Pain” national media communication conference, initiated by Doctors News and jointly supported by China Elderly Care Association and People’s Daily Health Client, was held in Beijing recently. The “Research Report on Pain in Five Regions of my country” was announced at the meeting. Experts and association representatives from multiple disciplines discussed common pain in middle-aged and elderly people, misunderstandings about pain, and scientific management of pain.
The third largest health problem in our country
In the pain department outpatient clinic, the pain experienced by patients coming and going is all kinds of strange: some describe it as “like a needle pricking”, some feel like “like a knife cutting”, some say it feels like “thousands of arrows piercing the heart”, some describe it as “like burning red” “The tongs are burning the bone marrow”… Fan Bifa, director of the Pain Department of China-Japan Friendship Hospital, said that severe pain has a huge negative impact on people. It not only makes people unable to eat and sleep, but also causes people to have a series of Negative emotions and psychological disorders such as anxiety, depression, and mania can also lead to dysfunction of various systems and low immunity, reducing the patient’s quality of life, and in serious cases, even threatening life.
Yu Hua, vice president and secretary-general of the China Elderly Care Association, said that according to statistics, nearly 56% of adults around the world experience pain at least once a week. In China, pain has become the third most common cause of death after cardiovascular and cerebrovascular diseases and tumors. health problems.
“From a medical point of view, pain is divided into mild, moderate and severe; from a disease course point of view, pain is divided into acute pain and chronic pain. Continuous or intermittent pain for more than 3 months is called chronic pain.” Fan Bifa said that acute pain is often is a symptom, but chronic pain is a disease in itself.
How much pain is considered severe pain? “We understand severe pain as at least moderate to severe pain and above.” Fan Bifa introduced that there is a quantitative indicator for moderate to severe pain and above, that is, it affects sleep. “For example, after a patient finally falls asleep, he turns over and wakes up again. Sleep On and off, it is necessary to seek painkillers or doctor’s help to resolve the pain, which is at least moderate pain; what is severe and above pain? Patients may be awake all night, desperate to even go to the emergency room to solve the pain problem.”
According to experts, after entering the middle-aged and elderly stages, the human body’s motor system, nervous system and other functions tend to degrade, and pain problems often follow. Common pain problems among middle-aged and elderly people include soft tissue pain, musculoskeletal pain (pain caused by cervical spondylosis, lumbar spondylosis, frozen shoulder, arthritis, etc.), neuralgia (such as pain caused by diabetic peripheral neuropathy, trigeminal neuralgia, etc.) , sciatica, postherpetic neuralgia, etc.), head or maxillofacial pain, cancer pain (pain caused by various types of cancer), etc.
5 discoveries and 7 misunderstandings
What is the daily diagnosis and treatment situation in the field of pain? The “Research Report on Pain Field in Five Regions of my country” released at the meeting showed 5 findings and 7 misunderstandings about pain.
This survey found that neck, shoulder, waist and leg pain, neuralgia, cancer pain, and soft tissue pain are common chronic pains in outpatient clinics; herpes zoster-related pain is more common, and the proportion of such diseases in pain-related outpatient clinics in different hospitals varies, about 10 %-40%; middle-aged and elderly people with underlying diseases (chronic diseases, autoimmune diseases, cancer) have a higher risk of pain; middle-aged and elderly people with chronic diseases (diabetes, chronic kidney disease, cardiovascular disease, chronic obstructive pulmonary disease) , rheumatoid arthritis, etc.), the risk of herpes zoster-related pain increases; the public has many misunderstandings about pain, and needs to improve their awareness of correct disease prevention and pain management.
“People often say it hurts to death. This sentence may seem ordinary, but some people really want to give up their lives because of the pain. Therefore, we appeal that there is no need to endure the pain, and there is no need to tolerate it.” Executive President and CEO of “Doctor’s News” Editor Zhang Yanping said that she hopes that with the release of this report, she can further enhance the public’s correct understanding of pain, manage the disease early, and prevent or reduce the occurrence of pain.
Experts say that pain is a distress signal sent by the body and a protective mechanism for the human body to avoid injury and detect hidden dangers in time. However, when faced with long-term, severe pain, many people tend to fall into cognitive misunderstandings.
“Some people think that pain is not a disease and does not require special treatment. The pain will naturally get better after the disease is gone. Some people think that pain can be solved by taking painkillers. No matter if it is a headache, stomachache, foot pain or anywhere else, just take them. Painkillers are an indiscriminate use of drugs, which can easily lead to a series of complications; some people think that painkillers have serious side effects and are highly toxic, so they refuse to take them, resulting in more and more pain.” Fan Bifa emphasized that medical research has found that if it can be scientifically and effectively With pain relief, the underlying disease will tend to improve or be cured. At the same time, many chronic diseases may accompany patients for life, but people do not have to live with pain for a long time.
For patients, does the ability to tolerate pain increase the longer they tolerate pain? In this regard, Fan Bifa said that long-term pain tolerance will not only make people less and less tolerant to pain, making it easy for them to feel pain when touched, but in particularly serious cases, it will also cause the body’s anti-pain system threshold to drop to zero, causing pain even without touching it. The phenomenon of “pain hypersensitivity”. Fan Bifa emphasized that once pain occurs, it is necessary to seek help from a doctor in time and standardize treatment and management as soon as possible. “The treatment of pain takes a certain amount of time. Not all pain can completely disappear once treated, and not all nerves can be ‘burned’ away.” , requires a comprehensive evaluation by a doctor, and we pain doctors hope to work together with patients and their families to help patients avoid or relieve pain and improve their quality of life after treatment.”
Chronic disease superimposes pain and escalates
“The more comorbid chronic diseases there are, the easier it is for the pain to increase and the severity of the pain to escalate.” Wang Hong, director of the Chaoyangmen Community Health Service Center in Dongcheng District, Beijing, said that research has found that body pain is closely related to chronic respiratory diseases and heart disease. , kidney disease, and increased risk of digestive system disease. Taking herpes zoster as an example, patients with chronic diseases such as patients with diabetes, COPD, cardiovascular disease, rheumatoid arthritis, and chronic kidney disease are at increased risk of contracting herpes zoster. The pain these patients feel after getting herpes zoster It is stronger and the risk of developing post-herpetic neuralgia is higher than in healthy people. “Therefore, for middle-aged and elderly patients with chronic diseases, personalized chronic disease education and management is very important to help them change from ‘passive’ to ‘active’ in the face of disease and pain.” Wang Hong said.
According to experts, most pain is also related to daily living habits such as prolonged sitting and standing, bad posture, excessive bending, lack of exercise, and unreasonable diet. Managing these triggers can help prevent pain before it occurs. For example, maintaining a good mood, ensuring a regular schedule and sleep, and eating a balanced diet can prevent the occurrence of tension headaches and migraines to a large extent; changing bad posture and properly exercising the muscle strength of the lower back can prevent lower back pain. Attacks; active supplementation of calcium and vitamin D can help treat osteoporosis and prevent or delay the progression of arthritis. For middle-aged and elderly people with underlying chronic diseases, vaccinations can also be used to prevent common infectious diseases such as influenza, pneumococcal disease, and herpes zoster in advance, and to reduce the risk of pain caused by the superposition of chronic diseases.
Can middle-aged and elderly people with chronic diseases get vaccinated? Chen Qiuping, head of the Preventive Health Care Department of Liulitun Community Health Service Center in Chaoyang District, Beijing, said that vaccination for the elderly needs to be under the guidance of a professional doctor, taking into account their own physical condition, and focusing on the applicable age, protective efficacy, and contraindications of the vaccine. The big keyword is to choose the vaccine that suits you. Regarding the contraindications for vaccination, Chen Qiuping said that there are generally three situations that require special attention: those who are allergic to vaccine components cannot receive the vaccine; if the patient is in the acute attack phase of a chronic disease or is in the acute phase of the disease, it is recommended to postpone vaccination; People with immune deficiency or immunosuppressive diseases cannot receive live attenuated vaccines.
Seven misunderstandings about pain, have you fallen into any trap?
Misunderstanding 1: Pain is not a disease, it will pass if you tolerate it.
The truth: You can’t bear the pain and you don’t have to. Chronic pain can bring many harms to the body, such as increased blood pressure, increased heart rate, endocrine disorders, sleep dysfunction, impaired immune function, etc. In addition, it can also cause psychological harm to patients and their families. Many patients may suffer from anxiety, depression or even suicidal tendencies due to long-term intractable pain.
Myth 2: Pain is innate and unavoidable.
Truth: By developing healthy living habits or strengthening the management of chronic diseases, and early vaccination against some infectious diseases, the occurrence of related pain can be avoided to a large extent.
Misunderstanding 3: Painkillers have serious side effects, so you should never take them.
The truth: Painkillers prescribed by specialists can relieve the patient’s pain to the greatest extent with minimal side effects. Patients need to follow the doctor’s instructions and take them on time and in a quantitative amount.
Myth 4: The longer you endure pain, the greater your ability to endure pain.
Fact: If chronic pain persists, it will lead to sensitization of peripheral nerves and central nervous system, making the patient more and more sensitive to pain.
Myth 5: Taking painkillers will mask the cause of pain.
Truth: For the treatment of neuropathic pain, treating the pain itself is treating the disease.
Myth 6: Pain can be eliminated 100% through treatment.
The truth: The pain of many chronic diseases cannot be eliminated 100%. Most of the pain can be reduced to improve the patient’s quality of life.
Myth 7: If you “burn” the nerve that causes pain, there will be no pain.
The truth: In clinical practice, some nerves can be “burned” and some cannot. All pain cannot be treated by “burning” nerves. The treatment measures for nerves depend on the time and location of the pain and the patient’s basic condition.