Figure 5: Face, Legs, Activity, Cry, Consolability Scale. 0 1
2
Face
No particular expression or smile.
Occasional grimace or frown, withdrawn, disinterested.
Frequent to constant quivering chin, clenched jaw.
Legs
Normal position or relaxed.
Uneasy, restless, tense.
Kicking or legs drawn up. Arched, rigid or jerking.
Activity
Lying quietly, normal position, moves easily.
Squirming, shifting back and forth, tense. Moans or whimpers; occasional complaint. Reassured by touching, hugging or being talked to, distractible.
Cry
No cry (awake or asleep).
Crying steadily, screams, sobs, frequent complaints. Difficult to console or comfort.
Consolability
Content, relaxed.
Note . Image adapted from: http://www.health.gov.au/internet/main/publishing.nsf/Content/387970CE723E2BD8CA257BF0001DC49F/$File/ Triage%20Quick%20Reference%20Guide.pdf OVERVIEW OF STRATEGIES OF PAIN MANAGEMENT
Pain management has many aspects. The main goal of pain man- agement is to reduce suffering caused by an illness or injury and improve the quality of life of the affected patient. The strategies of pain management differ according to the characteristics of pain Acute vs. chronic pain management Management of pain may vary according to the time since the on- set of the pain. Pain persisting for less than 6 months is acute pain, whereas pain continuing for more than 6 months is chronic pain [16] . Very often, the causes for acute pain are identifiable. For exam- ple, the pain caused by a recently sprained ankle is an acute pain. The reasons for chronic pain may vary extensively. For instance, a dull, aching pain continuing for a long time in the small joints of the hands is chronic pain. This can be either due to a known rea- son (e.g., rheumatoid arthritis) or due to an unidentifiable cause. The main objective of acute pain management is to aggressive- ly alleviate pain and avoid pain persisting as a chronic pain. In
such as type, duration, and/or location, as well as available medici- nal and alternative techniques. There are two distinctive strategies of managing pain. They are: 1. Acute vs. chronic pain management. 2. Pharmacological vs. non-pharmacological pain management. chronic pain management, the objective is to treat the pain con- tinuously, lessen the frequency of pain, and thereby improve the patient’s quality of life. In pain management, acute pain is generally treated with medica- tions, while chronic pain can be treated through a variety of thera- peutic strategies including medications, physical therapy, and al- ternative therapeutic medicine. This is not always the case, but as physical therapy and other alternative therapies take some time to show results, medication is the best option to see rapid pain relief, especially in acute pains. any of the non-pharmacological strategies. However, medications may have negative effects on the kidneys and liver; the two main protectors of the body, but physical therapy and other alterna- tive therapies do not harm these organs. When considering the side effects, non-pharmacological strategies have no side effects, though many drugs do. There is no risk of overdosing on alterna- tive therapies, unlike drugs, which do have a maximum dosage and can lead to overdose. In terms of cost effectiveness, the phar - macological approach is more costly due to the complexity of the drug preparation process, but the rates of therapeutic sessions may vary. For example, a session of physical therapy may charge more or less than a session of acupuncture.
Pharmacological vs. non-pharmacological pain management The other most common classification of pain management in- cludes pharmacological and non-pharmacological approaches. Pharmacological pain management involves drugs and medica- tion. Analgesics (i.e., painkillers) are used to control pain. Non- pharmacological pain management comprises a variety of thera- peutic techniques. Cryotherapy, physical therapy, manipulative techniques, Pilates, reflexology, acupuncture, yoga, and medita- tion are some of the commonly used alternative therapeutic strat - egies to overcome pain. Pharmacological and non-pharmacological strategies of pain management have their own advantages and disadvantages. As the drugs act faster, they give a sudden pain relief comparative to
MEDICATION USED FOR PAIN MANAGEMENT
Pharmacological pain management has evolved over the years. The drugs used in pain relief are called analgesics . The Three- Step Pain Ladder developed by the World Health Organization (WHO) (shown in Figure 6) has addressed how mild, moderate, and severe pain should be medicated [17] . Initially, this pain ladder was created to help health care professionals relieve persistent pain in cancer patients. Later, this concept was expanded into other areas of pain medicine as well.
Figure 6: WHO’s Pain Relief Ladder
Note . Image adapted from: http://www.who.int/cancer/palliative/ painladder/en/
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