Dr. Arun Sharma

treatment-in-Dubai

Pain Management Consultant in Dubai

The World Health Organization (WHO) has updated the International Classification of Diseases (ICD-11). For the first time, they have included chronic pain and provided specific pain diagnoses. Under the new system, chronic pain is classified as either chronic primary pain or chronic secondary pain.

Chronic primary pain is defined as pain that persists for longer than three months and is associated with significant emotional distress or functional disability and that cannot be explained by another chronic condition. This new definition applies to chronic pain syndromes that are best conceived as health conditions in their own right. Examples of chronic primary pain conditions include fibromyalgia, complex regional pain syndrome, chronic migraine, irritable bowel syndrome and non-specific low-back pain. Chronic secondary pain syndromes are defined as pain that may initially be regarded as a symptom of other diseases having said disease being the underlying cause. However, a diagnosis of chronic secondary pain marks the stage when the chronic pain becomes a problem in its own right. In many cases, the chronic pain may continue beyond successful treatment of the initial cause; in such cases, the pain diagnosis will remain, even after the diagnosis of the underlying disease is no longer relevant. Examples of chronic secondary pain are chronic pain related to cancer, surgery, injury, internal disease, disease in the muscles, bones or joints, headaches or nerve damage.

Types of pain

Pain Management Consultant in Dubai can classify pain into several types.

Nociceptive pain

This is the type of pain illustrated in the first diagram. Nociceptive pain is caused by any injury to body tissues, for example, a cut, burn or fracture (broken bone). Postoperative pain and cancer pain are other forms of nociceptive pain. This type of pain can be aching, sharp or throbbing. Nociceptive pain can be constant or intermittent and may be worsened by movement or by coughing, depending on the area it originates from.

Neuropathic pain

This is caused by abnormalities in the system that carries and interprets pain — the problem may be in the nerves, spinal cord or brain. Neuropathic pain is felt as a burning, tingling, shooting or electric sensation. One form of neuropathic pain is associated with shingles — a skin condition caused by varicella zoster virus. The virus triggers inflammation of the nerves and this inflammation can set off a constant deep aching, tingling or burning sensation that in some people can persist for months after the shingles rash has resolved. People with neuropathic pain may feel pain from stimuli that are not normally painful, such as light touch or cold. They can also be more sensitive than normal to stimuli that are usually painful. For example, bedclothes touching the affected area could feel painful, and a pin prick could feel excessively sharp.

Neuropathic pain can be caused by various processes.

  • Physical damage to nerves, causing abnormal signalling.
  • Failure of the spinal cord or brain to dampen down the pain.
  • ‘Wind-up’. When the spinal cord is constantly bombarded by incoming pain messages from C fibres, it amplifies the pain signal that it sends to the brain. So you feel more intense pain. This is a brief change, lasting only seconds or minutes, but it may set the scene for more permanent changes..
  • Increased efficiency of signal transmission at the junctions (synapses) between neurones. This is a complex process that can last up to several months.

Acute pain

This is short-lived pain warning the body that damage is occurring. It is a symptom of injury or disease at the tissue level, and tends to resolve as the injury or disease does.

Chronic pain

Chronic pain (also called persistent pain) can be caused by ongoing tissue damage, such as in osteoarthritis. However, in some cases no physical cause for the pain can be found or pain persists long after the injury has healed. In many cases chronic pain is a disorder in itself rather than being the symptom of a disease process. Chronic pain can persist for months or even years after an initial injury and can be difficult to treat. People with chronic pain may experience sleeplessness, anxiety and depression, all of which can compound the problem. However, support and help are available, often in the form of a multidisciplinary approach, as carried out in pain management clinics. Chronic pain is an area that is being researched intensively, with the hope of relieving this distressing condition in the future. Chronic pain management is a complex and has to be strategized in a very understanding manner along with appropriate medications.