Fran Hall, MSc Pain Management, RN.
Clinical Nurse Specialist, City Hospital, Sandwell and West Birmingham Hospitals NHS TrustNon-malignant chronic pain, no matter where it is and whatever the cause, can be extremely debilitating. It has been defined as 'pain that has lasted for three months or longer, is ongoing on a daily basis, is due to non-life- threatening causes, has not responded to currently available treatment methods, and may continue for the remainder of the patient's life' (McCaffery and Beebe, 1994). It seems to take over the patient's life and involves his or her family, friends, workmates and health-care workers. More often than not, a patient ends up in a chronic pain clinic as a 'last resort' because other health-care professionals can 'do nothing further for them'.
In an everyday situation it is obvious to health-care workers that a certain amount of controlled exercise such as gently mobilising a badly sprained ankle can effectively reduce discomfort and hasten recovery even though it may hurt initially.
Chronic pain in patients who have sometimes had pain for years remains a huge problem. Fortunately, the advent of the multidisciplinary approach to pain management (Bonica, 1985) and a heightened awareness of the need for pain-management clinics and programmes is now helping to solve some of the problems for some people.
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