The epidemic of the 21st Century

Chronic pain is multifactorial and the result of the "wind up" of the central nervous system along with depressed neuro immunity, fatigue and psychomotor fatigue.
Dr. CM de Villiers (Pain Interventionist, Spinal Orthopaedical Surgeon) - The Cleveland Ohio Clinic defines chronic pain as a constant severe pain lasting more than 3 months. This translates to a VAS Score of 7/10 that interferes with sleep (insomnia), mood swings (anxiety or depression) and results in workplace conflict.
What causes chronic pain?
Chronic Pain is a multifactorial disease entity and the International Study for Pain (ISAP) divides it into:
•Classic chronic pain where pain is present for more than 3 months. • Atypical Pain Syndromes i.e., Fibromyalgia, Multiple Sclerosis and Myalgic Encephalitis (ME).
•Cancer pain i.e., severe pain due to infiltration or stretching of nerve endings.
•Amputation pain i.e., amputation pain due to damage to a nerve ending.
Classical chronic pain lasting more than 3 months has 10 major causes which are all preventable.
1. Aging patients - 60% of people in Europe, South Africa and Japan older than 60 years suffer from arthritis of a hip, knee, shoulder or ankle.
2. Chronic back pain.
3. Chronic headaches.
4. Chronic neck pain.
5. Cancer pain. 6.
6. Post Herpes Neuralgia/Neuritis.
7. Phantom limb pain.
8. Post trauma neuralgia (Sudeck’s Atrophy)
9. Failed back surgery.
10. Post Covid-19 pain i.e., headaches, myalgia and joint Pain.
Critical concepts about chronic pain can prevent it by early active intervention of acute pain and by consulting a health professional for early accurate diagnosis and treatment.
It is important to realize pain is multifactorial and “feeds on itself”: The pain is severe when it is constantly more than 8/10 on the pain scale. This causes anxiety and stress which again causes cortisol and adrenaline levels to rise. The result is in insomnia and more anxiety, with the insomnia leading to fatigue and depression. Patients are ”booked off” which causes conflict at work. The cycle continues with a lack of income and the threat of losing your job again causing increased anxiety and the process is repeated.
Prevention is therefore the best treatment with the aim to stop the pain in its tracks.
1. Identify the area involved.
2. Identify the type of pain - nerve, muscle, joint, bone or viscus.
3. Score the intensity on a scale of 0 – 10. When the intensity is greater than 7/10 see your doctor.
4. Don’t ever let pain last more than 6 weeks! It has been proven that by using a pain drawing and the patient adheres to the previous 4 steps 70% of acute pain is correctly diagnosed, treated early and efficiently.
All Chronic Pain must be treated by a Multidisciplinary Pain Clinic Team consisting of a Pain Nurse, Pain Interventionist, Psychologist (if needed), Physiotherapist/Biokineticist or Chiropractor.
Usually a minimally invasive procedure is done and if not successful the patient is referred to the correct specialist i.e., hand, hip, knee, spinal or trauma surgeon, cardiologist or gynaecologist for definitive treatment by the correct specialist. – [email protected]

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Namibian Sun 2024-11-23

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