Complimentary Care: Non-Pharmacological Pain Management

Abstract

Aristotle (4th century B.C.) described pain as emotion, being the opposite of pleasure. Whereas, Buddha stated “Pain is the outcome of sin”, as evidence that an individual was possessed by demons. In some religions it is the cost of attachment. Spiritual counseling thus may be more of a priority than medical management. Many non-physiologic factors (psychological, familial and societal attitudes, life stressors, and cultural or spiritual) contributing to the experience of and response to pain. Emotional stress such as anxiety and depression play a key role in experience of pain. Chronic pain is associated with increased levels of depressive symptoms, anxiety, and insomnia regardless of disability status. it has both modifiable factors (mental health, co-morbidities, smoking, alcohol, obesity, physical activity/exercise, sleep, nutrition, economic status and occupational) and non-modifiable factors (age, sex, cultural and socioeconomic background, history of trauma/ injury/ interpersonal violence, heritage). The relationship between increased BMI and chronic pain in adults seems intuitive and may be related, in part, to increased weight-bearing on joints, reduced physical activity and deconditioning. Patient with physical disabilities may have co-occurring chronic pain, but the prevalence and specific associated factors are unknown. Neuropathic pain (NeP) can be the result of a variety of conditions, including metabolic disease, infection, malignancy, trauma, medications, and toxins; estimates of 60% among those with chronic pain. Chronic pain affects 20% of the European population and is commoner in women, older people, and with relative deprivation. Its management in the community remains generally unsatisfactory, partly because of lack of evidence for effective interventions. Also, family and caregivers’ beliefs and attitudes towards pain, either positively and negatively to tolerate and express pain are important. Risk factors include socio-demographic, clinical, psychological, and biological factors. Pain increases depression risk 3-5-fold. Pain, rather than chronic disease, is associated with the recurrence of depressive and anxiety disorders; 50–80% of chronic pain patients report insomnia of a severity that warrants clinical attention. It is estimated that approximately one in five of the adult population in Europe suffers chronic pain, which is therefore more prevalent than asthma or diabetes. Chronic pain has long-term biological, psychological and social causes and consequences that are important in prevention and management.