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Exploring nonpharmaceutical interventions.
Posted Oct 02, 2019
In the past few posts, I discussed a number of pharmaceuticals that can be used in treating pain. Most recently, CBD has received a great deal of attention and press, but there is still a lack of consistent research findings to support many of the claims being made. I also discussed the use of nonpharmaceutical interventions to treat pain. But before we talk more about these, we will talk about what pain is.
The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” Acute pain is usually transitory and resolves quickly. Pain that lasts a long time, usually 3 to 6 months, is called chronic or persistent.
More people live with chronic pain than suffer from cancer, heart disease, and diabetes combined. According to one estimate by the National Institutes of Health, chronic pain affects 116 million people. Nociceptive or cancer pain, neuropathic pain, and inflammatory pain, such as rheumatoid arthritis, are three major categories of pain.
The problem with the definition of pain that we just reviewed is that pain may exist when there is no evidence of tissue damage or potential tissue damage. Pain is an individual response and may be unique to the person who is experiencing it. There is no way of measuring the severity of pain other than asking the patient to rate the pain usually on a scale of 0 to 10, with no pain being a zero and the worst pain imaginable being a 10.
As pointed out in the previous post, there are a number of nonpharmaceutical interventions, many of which have existed for some time. These interventions include many of the cognitive-behavioral strategies, such as the use of relaxation and mindfulness techniques and acupuncture, yoga, guided imagery, and hypnosis.
This is not to say that pharmaceuticals do not play a major role in treating pain, especially acute pain, but the use of opioids in the treatment of chronic pain has proved to be far less effective. Patients often develop a tolerance to the medication after repeated use and may become dependent upon the opioid for relief. They also may develop an increased sensitivity to pain, which compounds the problem.
We will be talking more about nonpharmaceutical, especially non-opioid, interventions for the treatment of chronic pain in the next few posts.