Recently, because of the experiences of a relative suffering from multiple conditions, I have been giving a lot of thought to the question of pain. In the complexity of medicine with the scores of things that go wrong with every body part, it is a rare common denominator. In the etymology of medicine, with its array of classical language suffixes, it is a stark, four-letter rebuke to the hubris of clinicians. We have the power to diagnose this, treat or at least manage that, but the question most patients want answered is, can we make the pain go away?
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- Relieving musculoskeletal pain
The International Association for the Study of Pain defines pain as: ‘An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.’ A useful marker for the clinician who can see it as a signal for a patient to seek help for a condition which unchecked will limit or end their life.
But many patients will identify more with Emily Dickinson on the grim predicament of being unable to remember a past when there was no pain, or conceive a future without it – ‘It cannot recollect when it began, or if there were a day when it was not. It has no future but itself...’
Once within the acute sector, my relative has been on a structured treatment path for his multiple illnesses. His pain relief meanwhile has ranged from paracetamol to heavy duty opioids. Pain is subjective – not just to the senses of the patient, but also to the whims of the clinician.
There is more I can write, but much, much more we don’t know. Pain needs more research, but also more compassion and care in its relief. With our present mindset, as in Dickinson’s time, pain is going nowhere.