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"Pain ladder", or analgesic ladder, was created by the World Health Organization (WHO) as a guideline for the use of drugs in the management of pain. Originally published in 1986 for the management of cancer pain , it is now widely used by medical professionals for the management of all types of pain .
Where is the pain? Or the maximal site of the pain. O Onset When did the pain start, and was it sudden or gradual? Include also whether it is progressive or regressive. C Character What is the pain like? An ache? Stabbing? R Radiation: Does the pain radiate anywhere? A Associations Any other signs or symptoms associated with the pain? T Time course
The Guideline Development Group then finalises the recommendations and the National Collaboration Centre produces the final guideline. This is submitted to NICE to formally approve the guideline and issue the guidance to the NHS. [citation needed] To date NICE has produced more than 200 different guidelines. [27]
The most common are acute and chronic. Acute pain occurs suddenly, is sharp, and goes away once the issue is treated. Acute pain is caused by things like broken bones, childbirth, strained muscles, or burns. [5] Episodic pain occurs irregularly from time to time. Underlying medical conditions may cause it or can come out of nowhere. [5]
Neuropathic pain is pain caused by a lesion or disease of the somatosensory nervous system. [2] [3] Neuropathic pain may be associated with abnormal sensations called dysesthesia or pain from normally non-painful stimuli . It may have continuous and/or episodic components. The latter resemble stabbings or electric shocks.
Pain management often uses a multidisciplinary approach for easing the suffering and improving the quality of life of anyone experiencing pain, [2] whether acute pain or chronic pain. Relief of pain in general (analgesia) is often an acute affair, whereas managing chronic pain requires additional dimensions.
Kehr's sign is the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated. Kehr's sign in the left shoulder is considered a classic symptom of a ruptured spleen .
Acute muscle soreness (AMS) is the pain felt in muscles during and immediately, up to 24 hours, after strenuous physical exercise. The pain appears within a minute of contracting the muscle and it will disappear within two or three minutes or up to several hours after relaxing it. [1] There are two causes of acute muscle soreness: [1]