Pain...why do we experience it?

Pain is described as "an unpleasant sensation, occurring in varying degrees of severity as a consequence of injury, disease or disorder. In short, pain is a warning signal telling us that something is wrong with our body." So if you experience pain, it is an 'alarm' sounding off that your body has been injured or infected. Pain is categorized either as Acute or Chronic. Acute pain is pain that begins suddenly and usually does not last long. When severe, it may cause a rapid heartbeat, increased breathing rate, elevated blood pressure, sweating, and dilated pupils. Chronic pain is pain that lasts for weeks or months; the term usually describes pain that persists for more than 1 month beyond the usual course of an illness or injury; pain that recurs off and on over months or years, or pain that is associated with a long-term disease such as cancer or arthritis.

When we fall and break a bone or sprain an ankle, we start to feel pain and swelling in the afflicted area. This pain is brought about by the production of many chemical substances, one of which is Prostaglandin, produced by an enzyme in our bodies called Cyclooxygenase or COX. To alleviate pain, you would have to stop the production of Prostaglandin by blocking the COX.

This enzymatic conversion leads to the generation of prostaglandins. Since the early 70's and until now, NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as diclofenac, aspirin, ibuprofen and naproxen sodium have been widely used for pain treatment.

However, in 1992, clinical investigations revealed that there are two COX enzymes, COX-1 and COX-2, present in our bodies. They discovered that only COX-2 derived

Prostaglandin is responsible for pain and inflammation, while COX-1 generated Prostaglandin is needed for normal physiological functions including the protection of the stomach lining. Therefore, when using NSAIDs in the treatment of pain, which blocks both COX-1 and COX-2, there may be an increase in a person's risk for gastro-intestinal side effects.

These findings led to the research and discovery of Coxibs, a new class of anti-inflammatory and analgesic agents. Coxibs like rofecoxib, would only inhibit COX-2 while simultaneously allowing COX-1 to retain its protective properties. Clinical trials have shown that rofecoxib was effective in relief of osteoarthritis and rheumatoid arthritis as well as various types of acute pain such as post-operative dental pain, post-orthopedic surgical pain, and primary dysmenorrhea without the serious gastro-intestinal side effects.

It helps to be aware of the benefits and possible side effects of the medicines you are taking. Pain treatment and management need not cause unnecessary and avoidable side effects. Do not hesitate to ask your doctor about better treatment options for pain.

In its pursuit to help uplift the physical quality of life of Filipinos through information dissemination of proper pain management, the Pain Management Information Agency (PMIA) accepts inquiries from the general public. PMIA can be reached through e-mail paincare@pmia.com.ph or send letters to P.O. Box 3485 Makati.

PMIA was established primarily to increase public awareness and understanding of pain and to recommend appropriate medical and practical ways to manage and control pain.