Pain alerts you when something bad is happening in your body, but when it lasts too long, it disrupts the body, reduces immunity, and causes depression. Therefore, chronic pain has been recognized as a disease that must be treated. Almost one third of Poles require professional help in combating it, which can be provided by pain treatment clinics. Where to look for them?

Pain , like an unwanted shadow, accompanies us from birth to death. Every tenth person struggles with migraine, every fourth person experiences back pain every day. In 50-80 percent of patients, evenchronic painis not treated at all or is not treated properly. About 50 percent of cancer patients suffer from pain.

The patient suffers because "there is nothing else for him". After all, it is believed that suffering ennobles, and pranksters say that "when a 40-year-old wakes up in the morning and nothing hurts, it means that he is dead". Meanwhile, medicine knows how to deal with pain perfectly, regardless of its origin. That is why you must not accept suffering.

If your doctor acts sluggishly or tries to convince you that you have to get used to the pain, don't put up with it. As recommended by the World He alth Organization (WHO), chronic pain, like any disease, should be treated as soon as possible. Then there are the best chances that it will be overcome with simple methods.

Pain - types of pain

Pain is our ally only when it signals danger (it warns you against burns if you put your hand close to the fire), it informs you about the disease (appendicitis, hepatic colic, heart attack). If suffering lasts too long, it causes distraction, insomnia, chronic fatigue, distress and even depression.

Acute pain , i.e. pain that lasts a short time and passes along with the disease that causes it, is useful both for us and for the doctor, because it forces us to look for its cause and specialist help. When a tooth hurts, we go to the dentist, and when the ear - to the ENT specialist. How would we know about appendicitis if it wasn't for the pain? The acute pain goes away after the disease is cured. If this does not happen, then he turns from a benefactor into an enemy.

Chronic (chronic) painis pain that lasts more than 3 months. It can accompany many diseases - degenerative changes in joints, diseasesrheumatic, migraine, neuralgia, although we most often associate it with cancer. He doesn't have to tease all the time. Sometimes it appears every day for a few hours or it occurs several times a week or a month. It always worsens the quality of life.

Pain sensation mechanism

Most often we deal with the so-called receptor pain, which arises as a result of irritation (as a result of trauma and then inflammation around the site of the injury) pain receptors scattered across our tissues. The nerve impulse from such a receptor is sent on through the nerves that lead to the spinal cord and the cerebral cortex, where pain is perceived (perceived).

Numerous substances (including prostaglandins) play an important role in this mechanism, which are produced at the site of the injury and by lowering the excitability threshold of pain receptors, they strengthen the impulse, increasing the pain sensation. This is how the knee hurts when we hit ourselves, the throat hurts when we catch infections.

About 1 percent of all pain syndromes are neuropathic pain (radicular pain, phantom pain after amputation of a leg or arm, post-herpetic neuralgia, diabetic neuropathy). Pain then does not indicate that the tissues are sick, but that our nervous system is damaged. It is most often experienced as burning or burning.

Due to the complicated mechanism of its origin, neuropathic pain is very difficult to treat - it is only possible in approx. 60% of patients. sick. Receptor pain can be overcome in almost 100%.

Chronic Pain

You have to fight every pain. When it is severe, we treat its cause and only relieve the pain. In the case of chronic pain, which is a disease in itself (it has lost its warning and defense function), you need to fight both the cause and the pain itself.

Why is it so important? Because long-term pain ruins the entire body. It leads to chronic stress that disrupts the work of all systems. People plagued by chronic pain suffer from insomnia, have no appetite, and are irritable or apathetic.

With time, there are changes in the nervous system, distortions in the psyche. We can't focus our thoughts on anything except pain, we don't feel like talking or working. People suffering from pain lose their joy in life, withdraw into themselves or become aggressive.

According to an expertMałgorzata Malec-Milewska, MD, PhD, anaesthesiologist, Pain Treatment Clinic of the Medical Center of Postgraduate Education Center in Warsaw

You can claim medical treatment

Every doctor, apart from treating the underlying disease, should deal with pain relief. Suffering is forbidden nowadays because there are methods that allow you to endure painat least to the limit acceptable to the patient. Therefore, if the doctor does not provide such help, it must be categorically requested. In the event of problems with setting painkillers, when the patient needs stronger and higher doses of drugs in a very short time or invasive methods of therapy are indicated, the doctor should refer the patient to a pain treatment clinic. The patient may request such a referral himself when he does not see any progress in the treatment. Doctors in specialist clinics deal with the treatment of chronic pain of various origins. The problem is that there are about 200 such clinics in Poland, and only about 20 are certified by the Polish Society for the Study of Pain. That is why you sometimes have to wait a while for a visit to a modern resort.

Pain resistance

The same stimulus can cause severe pain in one person, while in another it does not impress. Pain is a complex phenomenon, not only sensory, but also emotional. It depends on the individual pain threshold (lowest level of intensity of the stimulus considered painful), pain tolerance (upper limit of pain intensity), pain sensitivity (intensity scale determined between pain threshold and pain tolerance), previous experience in this area (whether the pain was repeated often) and the mood, weather, time of day.

A stressed person feels any pain more strongly. Sometimes it hurts more at night. The hormones testosterone and progesterone also have an impact on the intensity of pain sensation - their high levels make it easier to cope with ailments.

The intensity of pain can be measured. For this purpose, the most common is an 11-point numeric scale (NRS), from 0 to 10. The patient marks a point on it that expresses his pain, counting from zero (no pain) to 10 (the pain is unbearable). This is very useful - it allows you to choose the treatment appropriate to the pain you feel and control its effectiveness.

Prof. Jacek Łuczak, the honorary president of the Polish Palliative Care Association, claims that pain - apart from temperature, pressure, pulse and respiratory rate - is the fifth vital parameter and should be entered in the patient's hospital medical record.

If the patient evaluates his pain above "5" for 2-3 days, he should tell the anaesthesiologist (in Poland there is no specialization of an algesiologist, i.e. a doctor dealing with pain treatment yet) and ask for help.

Painkillers - a method of fighting pain

Although pain can be de alt with in many different ways, pharmacology is the dominant method. Most often, we make painkillers ourselves, without consulting a doctor, although we are not always aware of the side effects of overusing them. Bleeding fromgastrointestinal tract, kidney failure, liver failure, cardiovascular ailments - this is how overdosing of popular preparations may end. Meanwhile, for the drug to be effective and safe, it must be selected individually. Because what helped our neighbor can hurt us.

When choosing drugs with an analgesic effect, the doctor uses a 3-step analgesic ladder (initially this method was only used in cancer pain). It is about administering the right drug in the right dose and at the right time - as a result, obtaining the best effect while minimizing side effects (e.g. sleepiness or constipation). The dose and form of the drug (drops, tablets, plaster) are selected individually.

  • For mild pain (NRS 1-4), paracetamol and non-steroidal anti-inflammatory drugs are used. They have an analgesic and anti-inflammatory effect, incl. by reducing the production of prostaglandins, which are responsible for sensitizing our pain receptors.
  • In moderate pain (NRS 5-6), weak opioids (e.g. codeine, DHC, tramadol) are administered.
  • In severe pain (NRS 7-10) strong opioids (e.g. morphine, fentanyl, buprenorphine, methadone, oxycodone). They act on the central nervous system (brain and spinal cord).

Combining drugs with different mechanisms of action brings good results - you can then use the synergy of their action (giving smaller doses of each drug, in total, a better therapeutic effect is achieved than each of them separately).

There are also ready-made preparations that are a combination of drugs, e.g. paracetamol with tramadol or codeine. Various adjuvants are also often used (e.g. antidepressants, anticonvulsants, antispasmodics, steroids, antiemetics, etc.).

The myth that equates morphine (used in chronic cancer pain reliever therapy) with a drug lingers even among doctors. Therefore, they unnecessarily condemn the seriously ill to additional suffering. Meanwhile, as shown by American experiments carried out on 12 thousand. patients, after using morphine, only 4 people from this group became addicted to it.

In Poland, this drug is used as a last resort. And morphine, administered in the right doses under the supervision of an experienced anesthesiologist, relieves suffering and - as you can see - is extremely rarely addictive. Doctors get more and more modern preparations with morphine at their disposal.

You must do it

5 rules for taking painkillers:

  1. Read the flyer. From it you will learn when and how to take the drug and what are the contraindications.
  2. Do not exceed the recommendeddaily dose. Most drugs achieve a ceiling effect, i.e. after taking a higher dose, their effectiveness does not increase.
  3. Do not mix different non-steroidal anti-inflammatory drugs (NSAIDs) or you will accumulate side effects.
  4. If the leaflet says to take the drug every 4 hours, follow this rule to maintain a constant level of the drug substance in the body.
  5. Most over-the-counter painkillers should be taken with water after eating.

Alternative Pain Treatment

Drug treatment can support invasive treatment methods such as thermolesion or blockages (neurolysis). Indications for these treatments are available to 15-20 percent of patients suffering from chronic pain.

Thermolesion is the temporary shutdown of the pain-conducting nerve by means of an electric current. It brings good results, e.g. in trigeminal neuralgia and some spine pains. Blockades are used for a short (if local anesthetics are used) or several months (in the case of so-called neurolytic agents) shutting down nerve conduction. They work well, for example, in pain in the musculoskeletal system, after shingles, pancreatic cancer.

Sometimes the treatment is aided by physical therapy. It improves blood circulation, reduces muscle tension, and relieves pain associated with degenerative disease. Muscular and joint pains relieve relief from relaxing, stretching, loosening and strengthening the muscular corset. Treatments and exercises must be selected by a doctor.

Some people resort to alternative medicine, e.g. acupuncture, herbal medicine.

Psychotherapy is extremely helpful.

Sometimes it is necessary to perform an operation - e.g. replace a sick, damaged joint or eliminate a discopathy.

In some cases, pain transmission pathways are intersected or selected brain structures are destroyed.

How to heal and relieve pain? How to help the suffering? You will find the answer in the video below!

Where to go for help

There are approximately 80 pain treatment clinics in Poland (the first one was established in 1973 in Gliwice and de alt with the treatment of cancer pain). They are usually located in big cities, mostly near hospitals of medical schools. A referral to the clinic is issued by the primary care physician. You can find a list of institutions specializing in the fight against pain at zip.nfz.gov.pl.

Centers certified by the Polish Society for the Study of Pain

  • NZOZ VITAMED Pain Treatment Clinic - MEDIFOR Medical Center, 15-250 Białystok, ul. Kopernika 3A, phone: 85 688 31 31, [email protected]
  • Pain Treatment Clinic,Beskidzkie Center of Oncology, Municipal Hospital Jana Pawła II, 43-300 Bielsko Biała, ul. Emilii Plater 17, phone: 33 819 87 77
  • Pain Treatment Clinic NZOZ DARMED, 43-300 Bielsko Biała, ul. Krasickiego 12A (building of the He alth Clinic), tel .: 503 607 429
  • NZOZ NEURON, 41-908 Bytom, ul. Stolarzowicka 39, tel .: 32 283 11 40
  • Pain Treatment Clinic PPL NZOZ "ATOMED", 41-500 Chorzów, ul. st. Pawła 11
  • Chronic Pain Treatment Clinic NZOZ "SALUS", 43-502 Czechowice Dziedzice, ul. Sienkiewicza 8, phone: 32 214 61 19
  • Pain Treatment Clinic, SN ZOZ "PANACEUM", 41-300 Dąbrowa Górnicza, ul. Ludowa 7, phone: 32 260 05 70
  • Pain Treatment Clinic Morska Clinic, 81-049 Gdynia, ul. Morska 7 / 1-2, phone no .: 58 620 99 01, [email protected]
  • Pain Treatment Clinic, NZOZ, Border Medical Center, 40-018 Katowice, ul. Graniczna 45, phone: 32 255 49 49 ext. 849
  • Pain Treatment Clinic, Treatment District Katowice OLK-MED sp.z o.o., 40-012 Katowice, ul. Dworcowa 3,
  • phone: 32 253 52 95, [email protected]
  • Pain Treatment Clinic Department of Pain Research and Treatment, University Hospital of the Collegium Medicum of the Jagiellonian University in Kraków, 31-531 Kraków, ul. Śniadeckich 10
  • Pain Treatment Clinic NZOZ LUX-MED, 39-300 Mielec, ul. Drzewieckiego 31/36, phone: 17 773 00 55
  • Chronic Pain Treatment Clinic of the Municipal Complex Hospital, 10-045 Olsztyn, ul. Mariańska 4, tel .: 89 532 62 97
  • Pain Treatment Clinic NS ZOZ "ALGOS", 44-200 Rybnik, ul. Łanowa 11, phone: 32 739 33 88, [email protected]
  • Clinical Pain Treatment Clinic of the Provincial Hospital in Rzeszów, 35-301 Rzeszów, ul. Lwowska 60, tel .: 17 86 64 416
  • Pain Treatment Clinic. Specialist Medicine Clinic in the s.c. gardens, 37-450 Stalowa Wola, ul. Narutowicza 3A / 48, phone: 15 816 53 39, [email protected]
  • Pain Treatment Clinic NZOZ MEDYK, 58-100 Świdnica, ul. Gdynia 25a, phone: 74 852 72 27
  • Pain Treatment Clinic, West Pomeranian Cancer Center, 71-730 Szczecin, ul. Strzalowska 22, phone no .: 91 425 15 64
  • Chronic Pain Treatment Clinic, NZOZ, 43-100 Tychy, ul. Andersa 6a, phone no .: 32 219 11 77, [email protected]
  • Pain Treatment Clinic of the Military Medical Institute, 04-414 Warsaw, ul. Szaserów 128, phone: 261 816 463
  • Pain Treatment Clinic I Department of Anaesthesiology and Intensive Therapy, Medical University of Warsaw - Clinical Hospital of them. Baby Jesus, 00-668 Warsaw, ul. Emilii Plater 21, tel .: 22 629 52 30, [email protected]
  • Pain Treatment Clinic Clinic of Anaesthesiology and Intensive Therapy SP HospitalClinical prof. W. Orłowskiego CMKP, 00-416 Warsaw, ul. Czerniakowska 231, he [email protected]
  • Clinical Clinic for Pain Treatment University Teaching Hospital Jana Mikulicza-Radeckiego in Wrocław, 50-556 Wrocław, ul. Borowska 213,
  • Pain Treatment Clinic NZOZ "NOWE ŻYCIE", 29-100 Włoszczowa, ul. Mleczarska 11, phone: 41 394 44 06, [email protected]
  • Pain Treatment Clinic of the Primary Clinical Hospital No. 1 prof. Stanisław Szyszko Śląski UM, 41-800 Zabrze, ul. 3-go Maja 13-15, phone: 32 370 44 93
Worth knowing

History of the struggle with suffering

  • 3000 B.C. - a collection of "recipes" was discovered on tablets discovered in the excavations of the Sumerian city of Nippur. They talk about, for example, the pain-relieving willow bark (it contains derivatives of salicylic acid).
  • VIII century BC - in the "Odyssey" of Homer, preserved from that period, there is a mention of a mysterious drink nepenthes. Its ingredient was the juice of unripe poppies, i.e. opium.
  • 255 B.C.E. - Chinese doctor Pien Tsio introduced cannabis to treat pain; they contain tetrahydrocannabinol, a narcotic compound that relieves pain.
  • 1200 AD - the alchemist Ugo di Lucca has prepared an anesthetic with opium, Datura extract, mulberry juice, hemp extract and mandrake.
  • 1275 - the alchemist Lullis discovers the anesthetic properties of diethyl ether (forgotten for 6 centuries).
  • 1798 - English chemist Humphry Davy discovers nitrous oxide called "laughing gas".
  • 1805 - German pharmacist Friedrich Serturner isolates morphine (recognized only in 1817).
  • 1828 - German pharmacist Rafaelle Pinia isolates an ingredient 10 years later called salicylic acid from willow bark.
  • 1846 - American dentist William Morton successfully anesthetizes a patient with ether for the first time.
  • 1888 r. - phenacetin was invented, withdrawn due to its harmfulness (it was, among others, a component of "tablets with a cross" for headache).
  • 1893 - paracetamol was synthesized, which was not approved for sale over the counter until 1963.
  • 1899 r. - Henrich Dreser and Felix Hoffman launch salicylic acid under the name "Aspirin".
  • 1974 - ibuprofen - having an analgesic and anti-inflammatory effect - ibuprofen (since 1983 it has been sold without a prescription) is delivered to pharmacies.
  • 1991 - fentanyl - an opioid - in patches appears in the USA and Canada.

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