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Controlling Wound Pain

Pain is referred to as an unpleasant feeling of   physical suffering due to an injury or illness. The response that each patient has, to pain can vary significantly.

What causes wound pain?

  • Wound pain is normally classified in two groups: nociceptive and neuropathic.
  • Nociceptive pain refers to a pain which is generated due to damage, in the tissues. This type of pain is typically described as an aching or throbbing. The nerves affected send a message to the brain to reflect the pain.
  • Neuropathic pain refers to a disorder of the nervous system.  Each of these types of pain have exclusive starting points and features and the way they respond to treatment may be totally different. This type of pain is described as tingling, lancinating or burning.  This type of pain is often the main reason for chronic pain.
  • Neuropathic and nociceptive pain function as the preliminary medical foundation of pain. However, the signs, symptoms and causes of pain can be diverse.
  • Operative pain is the kind of pain that is endured after an invasive surgical procedure such as a biopsy or the removal of dead tissue from wounds (debridement).
  • Incident pain happens around the wound area due to normal actions, which occur in the course of the day such as walking, sneezing, coughing or simply switching positions.
  • Background pain can occur at irregular intervals or it can be a persistent pain at the wound site which can even be felt while resting.
  • Procedural pain is the one experienced during medical procedures such as changing medical coverings or wound dressings.

Alternatives on how to treat and control acute and chronic wounds

Acute wounds must be treated following a well-planned and exhaustive procedure to allow for a faster and better healing process. Surgery fundamentals state that if a wound has not healed in the course of four to six weeks, it must be categorized as a chronic wound. Various procedures are recommended to treat and control acute and chronic wounds, however the main objective, disregarding the treatment used, is to promote enhanced healing and satisfactory results.

There are different forms of treatment available which do not involve the use of any drugs or invasive surgical interventions. These options aid in alleviating and reducing pain and can serve as great stimulants for the tissue.

  • Ultrasound therapy
  • Pulsed radio frequency energy (PRFE)
  • Transcutaneous electrical nerve stimulation (TENS)

It is recommended to start a gradual assessment of pain alleviation by administering non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen. Moving forward to a gentle narcotic and onward to a stronger one if necessary may generate addictive behaviors. This is why extra care must always be present, when prescribing these drugs. Studies have shown that the use of medications to prevent convulsions (seizures) can be a great alternative to managing pain in wounds.

Another great alternative to reduce pain during the process of changing dressings is to apply a topical anesthetic to numb the surface of the body part being treated, in this manner the patient can better withstand the pain. Sometimes the option of an epidural or nerve block or a lumbar sympathectomy can be applied to manage long-lasting and disabling wound pain.

Specialists strongly recommend allowing the patient to fully engage in the decision as to which pain control treatment to use and the process of changing dressings as well. By doing this, health professionals help to alleviate uneasiness and any other feelings of distress that may arise before and during the treatment.

Different soothing methods like listening to a song can significantly help the patient to feel calmer and more comfortable during the removal and placement of medical dressings. Creating a variety of options for pain alleviation prior to the dressing change is of utmost importance. In this manner, the patient will have a less painful experience and a more satisfactory healing process.

It is imperative to be reminded that prevention and control of wound infection is a key component. Once a wound gets infected, pain will become more intense. Antimicrobial and antibiotic therapies can be effective for minimizing infections and related pain, if the status of the wound and drainage culture results allow these methods to be employed. Other alternatives that function well to control pain, are intravenous or oral antibiotics. During the dressing change procedure, some health professionals may include topical antimicrobial therapy if considered feasible to treat an infected wound. Nevertheless, all this depends on the status of the wound and evidence of bacteria in the infection.

The life of a patient can be drastically affected by wound pain. Fortunately, health care establishments have a wide variety of pain control options to choose from and therefore provide a better medical experience to the patient. Some of the treatments available are the following: Non-invasive, invasive, non-pharmaceutical, pharmaceutical, palliative, and aggressive. A health professional is able to advise the patient which is the best option to choose in order to treat and control acute and chronic wound pain.

Sometimes the process might become a trial-error experience since doctors and patients may need to test different methods to find out which one is the best for each patient’s need. Choosing the best and most effective option, has to do with the patience, experience and knowledge acquired by the specialist throughout his or her career as well as the patient’s engagement in the process.

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