International Journal of Pain Research and Treatment

  • HOW SURGERY SAVES MONEY: A PARADOX EXPLAINED

    “A new analysis from U.S. federal government actuaries say that Americans spent $3.65 trillion on healthcare in 2018, according to a report from Axios. “1 This impacts on companies, where health insurance benefits are the second largest cost in a service business, and 3rd largest in manufacturing business2. Back pain alone accounted for $86 billion a year in 2008 3. The top 5 expenses for a commercial line of insurance were for back pain, osteoarthritis, childbirth, injuries, and non-hip/non- spine fractures4. Work related injuries cost an estimated $1.2 trillion annually, which includes lost wage payment, medical care, and short and long term disability5. Of all health care expenses paid by a company, workers’ compensation becomes the most expensive, since the company pays not only for medical care, but also the lost wage of the employee. This is usually 66% of the employee’s salary, which come to the employee tax free. This provides the employee with essentially the same income received when at work. These generous benefits lead insurance adjusters to suspect potential for abuse. Estimates of fraudulent claims range from 1% to 80% depending on unsubstantiated reports in the insurance literature6,7,8,9. However, methods to identify fraudulent cases are not always productive. The State Auditor of the State of California reported that the $30,000,000 a year spent by the State of California to detect workers’ compensation fraud was not cost effective10. Detection methods used include Functional Capacity Evaluations (FCEs). However, Feeler and Schapmire in a review of 180,000 patients found that FCEs were subjective and had no predictive nor diagnostic value11. Attempts to blame prolonged recovery on psychological issues, using the Minnesota Multiphasic Personality Inventory MMPI are consistently thrown out of court often 12. The most reliable method of fraud detection is the Pain Validity Test, which can predict with 95%…

  • THE IMPORTANCE OF SPIRITUALITY IN COPING WITH PAIN IN THE PERSPECTIVE OF PARENTS, IN FRONT OF THE COMMUNICATION OF THE DIAGNOSIS OF CHILDREN AND ADOLESCENTES CANCER

    Introduction: In Brazil it is estimated that there will be 12,500 new cases of cancer in children and adolescents (up to 19 years). It is considered the second cause of death in the kids and adolescents population,for allregions of Brazil, according to the National Cancer Institute (INCA). Even with advances in medicine and a significant increase of about 70% in the survival rate of patients, cancer is still associated with death, pain, loss and suffering, bringing family, personal and social repercussions to patients and families. Objective: This study aimed to identify the importance of religiosity and spirituality as a coping mechanism used by caregivers in relation to the diagnosis of childhood and juvenile cancer. Method: Qualitative descriptive study. Approved by the CEP of the Institute of Integral Medicine Prof. Fernando Figueira – IMIP, with CAAE 10829312.0.0000.5201. Participants were 10 caregivers of patients under going treatment at a pediatric oncolog yunitat a reference hospital in the cityof Recife / PE. Results and discussion: The reports showed the relevance of spirituality as an emotional support to caregivers, a source of Faith and hope in understanding the coping strategy used, in the face of pain, anguish and uncertainty experienced in the search for re – signification and understanding of cancer and its treatment. Conclusion: Considering the importance of the caregiver as essential in the patient’s coping with the disease and treatment, it is concluded that he experiences stress with the impact of diagnosis, seeking in religion and spirituality, an attempt to develop healthier ways of dealing with the suffering and confrontation of children and adolescentes cancer.

  • THE PAIN OF WHO CARES FOR HEALTH: WHAT IS THE COMPASSION FATIGUE?

    Background: Health workers get sick annually because of the characteristics and routine of their work and the peculiarity of dealing with the pain of others. Being sensitive and predisposed to care for the other suffering, involves empathy and compassion. Continuous and prolonged exposure to this labor context can generate stress and exhaustion of the professional, due to prolonged affectation with the pain and suffering of others, which can cause fatigue through compassion. Objective: to reflect about compassion fatigue in the context of health. Methodology: bibliographic review. Results and discussion: Health professionals present a commitment that moves them to relieve and intervene in the pain of the other. When the care is lived exhaustively and chronically, with the excessive use of compassion, it can directly affect the health of the worker, interfering in their quality of life and in the execution of their work, leading to fatigue by compassion. Final considerations: Fatigue of compassion can impact psychologically on health professionals and the ability to tolerate pain and suffering of the patient, interfering negatively in their work. Therefore, it is necessary that more research be developed in the different fields of professional work in health, aiming to stimulate reflections and actions focused on the quality of life of these professionals

  • THE ROLE OF BASIC CARE IN FOLLOW-UP PATIENT WITH CHRONIC PAIN

    INTRODUCTION: Chronic pain can be considered a pathology and not just a symptom, which negatively influences people’s quality of life, causing a decrease in autonomy, isolation and impact on social life. In this context, considering the pain related to chronic health problems, it can be stated that Primary Care represents a strategic service due to its high capillarity and potential to identify health needs of the population, supporting the organization of care throughout the healthcare network. health services. OBJECTIVE: To discuss the role of primary care in the management of patients with chronic pain. METHOD: This is a descriptive study of qualitative approach, conducted through literature review. DISCUSSION: Social determinants can be considered to strongly impact the prevalence of chronic diseases as well as their reflexes such as pain. Social inequalities, differences in access to goods and services, low education, and inequalities in access to information generally determine a higher prevalence of chronic diseases and diseases resulting from the evolution of these diseases. In this context, Primary Care plays a fundamental role as it represents a high capillarity strategic service. CONCLUSION: Primary Care has great potential to identify the health needs of the population, supporting the organization of care throughout the health services network, contributing to factors that negatively impact the health of the population causing pain and psychological distress.

  • LORBOR PAIN IN CANE CUTTERS: THE CONTRIBUTION OF ERGONOMICS IN HEALTH EDUCATION ABOUT PREVENTION: EXPERIENCE REPORT

    Objective: To identify the understandings of sugarcane workers on the contribution of ergonom-ics in the prevention of low back pain. Understanding that knowledge of issues pertinent to this field is fundamental, members of Uninassau’s academic health and safety union have held talks with sugarcane cutters. Results: These professionals seek in the cane cut a way to support their families. We believe in the potential of each sugarcane cutter that participated in an active and collaborative way during the activities. Starting from the qualitative and descriptive approach of this experience report, we find methodological subsidies in oral history, as a way of listening and dialoguing with the subjects during the conversational wheels. Considering the purpose of the study, several lines were observed during the wheels. Conclusion: They indicate that although cane cutters understand ergonomics as a relevant element in the prevention of postural con-straints and consequently the prevention of pain in the lumbar before, during or after their work activities, their understandings about the working environment in the cut do not seem to have any impact in consolidating a broader and more critical formation.

  • BENEFITS OF LUDIC ACTIVITIES IN MODIFICATION OF PAINFUL FEELING OF CHILDREN WITH CANCER IN HOSPITAL INSULATION UNITS

    Introduction: In relation to the negative impacts of pain on the quality of life of the child with cancer, they tend to represent an environment of frustration, fear and anxiety, and this should identify and stimulate the use of effective strategies, since distraction, presence family members and playful activity help to minimize these painful sensations as well as social issues as the child leaves home and friends and moves inward for a period of time, so it is of great relevance for the care of children with cancer, not only invasive treatments but also dynamic strategies that rescue the child’s joy and the stimulation of living. Objective: To relate the benefits of playful activity in the treatment of children with hospitalized cancer, and the reduction of pain sensation. Methodology: This is a bibliographical review of the integrative type. Result: The distraction that play activities bring besides being defined as one of the intrinsic characteristics of playing can also be an important auxiliary tool in coping with acute painful situations, and helps in recovery. Conclusion: In this way, it is of fundamental importance to the use of play activities, because even with all the difficulties of hospitalization, the child tends to have a good recovery behind the realization of these dynamic practices as well as develop abilities throughout their treatment.

  • Ergonomics as an Intervention of Health Education in the Prevention of Lumbar Pain and The Legs in the Trucks of the Gasoline Posts of BR 101 Alagoas

    Objective: To describe ergonomics as a health education intervention through members of the UniNassau multidisciplinary academic leagues and students of the Nursing, Nutrition, Medicine, Physical Education and Physiotherapy courses at UFAL / UFPE in the prevention of low back pain in truck drivers of gasoline in BR 101 Alagoas. Results: This is a descriptive study, an experience report, with activities carried out with BR 101 Alagoas truck drivers. Intervention activities included guidelines on RSI, DORT, Workplace Gymnastics, Relaxation, Stretching, Postures, Cognitive Ergonomics as Stress in the Direction during Transit and Cargo Burglaries. The approaches by means of conversation wheels, counted on the measurement of the arterial pressure, verification of anthropometric measurements and evaluation of body mass index, as well as, practical demonstrations of health care, such as workout gymnastics and relaxation. Conclusion: It was evidenced that the health education activities through the Ergonomics to the truck drivers incorporated the characteristics of intervention directed to the reality of the target public, as an active subject of the process of care to improve the quality of work life.

  • ORAL MUCOSITE AND EMPLOYMENT OF LOW INTENSITY LASER

    Background: Oral mucositis is an inflammatory toxic reaction of the oral mucosa due to exposure to chemotherapeutic agents or ionizing radiation, being one of the most frequent side effects of antineoplastic treatment. It is found in almost 100% of patients submitted to radiotherapy in the head and neck region and can cause dysphagia and infection by opportunistic microorganisms. It is considered the most common cause of oral pain in these patients. This pain can reach significant levels, compromise nutrition, and even lead to treatment modification or discontinuation. Objective: to describe the efficiency of low level laser therapy in the control of pain and oral mucositis. Methods: case report and literature review contextualized to the proposed theme. Results: J.A.P, male, 56 years old, fisherman. Diagnosed with squamous cell carcinoma (AP nº 173864) in posterior wall of oropharynx. The recommended antineoplastic treatment involved surgery with chemotherapy (CDDP weekly) and adjuvant radiotherapy. The patient was being submitted to radiotherapy with 180 cGy / day. At the 11th week of therapy, he developed severe pain and difficulty feeding and was referred to the Dentistry Oncoly Center service of the Oswaldo Cruz University Hospital. On intraoral examination was verified the presence of ulcerations on the back of the tongue, buccal floor and right and left jugal mucosa, characterizing oral mucositis grade III, according to the classification of the World Health Organization. And in the Numerical Pain Scale the patient listed the number 8. The antineoplastic radiation therapy was temporarily suspended. The Standard Operational Protocol for Oral Care (POP-Oral) of the service was instituted and the use of low-level laser (Laser Duo MMO) with the wavelength of 660nm, power of 35mW. In the second session of photodynamic therapy, the patient already reported improvement in food acceptance, and listed number 5 in the Numerical Pain Scale. Photodynamic…

  • Alternative Measures to Chronic Pain Management

    “No pain no gain” still is one of the most widely used inspiring quote. With that spirit, chronic pain sufferers should find heaven on earth at some point of life. However, chronic pain is a widespread and complex set of conditions that are often difficult and expensive to treat. The Institute of Medicine (US) estimated that chronic pain affects over 100 million Americans [1] and is associated with $874 billion in healthcare costs annually [2]. Of this, close to 10% ($78 billion) is associated with the economic burden of prescription opioid overdose, abuse and dependency [3]. Pain increases depression 3-5-fold [4-6] and 50–90% of chronic pain patients report insomnia that warrants clinical attention [7-10]. Conventional pain killers are usually associated with a variety of adverse side effects, such as constipation, urinary retention, nausea, sedation, respiratory depression, low platelet count, sexual dysfunction and hyperalgesia [11-14]. Pain affects more than 65% cancer patients [15], distressing or intolerable in more than one‐third of patients [16]. Although, WHO described opioids as essential medicines for pain control but distribution shows substantial inequity, 10% of the world’s population consuming more than 90% of the world’s supply [17], 80% opioids consumed by US alone [18-23]. Famous celebrities like Bruce Lee, Chris Penn, Elvis Presley, Heath Ledger, Anna Nicole Smith died from opioid overdose. Also, some 85% of primary care physicians perceived their training in pain management to be inadequate in a Pan-European survey [24,25]. Along with these, fear of dependence, prescription diversion, regulatory scrutiny, withdrawal symptoms, opioid-related adverse events and deaths limit its use. Although, abuse and availability of medical cannabis are big issues, several studies support use of cannabis/marijuana in cancer pain management [26-36]. Its social acceptability is gradually increasing around the world [37], but many studies oppose it’s use or at least demand further investigation…

  • THE ROLE OF BASIC ATTENTION IN THE ACCOMPANIMENT OF PATIENTS WITH CHRONIC PAIN

    INTRODUCTION: Chronic pain can be considered a pathology and not just a symptom, which negatively influences people’s quality of life, leading to a decrease in autonomy, isolation and impact on social life. In this context, considering the pain related to chronic health problems, it can be affirmed that Basic Care represents a strategic service due to its high capillarity and potential to identify health needs of the population by subsidizing the organization of care throughout the network. health services. OBJECTIVE: To discuss the role of Primary Care in the management of patients with chronic pain. METHOD: This is a descriptive study of a qualitative approach, carried out through literature review. DISCUSSION: Social determinants can be considered to have a strong impact on the prevalence of chronic diseases as well as their reflexes, such as pain. Social inequalities, differences in access to goods and services, low level of schooling and inequalities in access to information generally determine a higher prevalence of chronic diseases and diseases caused by these diseases. In this context, Primary Care plays a fundamental role because it represents a strategic service with high capillarity. CONCLUSION: Primary care has great potential to identify the health needs of the population by subsidizing the organization of care throughout the health services network, contributing to factors that negatively impact the health of the population, causing pain and suffering.