Chronic Pain

What factors may effect how pain is perceived?
Pain is a subjective experience to an objective stimuli, therefore varies significantly between individuals and situations. The amount of pain experienced bears little relation to the degree of tissue damage. 60% of injured soldiers reported little or no pain following severe injuries in battle. This is presumably related to the overriding need to survive. So called phantom pain occurs in a "part" of the body which has been amputated.
Anxiety is perhaps one of the main factors which exacerbates pain. Other potentially influencing factors in pain perception include expectation, cultural factors, emotional status, personal circumstances and the immediate environment.
What are the signs and symptoms of pain?
The individual may describe the sensory experience of pain if he or she is able to do so. Pain is also an unpleasant disturbing affective experience. The autonomic nervous system may be effected causing sweating and increasing parameters such as respiratory rate, pulse and blood pressure. If pain is prolonged and severe blood pressure may drop through the mechanism of neurogenic shock. There is also usually motor expressions of pain, such as thrashing about or lying still, facial expressions and general agitation, this is often accompanied by some vocalization consistent with the symptom of suffering.
How may the degree of pain be assessed?
Pain threshold is the point at which a stimuli is first described as painful. Pain tolerance is the point when a subject is forced to withdraw or to ask for the inducing stimuli to be withdrawn. Nurses may observe for signs of pain as mentioned but should wherever possible join with the patient in pain assessment. A pain "thermometer"(15) asks the patient to assess their own pain from no pain at all, a little pain, quite a lot of pain, severe pain to unbearable pain, this may be done on a scale of 0 - 5 or 0 - 10.
How do analgesics work?
Aspirin and NSAIDs block the synthesis and secretion of prostaglandins, therefore prevent nociceptor sensitization. Other non-steroidal anti-inflammatory drugs also have analgesic properties. Opioid analgesics work by fitting into opioid receptors in the brain and spinal cord. These receptors exist for the bodies own opioid molecules such as the endorphines. General anaesthetics depress the function of the consciousness centre in the brain. Nitrous oxide reduces nervous transmission by acting on the neuronal membranes. Local anaesthetics block sodium channels in peripheral nerves.
What is the role of the nurse in pain management?
Each patient must be individually assessed and believed. The well known statement of McCafery is still valid, "pain is whatever the experiencing person says it is existing whenever he says it does". Any reports of pain must therefore be believed and acted upon. In addition nurses should be able to anticipate and prevent the occurrence of pain. Full psychological support must be given to minimise anxiety. Analgesia should be given and the effects monitored, if the pain is not effectively relived an alternative preparation should be considered in consultation with the medical staff. Patients must never be forced to wait for four hours after the administration of an non-effective analgesic. The risk of addiction from correctly administered analgesia is essentially not a potential problem.
Pain may be relieved through simple nursing measures such as optimal positioning of the patient, supporting with pillows, slings etc. Wounds may be much less painful if kept moist. Stretching a cramped muscle will relieve spasm. Ice packs and warm baths may also be selectively used. Acupuncture, massage and trans cutanious nerve stimulation may be used by suitably trained practitioners. Psychological diversion may be employed to distract the patients attention from some pains.
Increasing the patients level of control over their situation can be a helpful aspect of pain management. This principle is applied in the increasing use of patient controlled analgesia, (PCA). In addition to analgesics, pharmacological management may include the use of anticonvulsants, tricyclic antidepressants, antispasmodics, muscle relaxants, steroids and non-steroidal anti inflammatory drugs. Opioids and local anaesthetics may be given via the epidural or intrathecal route.

[@PureLogic777]

You're a very good teacher. Thank you for these lectures. I love them.

[@PureLogic777]

How prolonged untreated pain can cause nociplastic chronic pain is one of the most important things I've ever learned. In my case I've learned that I'm very susceptible to developing chronic pain because before I started treating my acute pain from injuries with an NSAID then even minor injuries would bother me for many weeks or months with allodynia, but if I take an NSAID soon after the injury I'm preventing the central sensitization from occuring in the first place, therefore I'm not risking it getting stuck in that sensitzed state to cause chronic pain after the injury has even healed. Thank you for these lectures.

[@johnathanabrams8434]

NSAID isn't gonna do shit for chronic pain

[@jadewilson7412]

Thanks John, You are an awesome teacher!!!

[@geeuphorsey]

Brilliant! Exactly what i needed to know to understand chronic pain! Thank you!

[@levinericky8584]

"Does anyone with chronic illness doubt natural herbs? I have seen the great importance of natural herbs in my life and the wonderful work they have done in people's lives. I wonder why people still spend their money on drugs.. you can get a confirmation yourself by joining is WhatsApp group chat.whatsapp.com/DkHm2gv0yZ2Aff4V1H5Uvc for solution

[@alikteich9169]

Dr jhon your presentations are easy to understand you are amazing

[@RunPJs]

Incredibly useful video....time now to look for something more up to date 😉

[@AbdulRahman-sh3jd]

Nice one

[@petramajernikova3260]

Thank you

[@geojor]

new to me, thank you...

[@faranakjafari1413]

thank you really really

[@phillipmyglass4543]

THANK YOU!!!!

[@raogongfu]

Hi Dr Campbell great video lectures. Can I just ask how do theories such as wind up and long term potentiation relate to the glial interaction concept?

[@levinericky8584]

"Does anyone with chronic illness doubt natural herbs? I have seen the great importance of natural herbs in my life and the wonderful work they have done in people's lives. I wonder why people still spend their money on drugs.. you can get a confirmation yourself by joining is WhatsApp group chat.whatsapp.com/DkHm2gv0yZ2Aff4V1H5Uvc for solution

[@joseemiliano5947]

Great, thank ya!

[@AllThingsConsidered333]

I deal with pain every day due to chronic tick diseases. It’s everywhere in my body but mostly in my lower legs & feet. It burns and it feels more like it’s in the fascia & nerves more than muscle or bone (although I get that too) I had several severe cases of body wide rhabdomyolysis (from bartonella) and I nearly died as it was shutting down my kidneys & liver. Since then the pain has been very persistent, every day. Some things increase pain tremendously, like stress response, high oxalate foods, foods high in lectins or sugars. Damp weather also flares the pain. I take narcotics (baby doses bcs my body so super sensitive these days) but all it really does is separate me from the pain it rarely ever takes the pain away. I would love to not be in pain every day. Usually I can deal with it but sometimes it makes daily life incredibly difficult.

[@shacklesofillusion]

You are not alone. I'm a cancer survivor and multiple kidney survivor. My kidneys failed 48 hours after being taken out of a catheter. I've lived with chronic pain thru out my body for 4 years now. I also have diverticulitis and 2 autoimmune deseases. I also had gallstones which made me live in fear of eating. I need hernia, shoulder,knee and possibly neck and back surgery. On top of a prostate procedure. I'm 56 years old and I have a body of a 76 years old. I do the same I take half of a half of a pain pill. Sometimes they work other times they cause me nausea. Anxiety,stress and depression and insomnia made it all worse. I'm taking a stand to reclaim my mind,body and soul no matter what! Stay strong and never give up! God Bless!

[@AllThingsConsidered333]

@@shacklesofillusion I’ve been watching Eliot Overton’s videos (EONutrition) about b1 megadosing and the benefits.. I did it for a few months and had improved energy & stamina & greatly reduced pain. About 2 months after I stopped, everything started getting worse again. I just watched his most recent videos on the topic and have restarted ramping up b1 in the forms of TTFD & benfothiamine. Also taking b-complex, trace minerals & electrolytes. I guess if I need to supplement forever then I will if it gives me ability to do the things I want to do and be active

[@lylcanadaful]

Guided exercise and pain science education should be at the forefront of the interventions required

[@Tpainkiller21]

Why dosent this always happen? What makes glial cells creat this cycle for only 10 percent of the cases?

[@thebillfan123]

ohmg another one of these video, if only they were acurate, i have been using the above techniques and with these analgesics and still after 20 years no help, there seems to be a very obvious thing that is missing!

[@angelinet190]

Could you speak to my egotistical and unsympathetic GP who treats me like I’m an actor and painkiller seeker?? When the suffering gets too much, I start feeling suicidal. Then my doctor has brandished me manipulative. I can’t win!!!

[@mindingpaul3240]

Hey how are I it the stomach pain for me am so tired of going to doctor is your pain gone its been a year for me

[@laurahachenberg2589]

really great great video, thanks. If a person's chronic pain came purely from glial cells that would mean their pain was constant and not made better or worse by certain activity, is that correct?

[@kathryncarter6143]

Nice basic review.

[@alenimamovic5229]

Little confused right now...isn't too much of analgesics involved in hyperalgemia?

[@PureLogic777]

Taking opioids too long can increase hyperalgesia. I'm not sure about other analgesic classes.

[@pallavisreetambraparni6995]

perfect

[@sharmayogaclasses9748]

🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥🔥

[@MrMerkMarley]

So how do kill glial cells? My back hurts.

[@starscream5813]

Fantastic drawing! What's the solution!?

[@danesha4705]

There is no solution

[@leawilliams7893]

Please someone help me

[@harrytoyshirt4146]

I had morphine for 63 days until limb was amputated. Now I have chronic pain still feeling the pain that the morphine masked. Sort of invalidates his theory, altho that is a bit oversimplified.

[@Hoarax1]

Learning about TMS or MBS could be your cure. Dr. Sarno or Dr. Schubiner

[@ishouldbesleeping1354]

It’s true and horrible. I told my surgeon to make sure after my cancer surgery she only gave me 24 hours of pain medicine and I’ve been in pain ever since then it’s been two years ago

[@defeodome2]

I feel for you, my cancer treatment left me with chronic pain 5 years and counting.

[@hdv6]

​@@defeodome2😮 is your pain 24/7 ?

[@defeodome2]

@@hdv6 yes

[@hdv6]

@@defeodome2 so sorry for you. Mine too, on the face, a kind of variant of trigeminal neuralgia. Did you also meet problems with doctors trusting you etc ?

[@Truerealism747]

Vitamin c quercetin Q10 magnesium vitamin d b vitamins omega 3 if it can bet taken

[@asidevoyagemy382]

IRON IRON OH IT HURTS

[@CookieMonster-hl9eg]

I can’t walk properly 😢 severe pain

[@Simply_marshall]

Hello

[@TraceyMush]

Yes. l have long thought that pain, insufficiently treated, leads to more pain. l wish that doctors would be very aggressive when a patient comes in with pain.

[@levinericky8584]

"Does anyone with chronic illness doubt natural herbs? I have seen the great importance of natural herbs in my life and the wonderful work they have done in people's lives. I wonder why people still spend their money on drugs.. you can get a confirmation yourself by joining is WhatsApp group chat.whatsapp.com/DkHm2gv0yZ2Aff4V1H5Uvc for solution

[@MrMerkMarley]

Your marker makes a horrible sound.

[@salmanchk]

😬 i am literally feeling like this

[@charleskidney4279]

Many people are dealing with chronic pain, due to low grade latent infections. If given a prolonged dose of antibiotics would 100 percent cure them. Others the pain is there due to structural damage that won't go away till structural damage is repaired. A summary of a two stories - lyme disease - patient suffering for year's - given a prolonged dose of antibiotics - 100 percent cured. Structural pain. Man for over 10 years crippling back pain, a good chiropractor fixed him in 2 visits 100 percent. For some a way out is there. I unfortunately am not in those categories due to medical error which has ruined my life, but maybe the information might help someone

[@debbiebeckford1277]

I'm suffering from chronic pain,I see different doctor's done alot test but this pain never leave me,I'm 43yrs old and every month I have to live on pain pills,right now as I text I'm in crazy pain 3 weeks straight,omg my back pain sometimes I find myself crying and no sound just tears running down my cheeks😭,I'm tired of taking pills this pain won't let me be great,...

[@Truerealism747]

Have a look at TMS Dr schubiner also recommend oxygen therapy and good minerals I still have chronic pain but ime fighting it

[@kathycrosbie8048]

Now I understand what happened to me. I refused to take any medicines because I'm one of those "all natural" people. Now I'm stuck. So so sad....

[@PureLogic777]

Yeah I used to be one of those people. But after learning some pharmacology, science-based medicine, and the importance of treating pain, I realize how ignorant I was. Now I'm very passionate about pharmacotherapy and pain management.

[@calvinlee8076]

If you knew where and how you feel about your pain, that isn’t meant the doctor and pain medicine knew it. Rethink that how you can cure your pain by yourself

[@asidevoyagemy382]

HAHA NEVER NEVER