Pain is not only a symptom, but a pathology in itself. It is known as chronic pain. In Hospital La Paloma’s Pain Unit, we specialise in a multidisciplinary approach to a problem that affects a large portion of Spain’s population. Of course, the department specialists know perfectly the nerve mechanisms that are activated when pain arises, so, whatever the type of acute crisis, we are prepared to handle it.
How many people suffer chronic pain in Spain?
Living with pain is a problem that not only affects the patient’s quality of life, but also their closest relatives, they must witness, without being able to help, how their family member or friend suffers from pain that can not be calmed. According to an epidemiological study on chronic pain in Spain, it is estimated that over 6 million Spanish adults suffer from chronic pain, precisely 17.25% of the population. A very high rate that should make us think twice about its situation.
Does it affect women more?
That’s right, most of those affected are women. The most common pains are back (60.53%), joint (40.21%), head (34.72%) and cervical (28.62%). Within our closest relatives or friends there are sure to be those who suffer and are treated for chronic pain.
Who should go to the Pain Unit?
People with pain in any part of the body who have not achieved relief with conventional treatments come to the Pain Unit. Also those with lumbar pain (back), de novo sciatica or pain derived from interventions for herniated discs.
Many patients suffer from pain caused by osteoarthritis, intense muscular pain or headaches, which have not been able to improve with usual treatments.
Patients who are diagnosed with cancer or who suffer severe pain after a surgical intervention come to our unit.
Patients with severe discomfort after car or work accidents are also assisted.
La Paloma multidisciplinary Pain Unit team
The Pain and Palliative Care Unit of Hospital La Paloma has as a mission to subtract pain and add quality life by applying a multidisciplinary approach to relieve the pains.
This unit is made up of specialists in various areas:
- Alexis Rodríguez, Unit head.
- Javier Prieto de María, nurse-acupuncturist.
- Paola González Gil, psychologist.
When the patient arrives at the consultation, the doctor performs a physical examination and assesses the performance of complementary tests, such as analytical, electromyogram, radiography, magnetic resonance and / or tomography.
If necessary, the doctor will redirect you to specialists of other areas for greater effectiveness of the treatment. The doctor will also assess the need for a psychological study and nutritional counselling.
After performing these steps, a multidisciplinary meeting of the entire team is held to establish the conclusions of each party. Finally, the specialist will draw up a plan and set the appropriate treatment.
Acupuncture in pain treatment
Acupuncture stimulates a series of stimuli, in the nervous, hormonal and immunological systems, that the body itself finds the state of homeostasis, balance, with a global and unique vision of the patients physical appearance and mental state.
Nogier Auriculotherapy, discovered by Paul Nogier in France in the 50s, comes in aid of acupuncture reinforcing its treatment.
This technique is used in patients with chronic pain, arthritis, hypertension, infertility problems, migraine or respiratory problems, among others.
The role of psychology in the approach to chronic pain
The global approach includes the professional assessment of the psychological functioning of the person with chronic pain and its management, narrowing the areas of involvement (personal, social, family and work), in order to perform the necessary intervention to adapt the perceptive experience to the intensity of the pain, as well as to activate all the instruments and psychological resources necessary to carry out the appropriate adaptations to their style of operation and directed to an improvement of quality life.
Some of the characteristics present in the patients affected by chronic pain that require a psychological intervention are the following:
- Body capacity limitations
- Difficulty handling bodily sensations
- Mood impairment (sadness, fear, irritability)
- Social and family isolation
- Difficulties at work
- Medication excess
- Low effectiveness speciality treatments
Communication between patient and specialist
In general grounds, the Health Community, does not fully delve into the needs that arise in patients with chronic pain and how it should be addressed. This is why, the Pain Unit at Hospital La Paloma is lead by one of the most outstanding field specialists, Dr. Alexis Jesús Rodríguez León, who advocates, in his consultations, for intensifying communications between patient and practitioner and between the specialists themselves. This is intended to make an adequate diagnosis and an integral approach including biological and psychological pain aspects.
An ignored problem
Chronic pain has always existed. Primary care consultations are full of cases of patients who describe feeling pain without the drugs prescribed to resolve that symptom having their effect. Despite this, the World Health Organization (WHO) did not publish guidelines on the management of pain until 2008. In Spain, the situation continues to be worrisome despite the efforts to create the analgesic ladder and through strategies dedicated to pain by the Ministry of Health.
For the treatment of pain, the use of analgesics is common, among which are opioids. However, its side effects can be unpleasant. Therefore, the approach to chronic pain is complex and consists of different edges that must be analysed. The multidisciplinary study of each patient is essential. Aspects such as stress, lifestyle, diet or tolerance to pain, should be taken into account, as they directly affect the intensity with which we will perceive the pain and its persistence over time.
Thirty years ago, the analgesic ladder was created for nocifective pain and subsequently the neuropathic one (nerve damage). More recently, in Spain, the so-called analgesic elevator was created that directs the control of pain with a simple, valid and effective method to ensure a reasonable therapy in pain treatment.
Injuries in the nervous system
The Spanish Society of Pain explains that “sometimes, chronic pain is the result of a change or persistent disease in tissues, such as arthritis, but other times it is the result of an alteration or change in the alarm system itself. This can happen, for example, if there has been a nerve injury (neuropathic pain). Some cases are a consequence of neuropathic pain, such as diabetes or herpes. Surgery of the breast or in the chest area, or the amputation of limbs, can leave a pain similar to a persistent burning sensation or electric shock.
Chronic pain should be treated as a disease and not as a symptom, adequately assessing the possible causes and treatment according to each case.
Within Hospital La Paloma’s Pain Unit we have a palliative care area where patients in terminal stages or with advanced disabling diseases receive an integral treatment.
Our goal is to improve their quality of life, through the prevention and relief of suffering caused by these diseases. To achieve this, we carry out an early identification and treatment of pain and other physical, psychological and spiritual problems.
We will not try to accelerate or delay the death but, consider it a normal process of the human being, avoiding the suffering of the loved one.