The other day, around 1 AM, I got a phone call from my close journalist friend that his mother attempted suicide due to severe, unbearable pain after a surgery for her cancer. Yes, we do encounter this sort of issue often. In fact, because of ignorance of even the elite until crucial situations fall on their heads like this, many of them do not think of palliative care and pain management that has been available widely in our country from the last nearly four decades. The first hospice opened in 1986 in Mumbai, marking the formal introduction of palliative care in India. The Pain and Palliative Care Society (PPCS) was formed in 1993 in Calicut. The Indian Association of Palliative Care (IAPC) was established in 1994 to advocate for and develop the field.
Pain is one of the most common symptoms with which patients come to doctors of all systems, such as allopathy, (conventional) homeopathy, ayurveda, Yoga & Naturopathy, Unani, Siddha, and also other systems like Sowa Rigpa, acupuncture, and energy therapies. Some other people consult spiritual gurus, Buta Vaidya, or even past patients. The pain is the best friend of the patient, which gives a warning or gentle advice to take care of themselves herself indicating something wrong is happening in the body. Had symptom of pain is not their major portion of patients might not go to a doctor at all. In fact, the bare truth is that as many lumps and cancer growths are painless in the body, hence people ignore them and consult a doctor only in the third stage or fourth stage at that point not much intervention is help can be done the patient.
The systems mentioned above often take a holistic approach to health, focusing on preventing disease and promoting well-being through distinct philosophies and treatment methods. Further, some individuals go to traditional systems of medicine that are practiced by individual cultures throughout the world. Major Eastern whole medical systems include traditional Chinese medicine (TCM), Kampo medicine (Japanese), and other systems developed by Native American, African, Middle Eastern, Tibetan, and Central and South American cultures.
What is pain?
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is one of the most common symptoms for which people seek health-care advice. Our understanding of the mechanisms of pain has evolved considerably from the era of Hippocrates’ suggestion in 450 BC that pain arose as a result of an imbalance in vital fluids to new theories. We now know that pain is a complex symptom that is influenced and modified by many social, cultural, and emotional factors.
The bio-psychosocial model of pain can be illustrated by the perception of pain as a symptom that is dependent not only on sensory inputs but also on the individual’s cognitive reaction to the pain, their emotional state, their underlying disease, and their social and cultural background. A cognitive response is the mental process of thinking, evaluating, and interpreting a stimulus, such as a message, event, or piece of information. It involves thoughts, beliefs, and judgments that occur internally and influence how a person perceives and reacts to something, often shaping their attitudes and behaviours. The sensation of acute pain that occurs in response to inflammation or tissue damage plays an important role in protection from further injury. Chronic pain serves no useful function but results in significant distress and suffering for the patient affected, as well as having a wider societal impact.
Pain and palliative care
Pain and palliative care are specialized medical approaches focused on improving the quality of life for patients with serious or life-limiting illnesses by relieving suffering through the management of physical, emotional, and spiritual symptoms. It involves a team-based approach to assess and treat pain, as well as other issues like anxiety, fatigue, and nausea, and supports patients and their families at any stage of illness, not just at the end of life.
Pain Management
Palliative care is used to manage a disease or medical condition that is serious or life-limiting. The goal is to ease pain and other physical, emotional, or psychosocial symptoms. Palliative care also aims to ease other distressing symptoms, like depression, anxiety, fatigue, insomnia, and shortness of breath. Palliative care provides advanced care planning and a support system to help to lead a life that is as active, fulfilling, and pain-free as possible.
Palliative care may last for weeks, months, or years, and the relief of moderate to severe pain during that time can greatly improve quality of life. The biggest problem with palliative care is that many people are referred for care very late in the course of the disease. By initiating this type of care early and utilizing the appropriate pain management techniques, nearly all pain problems can be alleviated or significantly reduced. The principles of palliative care, including pain medicine and other pain control interventions, will be discussed in the coming issue. (To be concluded).
