Chronic Pain in Small Animal Medicine PDF. There is no pain pathway! Pain is the result of a complex signaling network. The cognition of pain, like cognition in general, requires sophisticated neurological hardware.
Chronic Pain in Small Animal Medicine PDF
Pain has many definitions because it’s an intensely subjective experience that is filtered through our emotions as well as our anatomy. It’s any sensation amplified to an uncomfortable level, and it’s a plethora of negative emotions called ‘suffering’. No one patient feels pain the same – there is no single accepted pain experience. Like the perception of beauty, it’s very real, but only in the eye of the beholder. Yet, pain is so fundamental to our well-being that it is added to heart rate, respiratory rate, temperature, and blood pressure as the ‘fifth vital sign’.
Without a ‘pain thermometer’ people in pain must rely on their language skills to describe what they are feeling. In human medicine pain is what the patient says it is, in veterinary medicine pain is what the assessor says it is! Trained as scientists, veterinarians are schooled to assess responses based on the mean ± standard deviation, yet effective pain management suggests we target the least-respondent patient within the population, so as to ensure no patient is declined the relief of pain it needs and deserves.
In its simplest sense, pain protects us from bodily harm, hence the proposal that pain is a teacher, the headmaster of nature’s survival school. Dangerous things are noxious things, and pain punishes us if we take excessive risks or push ourselves beyond our physical limits. Further, pain often forces us to observe ‘recovery time’. Another way of understanding pain is that any stimulus – noxious or otherwise – can become painful if the patient’s ability to cope with it has been diminished.
A working definition of chronic pain is that, unlike acute pain, it lasts beyond the time necessary for healing and resists normal treatment. The primary indicator of chronic pain is not how long it persists, but whether it remains long after it should have disappeared. As the father of pain medicine, John Bonica, explains, ‘Acute pain is a symptom of disease; chronic pain itself is a disease.