Many interactive factors produce pain of different intensities at different sites in the body. For example, if you accidentally strike your toe against a desk, a message is immediately sent to your brain via certain nerve fibres. An interpretation is made by the brain and further responses are initiated. These include swelling and inflammation at the injured site
In medical practice, every speciality has to deal with pain management. Accurate diagnosis through presentation of symptoms, identification of signs and appropriate tests would lead to the cause and treatment which would result in reduction of the painful condition.
Pain may be acute (temporary) or chronic (lasting several months). In the case of chronic pain, inability to work could impact on the productivity of the workforce.
Some of the more common causes of pain seen in medical practice are reviewed here:
Pain in the head can be acute or chronic. There are numerous causes of acute pain. Some include: eye strain, stress, irregular eating habits, lack of sleep, muscle tension, hypertension, post-operative pain and infections or inflammatory conditions in the body. Pains are relieved if the causes are identified and treated. Chronic pain includes migraines, cluster headaches, cerebral tumour and late cancer.
Migraines can be quite severe occurring over several days with very limited response to medications. Cluster headaches are also severe.
Pain in the back is a very common complaint and may occur in children as well as adults. There are many causes of back pain and this is understandable if the anatomy of the back is reviewed. Messages going from any part of the body to the brain for interpretation get a swift response. These messages travel in nerve fibres which coalesce in the center of the back to form the spinal cord which extends from the neck to the pelvis.
The individual vertebrae are held in position by ligaments and are prevented from rubbing against each other by the presence of a cushion of fibrous tissue with a gel-like center known as the intervertebral disc.
It is clear therefore that pain may originate from the backbone, spinal cord, nerves at all levels, muscles, ligaments and intervertebral discs.
Some examples of back pain are herniated or prolapsed intervertebral disc (causing very severe pain), muscle strain, osteoporosis and osteoarthritis. In severe cases surgery may be an option if conservative treatment fails, however, there are well recognised preventative measures which can be utilized. Physical exercise to maintain muscle tone, lifting weighted objects properly, stress management, proper posture standing or sitting – especially while using the computer, and also good sleeping positions. In the sports arena, warm-up exercises are important for preparing muscles for intense physical activity.
Pains in the knee are another very common complaint. The main causes are osteoarthritis and sports-related injuries. The knee is a hinge joint mainly allowing movement forwards (extension) and backwards (flexion). It is an important weight-bearing joint and depends on its functions from the integrity of ligaments within and outside the joint. It also depends on two C-shaped cartilage structures within the joint which have the function of shock absorbers, preventing the bones from rubbing against each other and also restraining certain movements. The knee cap or patella also provides protection for the forefront of the knee joint.
The painful knee is frequently seen in medical practice as a result of Osteoarthritis, the natural degeneration of aging joints. Rheumatoid Arthritis and Gout can also cause knee pain.
Sports injuries often affect the knee causing varying degrees of pain.
Torn ligaments, torn intra-articular cartilage, inflamed tendons (tendinitis), sprains and strains. Injuries to the knee cap cause significant pain and limitation of movement.
Sprains and strains
A sprain is a tearing of a ligament, the tissue which connects two bones. The sprained ankle is the result of a partial tear between the bones which comprise the ankle joint. This is a common injury caused by a sudden twist of the foot.
A strain is the stretching or tearing of muscle or tendon, the tissue connecting muscle to bone. Back strain is very common and is usually due to lifting a heavy load.
Carpal Tunnel Syndrome
This syndrome involves the compression of the median nerve on the palmer surface of the wrist. The nerve and the tendons of the muscles which flex the thumb and fingers, pass through the carpal tunnel under the transverse carpal ligament. Characteristic symptoms are intense pain, numbness and tingling in the index and third fingers.
Inflammation of the plantar fascia is an irritating and painful condition. The fascia is a firm tissue which stretches from the heel bone to the toes on the sole of the foot. If the condition persists, the stress of the fascia on the heel produces a heel spur. Conservative treatment is helpful but the condition may recur if preventive measures are not utilized.
Sore throats & Tonsillitis
Infections of the mouth and throat are very common and occur in children and adults of all ages. Pain is usually accompanied by fever, hoarseness, and in the case of Tonsillitis, the tonsils are swollen with difficulty on swallowing.
Earache is very common in children and can also be quite intense in adults. Some of the causes are infections in the external ear canal, the middle ear, foreign objects in the ear, barotrauma and rupture of the eardrum.
Chest pain is caused by many illnesses and is a frequent complaint. It may be caused by heart conditions, lung diseases, stomach disorders, trauma- for example, rib fractures and muscle disorders. Pain is relieved by treatment of the underlying condition.
Pain management is very important during recovery after surgery. It has been shown to assist with quick recovery, permit early mobility, and shorten hospital stay.
These conditions are just a brief summary of some of the common types of pain seen in the healthcare system. It is important to identify the underlying causes of these painful symptoms so that appropriate treatment can be prescribed. It is also important to apply preventative measures where necessary. •