[Review of the non-pharmacological approaches to the management of chronic pain]

By

Acknowledgement

I would take this opportunity to thank my research supervisor, family and friends for their support and guidance without which this research would not have been possible.



Abstract

In this study we try to explore the concept of “non-pharmacological approaches to the management of chronic pain” in a holistic context. As a result of recent neurophysiologic discoveries, these approaches gradually and largely give way to techniques totally conservative and completely reversible, such as electrical cord or central neurostimulation and intrathecal administration in 1977. In fact it has a wide range of surgical techniques: 1. Interruption techniques, to selectively cut pathways of messages: 2. the posterior interrupts the conduction of the first sensory neuron downstream of spinal ganglion, just before entering the spinal cord (spinal nerve) or the brainstem. In accordance with this model, pain is the result of the dynamic interaction of biological, psychological and cultural factors. In the end this study concludes that chronic pain deals with the individual, not only with the strain created by pain but also with a cascade of ongoing Stressors that compromise all aspects of the sufferer's life. Living with chronic pain requires considerable emotional resilience and tends to deplete emotional reserve, taxing not only the pain sufferer but also the significant others' capacity to provide support.

Table of Contents

CHAPTER 1: INTRODUCTION1

Outline of the Study1

Background of the research1

Problem Statement5

Rationale6

Aims and Objectives7

Significance7

Research Question9

Limitation of the Study9

Ethical Concern9

CHAPTER 2: LITERATURE REVIEW12

Peripheral stimulation analgesia15

TENS16

Types of Pain34

Medications38

Injection39

Other methods of treatment39

Psychological support40

Medicine in the treatment of chronic pain is developing intensively.41

Thermal therapy41

Physical stimulation42

Stimulation techniques42

Physical manipulations42

Injection into the nerve or trigger points42

Rehabilitation medicine44

The vibrotherapy50

Cry therapy and thermotherapy50

Massages51

Immobilization and restraint51

Vertebral tractions52

Spinal manipulation52

Cognitive-behavioural therapy (CBT)53

Research Design70

Literature Search70

Keywords71

CHAPTER 3: METHODOLOGY………………………………………………………………………………….………………….

CHAPTER 4: DISCUSSION AND ANALYSIS72

Recommendations84

Myths of Pain103

The manifesto of pain in patients104

The pain is invisible104

The chronicity of pain105

CHAPTER 5: CONCLUSION107

References109

Bibliography116

Appendices119

CHAPTER 1: INTRODUCTION

Outline of the Study

This research focuses on the various aspects of “Non-Pharmacological approaches” and comprises of the following chapters:

Introduction

Literature Review

Methodology

Results and Discussion

Conclusion

Background of the research

Chronic pain is common health problem in developed and developing countries, which can lead to work loss and human suffering. The most commonly used treatment for chronic pain is analgesic drugs, such as paracetamol, NSAIDs, opioids and adjuvant. 1Despite the fact that these pharmacological therapies are used regularly to treat chronic pain, many patients continues to report substantial pain and impact on daily life.

Over the years, non-pharmacological approaches have been used considerably in developed countries, such as the UK to manage chronic pain conditions. These approaches like physiotherapy options, which include TENS, acupuncture, physical exercise, and relaxation technique, as well as psychological options, which include CBT, education and information. However, these options are still not being used in developing countries, such as Libya. This is due to two reasons; the first reason is lack of knowledge about this issue. The second reason is medical staff focusing on pharmacological strategies like opioids, which can cause some side effects, such as tolerance and dependence.

Therefore; this dissertation is going to review the relevant research ...