Acute Pain Disorder

Acute Pain Disorder

Introduction

Acute pain is usually tissue damage. It is a symptom that has a role alarm, making the individual to perceive a potential threat to him. For a doctor, however, its diagnostic value is constant. Algogenous substances (i.e. likely to cause pain), released by the causal disease, stimulate nerve endings: the message is transmitted through peripheral nerves to the spinal cord and then to specific areas of the brain. These messages are a source of pain reflexes: some are useful as remove his hand from a hot source, other deleterious reactions such as sympathetic and endocrine-related stress. (Allaz, 2003)

According to the International Association for the Study of Pain (IASP), pain is defined as "an unpleasant sensory and emotional experience associated with tissue damage or potential or described in terms suggestive of this injury.” (Bovier, 2001)

A recent survey conducted at the visitor center and emergency HUG showed that 80% of patient's consultant in emergency has a painful symptoms and management of acute pain is often slow and inadequate. International studies also show that pain is still inadequately recognized and supported in the hospital emergency centers or outpatient. Caregivers often feel acute pain as a warning signal of an organic disease or underlying path physiology and tend to focus on finding a physical cause identifiable. Indeed, it is often assumed that if a physical cause behind the pain identified and treated, its removal will have an analgesic effect. In the meantime, the patient continues to have evil. In addition, many health professionals believe that analgesia administered before accurate diagnosis is posed can mask symptoms and interfere with the diagnostic process and therapy. (Davar, 2003)

However, in order to optimize and expedite the care, experts recommend considering pain as an entity co-existing illness or injury requiring assessment and management supports parallel.

Diagnosis

The diagnosis of Pain Disorder is made in patients when pain has existed for at least six months and there is strong evidence that psychological factors have caused or are maintaining the pain. (Edwards, 2004) Many of these patients have depressive illnesses, and in some of them major depression may be the root cause. The main diagnostic criteria are as follows:

The person's presenting problem is clinically important pain in one or more body areas.

The pain causes distress that is clinically important or impairs work, social or personal functioning.

Psychological factors seem important in the onset, maintenance, and severity or worsening of the pain.

Other Disorders (Mood, Anxiety, and Psychotic) do not explain the symptoms better, and the patient does not meet criteria for Dyspareunia.

The person doesn't consciously feign the symptoms for material gain (Malingering) or to occupy the sick role (Factitious Disorder).

Symptoms and Medication

Low back pain

Prescribe analgesics at regular intervals. We can use paracetamol, NSAIDs or weak opioids (e.g. tramadol) (see the strategies of the Polyclinic Ambulatory Medicine in most cases, a combination of drugs (different mechanisms) will preferred monotherapy should rather be the exception. The superiority of parenteral administration of NSAIDs on the oral has ...