Interviewed experts: Deputy Director of the Pain Department of Aviation General Hospital Wang Yong
Global Times Health Client Reporter Wang Bingjie
Today, there are more than 300 million chronic pain patients in my country, and they are growing at a rate of 10 million to 20 million per year. Pain has become the third largest health problem after cardiovascular and cerebrovascular diseases and tumors, and seriously affects people's health and quality of life. Recently, my country's first "Cognitive Survey Report on the Prevention and Treatment of Common Pain in Middle-aged and Elderly" (hereinafter referred to as the "Report") shows that middle-aged and elderly people generally underestimate the severity of pain.
Pain is not only a "feeling", but also a common clinical symptom, often a warning of damage to human body or disease invasion. Once the duration is 1 month or even more than 3 months, it can be considered an independent disease - chronic pain. The report shows that 56.6% of middle-aged and elderly people generally suffer from at least two common pains, but this "send signal" is generally ignored by middle-aged and elderly people. The results of this survey show that among the perceptions of middle-aged and elderly people, the top four common pains are:
skeletal muscle pain (such as cervical spine, lumbar back, and intervertebral disc pain): accounting for 80.4%.
This pain is a common chronic pain in clinical practice. The "Expert Consensus on Drug Treatment of Chronic Musculoskeletal Pain (2020)" subdivides it into 6 types:
Bone pain is generally located in the "deep", often a kind of dull pain, stinging or dull pain, which is often caused by traumatic fractures, osteoporosis , osteopenia and other injuries. To relieve pain, the primary disease must be treated first.
Muscle pain is lighter than bone pain . It often occurs during motor injuries such as sprains, muscle cramps or spasms, and may be relieved after rest and stretching; it may also be due to the autoimmune reaction that causes the blood supply of muscle to decrease, and symptomatic treatment is required.
The pain of tendons and ligaments is "sharp pain". After suffering from tendonitis , tendonitis , tendon injury and other diseases, the pain will worsen when the damaged tendons and ligaments are pulled and can be relieved after rest.
Spine-derived pain is related to spinal degeneration, such as spinal stenosis , intervertebral disc herniation, etc., which can cause "sequences of" pain, from the neck and shoulders to the waist and back.
Pain in many parts is mostly caused by systemic diseases such as rheumatoid arthritis and fibromyalgia. Systemic and symmetrical pain often occurs in multiple parts.
Pain caused by diabetic neuropathy: 53.1%.
In recent years, the prevalence of diabetes in my country has increased year by year, especially in the elderly, and the prevalence has remained high. Since the patient is in hyperglycemia for a long time, nerve cells can be directly "toxic", causing neuropathic pain. This pain often occurs in the limbs, such as numbness, ants, etc., or "burn-like" resting pain , initially limited to fingers or toes, and then gradually spread upward, light in the day and heavy in the night, seriously affecting the quality of life.
Generally speaking, the longer the disease is, the worse the blood sugar control is, and the greater the possibility of neuropathy pain in the patient. Since hyperglycemia is the primary cause, patients must strictly control sugar to reduce the incidence of peripheral neuropathy in diabetes. Since there are no obvious symptoms in the early stage of diabetic neuropathy, patients with type 1 diabetes should be screened for diabetic neuropathy after 5 years of diagnosis, and should be screened immediately after 2 diabetes and at least once a year in the future.
Head and maxillofacial pain: accounting for 48.4%.
In clinical practice, most headaches are primary headaches and the cause cannot be confirmed, such as migraine , tension headache , cluster headache , etc. If the exact cause can be found, such as intracranial vascular disease, sinusitis , intracranial infection , etc., it is secondary headache.
It should be noted that although most headaches are not caused by serious diseases, if headaches occur frequently, or new severe headaches, accompanied by temple tenderness, increased blood pressure, blurred vision, continuous aggravation, or headaches with fever, neck stiffness, etc., you need to seek medical attention as soon as possible.
Maxillofacial pain is common in trigeminal neuralgia, which is more common in middle-aged and elderly people.This pain is severely cut, burning, and electric shock-like. There is no sign before the attack. It mainly appears in the eyes, cheeks and other parts. Although it can return to normal in a short period of time, it often occurs repeatedly. Clinical treatment is often done. If the efficacy is not good, surgical treatment such as microvascular decompression can be performed.
shingles-related pain: accounting for 40%.
Herpes zoster is common in the elderly with poor resistance. If the acute phase is not thorough, it can leave behind postherpes zoster neuralgia, and the pain is burning, electric shock, and knife-cutting. Therefore, after shingles appear, you need to seek medical treatment as soon as possible. The golden period is treated within 48 to 72 hours after the rash occurs. The longer the delay, the more severe the neuralgia will be.
The report shows that after the pain occurs, nearly half of middle-aged and elderly people choose to "tolerate", and the older people are, the more they can tolerate it. But pain has one characteristic: the longer it drags on, the harder it is to treat. Otherwise, it will become chronic and even last a lifetime. For example, after postherpetic neuralgia develops into severe and stubborn pain, you will miss the best period for treatment of nerve block.
Therefore, in the face of pain, middle-aged and elderly people should not show off. More than 90% of chronic pain can achieve satisfactory treatment results. Generally, if it is acute or caused by the primary disease, you can go to the corresponding department for treatment. For example, if you have acute abdominal symptoms, you should go to the general surgery department, and you can also go to the pain department for treatment; if it is chronic, stubborn and the cause cannot be determined, you can go to the pain department for treatment directly. ▲
