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Pain management

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Some surveys estimate that around 13% of all adults in the UK – around 800,000 people – suffer from chronic unrelieved pain. Around one-third of those people say their pain is severe and about a half of people reporting chronic pain say it is constant. About one-fifth have suffered pain for at least 20 years.

The British Pain Society (BPS) – a multidisciplinary professional organisation – estimates that around 10 million people suffer pain daily in the UK.

The impact of pain on a person’s life can be significant and lead to financial insecurity because of inability to work and affect independence, relationships and emotional health.

An accurate cost to the NHS of pain is hard to calculate precisely, but the BPS estimates the cost of adolescent pain alone is £4 billion a year, while it costs the Exchequer around £5 billion a year because of people who are not able to work claiming allowances and benefits.

Pain management is an area in which nurses can play a key role by identifying patients in pain and managing that pain as effectively as possible. Nurses will probably spend the most time with patients of all health professionals so have more of an opportunity to identify and then help them with pain.

Pain has become a multidisciplinary specialty in recent years involving various professionals such as nurses, doctors, psychologists, occupational therapists and physiotherapists.

There is no coherent national policy on pain management currently because it crosses so many professional and clinical boundaries, but the BPS has a range of clinical guidelines on specific aspects of pain management and has recommendations for nursing practice.

Pain assessment tools and pain management techniques have developed over time and strategies exist for helping people to cope with intractable pain.

Spinal cord stimulation, for example, works by implanting an electrode in the spine that delivers low voltage electrical stimulation to the spinal cord. It generates a tingling sensation over the painful area and overrides or helps to block out some of the pain. It is said to work particularly well for problems such as pain after certain types of nerve injury, ischaemic limb pain, complex regional pain syndrome, and referred leg pain due to back problems or surgery.

The fundamental help that nurses can give is to ensure that patients receive proper assessment and early basic pain management to stop it becoming a chronic problem and refer patients on when necessary.

Specialist practitioners are helping in this area such as pain specialist nurses who work in hospitals and the community.

Updated: September 2006

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