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Left untreated, pain can become chronic and it may end up as a disease.
Ignoring the pain you feel in your body is a bad idea
If pain is not treated quickly, it can become chronic and affect your ability to work, sleep soundly, lift objects and do other normal activities. Your social life can be disrupted because of your depressed mood. This is the warning from Dr Tan Kian Hian, director of the Singapore General Hospital (SGH) Pain Management Centre.
There are many causes of chronic pain lasting more than the typical recovery period of three months for an illness or injury. These include cancer, neck, back and nerve-related pains, arthritis, strokes, diabetes and shingles.
Chronic pain tends to affect elderly Singaporeans more, especially those above the age of 65. The number of people affected here is probably close to 20 per cent of the number affected in developed nations, Dr Tan says. However, this number, he notes, will grow because of Singapore’s rapidly ageing population and greater awareness of chronic pain.
Dr Tan adds: “If pain is untreated and becomes chronic, it can become a disease on its own. “Patients should always see a doctor about their pain. They should take medications based on the advice given by their doctors.” SGH’s Pain Management Centre recognises pain as a vital sign to assess a patient’s basic body functions.
Pain is monitored and managed through a multi-pronged approach to address its medical, physical and psychological aspects. This helps to restore the functions of the patients and manage their chronic disabling disorders. SGH’s one-stop centre — the first and largest here — is staffed by pain specialists, nurses, physiotherapists and psychologists.
Identifying and eradicating the generator of chronic pain are top priorities for the Singapore Pain Care Center in Orchard Road. Its consultant specialist and founder, Dr Bernard Lee, says: “Very often we can come to a diagnosis that accurately represents the patient’s condition. “If the pain generator is not amenable to eradication, we can reduce the pain and control it effectively.” Standard painkillers are usually not the best treatment for chronic pain conditions.
Special anti-convulsant and anti-depressant drugs are required to stabilise over-excited painful nerves. Minimally invasive procedures can also be used to treat chronic pain. Dr Lee says: “If we fall and hit the knee, it is common sense to rest the painful knee and give the body an opportunity to heal.
“The initial bed rest of two days will be sufficient for any painful joints, back or neck conditions.” If the condition is not settled after two days’ rest, further medical attention and investigation will be required.
Prolonged bed rest may worsen the condition and lead to complications such as depression, decreased muscle tone and blood clots in the legs. Studies show that in cases of chronic back pain without any mechanical causes, people who kept up with their normal schedules appeared to improve the flexibility of their backs compared to those who decided to rest in bed for a week.
Where it hurts
Pain can affect your body in different ways, says Dr Bernard Lee. It can raise the heart rate and blood pressure, precipitating a heart attack or failure for patients with poor heart function. It can also restrict the respiratory movement of the rib cage, reduce breathing and restrict chest movements. Poor chest movements and shallow breathing can lead to pneumonia, Dr Lee says.
Prolonged bed rest can cause deep vein thrombosis, and increase muscular wasting and weakness due to immobility. The effects of chronic pain include depression, lack of confidence and proper sleep, complications from treatment-related side effects, excessive utilisation of health care services, lower productivity and higher physical disability.
Ref: V10
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