Understanding and managing pain
Pain constitutes one of the main reasons patients seek medical attention. It’s a debilitating condition both physically and mentally, with implications impacting social structures and the functioning and economic well-being of society as a whole.
An estimated 10 % of the world’s population suffers from some form of pain, which corresponds to around 60 million people.
For these reasons, pain is considered one of the main health issues of the 21st century, and since 2019 it has been classified as a pathology by the International Association for the Study of Pain (IASP).
How do we define pain?
Giving a definition of pain can be a difficult task, because the perception of pain varies from person to person; for this reason, the official definition of pain by the IASP focuses on the individual experience of the patient: in other words, pain is what each of us feels and decides is pain.
The IASP definition dates back to 1979 and underwent a process of revision and expansion in 2020, framing pain as:
“An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”
The definition is expanded upon by the addition of six key notes:
- Pain is always a personal experience that is influenced to varying degrees by biological, psychological, and social factors.
- Pain and nociception are different phenomena. Pain cannot be inferred solely from activity in sensory neurons.
- Through their life experiences, individuals learn the concept of pain.
- A person’s report of an experience as pain should be respected.
- Although pain usually serves an adaptive role, it may have adverse effects on function and social and psychological well-being.
- Verbal description is only one of several behaviors to express pain; inability to communicate does not negate the possibility that a human or a nonhuman animal experiences pain.
Acute pain and chronic pain
Pain can be divided into two main groups: acute and chronic pain.
Acute pain is characterized by a sudden onset and a limited duration in time. It’s considered the most frequent reason people seek medical assistance.
Among the most common painful conditions we can find headaches, musculoskeletal pain, toothache and menstrual pain. Postoperative pain falls under this definition as well, with around 86 % of patients reporting moderate or severe pain intensity following surgery.
Chronic pain can be defined as a condition of pain that persists or recurs for more than 3 months.
The most common syndromes related to chronic pain are fibromyalgia, chronic low back pain, headache and neuropathy.
This condition can have a substantial negative impact on the patient’s life, who as a result tends to also suffer from sleep disorders, depression and fatigue.
How do we assess pain?
An evaluation of the patients’ pain is based on the way the patients themselves describe it to their MD, on an intensity scale that ranges from “mild, moderate” to “severe”. Moreover, there are two other assessment methods, the visual analogue scale and numeric rating scale.
The visual analogue scale (VAS) represents the extent of pain experienced by a patient on a 10 cm long straight line, in which one end corresponds to the absence of pain and the other to the worst pain imaginable.
The verbal numeric scale (VNS) involves the patient’s rating of pain on a scale ranging from 0 (no pain) to 10 (the worst pain imaginable).
Both methods can also be used to measure pain relief during or following treatment.
The importance of pain management
Pain in all its forms can reduce both the patients’ and their families’ quality of life and have a lasting impact on a working, personal and social level. For this reason, an intervention to manage it and find a rapid solution is essential and a cross-disciplinary approach is needed, often embracing medical, physical and psychological therapies.
From the early 80s, the Menarini Group has been actively engaged to intervene on pain through intense research and sophisticated molecular engineering methods to develop new active ingredients that can respond to patients’ concrete needs.
Over the years, the Group has developed a wide range of pharmaceutical products for the treatment of painful conditions, both requiring prescription and over the counter, and aims to further expand its portfolio in the therapeutic area. Moreover, the company also supports a large number of clinical studies so that pain as a pathology may be explored with high-level scientific information.
Menarini stays true to its core values, always striving for the highest quality standards and putting the patient first.