Methods of Pain Management by Traditional Bonesetters: Experiences in the South-South Zone of Nigeria

Abstract

BACKGROUND:- Traditional bone setting is popular in our culture. Pain is a usual accompaniment of this treatment METHOD:- A prospective study of pain perception and the methods of analgesia/ anesthesia used in six traditional bonesetting centers (TBSC) was carried out in Calabar using a structured interview format. RESULTS: - 92 inmates (clients) with closed fractures of the lower limbs were interviewed. Using the verbal response scale, majority of the inmates, 78 (85%) expressed severe pain while 14 (15%) had mild to moderate pain during bone manipulation. 66 (71.7%) inmates had no form of pain relief (No analgesia-NA-group). Twenty-six (28.3%) had either herbs or orthodox medication for pain relief (Analgesia-A-group). During manipulation, the A-group had mild-moderate pain, an indication of pain relief while the (NA) group had severe pain. Considering the attitude of the Traditional bonesetters, 55 (.9.8% inmates found them hostile and nonchalant while 37 (40.2%) claimed that they were empathetic during painful manipulations. 78 (85%) inmates preferred TBSs because of the relative cheap cost, 9 (10%) chose TBS because of fear of limb amputation or other operations in the hospital while 5 (2%) did so because they do not like the delays associated with hospital treatment. Despite their unpleasant experiences, all the respondents claimed that they were satisfied with the TBS treatment. CONCLUSION: The study revealed clear evidence of ignorance of a need for adequate and proper analgesia and anesthesia during bone treatment among the TBS and their clients. There is a need to draw the TBS together for the purpose of education and awareness so as to discourage this aspect of harmful Tradition practices in our society. KEY WORDS: Pain perception, Traditional bone setting, analgesia, anesthesia, manipulation. Nigerian Journal of Orthopaedics and Trauma Vol.3(2) 2004: 176-184