Complementary Approaches to Pain Management’

Complementary Approaches to Pain Management’ By Oluwatoyin Olatundun ILESANMI (PhD) Clinical Psychologist, PN & M, Trained Genetic Counsellor, USIP Certificate in Conflict Analysis: 

Complementary Approaches to Pain Management ’ By Oluwatoyin Olatundun ILESANMI (PhD) Clinical Psychologist, PN & M, Trained Genetic Counsellor, USIP Certificate in Conflict Analysis Address: Centre for Gender & Social Policy Studies, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria. E-mail: toytundun@yahoo.com Phone: +2348052236377

Objectives: 

Objectives To describe the treatment of pain within a bio-psychosocial model of care. To describe complementary and alternative methods (CAM). To share strategies and treatment for mental health issues that impact the experience and treatment of pain. 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 2

What is Pain?- SCD Pain: 

What is Pain ?- SCD Pain SCD Pain is ‘an unpleasant sensory and emotional experience associated with either actual or potential tissue damage, or described in terms of such damage’ Its frequent crises causes much distress to patients and families It is physical and psychological (or emotional) It is significant & persistent It interferes with daily life It is cyclical in nature – i.e recurring, unpredictable intermittent or constant pain 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 3

Pain Cycle: 

Pain Cycle 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 4

Physician’s Therapeutic Task: 

Physician’s Therapeutic Task Two-fold: To Discover and treat the cause of the pain Treat the pain itself , irrespective of whether the underlying cause is treatable, in order to provide relief from it and reduce the suffering caused by it. 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 5

Function Of Pain: 

Function Of Pain Alerting function: It evokes protective responses (reflex motor withdrawal and behavioural responses ), Protective role : capacity to experience pain keeps tissue damage to a minimum. If tissue damage (cellular breakdown with liberation of biochemical substances) is unavoidable, a cascade of changes will occur in the peripheral and central nervous system responsible for the perception of pain 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 6

Bio-psychosocial Model of SCD Pain’s symptoms : 

Bio-psychosocial Model of SCD Pain’s symptoms Biological : Physical aspects of pain symptoms physical damage (actual & potential) objective tests Psychological: Mental , emotional, behavioral aspects Symptoms cognitions, perceptions subjective information Social: Hinders i nteractions with others (family, providers, peers, culture, etc.) 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 7

Types of pain I: 

Types of pain I Adaptive : Acute pain (at early onset) or Throbbing pain : e.g. headache usually occurring in response to an identifiable noxious event with stimulation of the nociceptive system (from the periphery through the spinal cord, brain stem, and thalamus to the cerebral cortex where the sensation is perceived). 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 8

Types of pain II: 

Types of pain II Maladaptive (pathological)Pain: Chronic pain: Pain for more than 3 months in response to damage to the nervous system (peripheral nerve, dorsal root ganglion, dorsal root, central nervous system). It is known as neuropathic pain . Difficult to explain & understand Demoralising and stressful Requires emotional resilience: helplessness , hopelessness, anxiety , & depression Burden: family , friends, support & finance 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 9

Perception of Pain I: 

Perception of Pain I Patients show wide variations in pain experience depending on their degree of Pain Awareness, which is t he intensity of pain as it relates to the interactions of: Physiological Response: wh at the body does? - heart beating fast, breathing is fast, difficulty in moving about much Sensory Response Cultural and Spiritual Factors E xpectations : i.e. outcome 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 10

Pain Perception II: 

Pain Perception II Emotion: i.e. Affective or mood state, Felling of helplessness to deal with pain symptoms Behavioural Responses: i.e. coping ability , Cognitive or Negative Thoughts: “ Catastrophizing ” pain (i.e. characterization of pain as awful , horrible and unbearable): Common among people with SC and S beta + thalassemia Tendency to pay more attention to and dwelled on their pain symptoms 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 11

Pain: Assessment : 

Pain: Assessment Goals of pain assessment : To Quantify and observe pain status and related experiences over time Document efficacy of interventions Assess intensity, effectiveness of relief strategies It must be multi-dimensional - i.e. measure cognitive, behavioral, affective experience 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 12

Pain: Assessment II: 

Pain: Assessment II May be subjected to: Subjective Estimate : verbal report Discordance : differences between clinician & patient Misinterpretation : lack of understanding e.g. exaggerating 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com P hone: 2348052236377 13 &

SCD Pain Management: 

SCD Pain Management Interdisciplinary team approach : For optimal compassionate care that is coordinated from the beginning of life and throughout the patient's lifespan 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 14

Adolescent Pediatric Pain Tool: 

Adolescent Pediatric Pain Tool 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 15

COMPLEMENTARY APPROACHES (CAM )TO PAIN MANAGEMNT: 

COMPLEMENTARY APPROACHES ( CAM )TO PAIN MANAGEMNT These are alternative therapies to pain management. Aim: Living Well with SCD improve coping improve medical adherence improve quality of life Increase daily functioning Increase patient empowerment and involvement in care Minimize frequency of admissions and/or length of admissions 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 16

CAM: 

CAM Acupuncture: ancient Chinese therapy, aims to revitalise and heal by inserting and removing fine needles at specific points on the body 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 17

PowerPoint Presentation: 

3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 18 Aromatherapy: or essential oils therapy, which uses a plant's aroma-producing oils (essential oils) to treat disease. Chiropractic therapy: a hands-on therapy based on the theory that many medical disorders (especially disorders of the nervous systems) may be caused by subluxations in the spine.

CAM: 

CAM Biofeedback: technique to measure body functions (e.g.. breathing, muscle tension) with a machine & to consciously control or alter these functions through e.g.. relaxation Hypnosis & Self-Hypnosis It is also an induced or self-induced state of mind due to extreme concentration of attention to experience thoughts, feelings, and images as almost real 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 19

CAM: 

CAM Guided imagery: a series of thoughts and suggestions that direct a person's imagination toward a relaxed, focused state. Healing touch: which influences a person's physical or emotional health without physically touching the person . 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 20

CAM: 

CAM Homeopathy: aims to treat illnesses with preparations called remedies, which are made from plants, minerals, metals, body fluids, insects and other materials. Homeopaths believe that the remedies stimulate the body's own healing processes. Hydrotherapy : which uses water, in any form, to treat a disease or to maintain health. 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com phone: 2348052236377 21

PowerPoint Presentation: 

3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com phone: 2348052236377 22

CAM: 

CAM Hypnosis : a state of focused concentration during which a person becomes less aware of his or her surroundings. Magnet Field Therapy: It uses magnets to stimulate areas of the body in an attempt to maintain health and treat illness. Massage: rubbing the soft tissues of the body, such as the muscles, to help reduce tension and pain, improve blood flow, and encourage relaxation. Meditation : the practice of focusing your attention to help you feel calm and give you a clear awareness about your life. 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 23

CAM: 

CAM Naturopathy : Promotes using organic foods and exercise, as well as... having a healthy balanced lifestyle applying concepts from other areas of complementary methods Relaxation Therapy: A systematic approach to gain sense of tranquillity through deep breathing & muscle loosening Spiritual : power of prayer (self or for you) and faith (locus of control ) 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 24

CAM: 

CAM Transcutaneous Electrical Nerve Stimulation (TENS): electrical stimulation of nerves to block out pain using a small machine with a patch placed on the skin Yoga: Uses meditation and exercises to help you improve flexibility and breathing, decrease stress, and maintain health. 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 25

Psychological Therapies: 

Psychological Therapies Psycho-education medical condition & related pain treatment & analgesia Cognitive Behavioural Therapy: pain coping strategies: Coping Attempts Negative Thinking distraction, imagery thoughts & feelings, diaries: Focus on thinking as influencing affective and physiological responses and vice versa activity & stress: Encourages active rather than passive stance relaxation 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 26

Why CAM?: 

Why CAM? Correlates of Frequent Pain: Negative self-concept 􀃇anxiety and depression Negative body image Poor school, vocational performance Social isolation, poor peer relationships Decreased participation in normal activities of daily living 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 27

Why CAM?: 

Why CAM? Common Mental Health Issues: Depression or Sadness Anger in Children Anxiety or Worries Pica (eating non-food items) Attention problems (ADD ) Hyperactivity & Impulsive Traumai ncludes some medical procedures Chronic Biopsychosocial Pain Disorder: Requires Biopsychosocial Plan of Care that is Comprehensive Integrative Multidisciplinary 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 28

PowerPoint Presentation: 

3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com phone: 2348052236377 29

Pathways To Pain: 

Pathways To Pain Psychological approaches to help improve quality of life include: Sensory Activation of the CNS Affective Emotional response to pain Evaluative Overall experience of the pain Temporal Experience of pain over time 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 30

PowerPoint Presentation: 

Thank You 3/10/2012 Oluwatoyin Olatundun ILESANMI (PhD) E-mail: toytundun@aol.com Phone: 2348052236377 31