8^th International Conference and Exhibition on Pain Research and Management October 14-15, 2019 Warsaw, Poland

Acute, short-term pain is often a sign of injury or disease, while chronic pain is most frequently associated with conditions such as headaches, lower-back pain, or fibromyalgia, which is often characterized by pain in the back, hands, neck, shoulders, or pelvis and accompanied by fatigue or sleep disturbances. Rehabilitation program usually design individualized patient assessments, treatments, and follow-up plans. Medication reduction, psychological treatment (directed particularly at depression and anxiety), family counselling, socialization skills, and educational or vocational counselling are emphasized. Migraine and other types of headaches, such as tension headache and sinus headache, are painful. Migraine symptoms include a pounding headache, nausea, vomiting, and light sensitivity and are treated with anti-nausea drugs and abortive or preventive medications. Headache remedies include pain relievers. Back pain includes lower back pain, middle back pain, upper back pain or low back pain with sciatica. Nerve and muscular problems, degenerative disc disease, and arthritis can result in back pain. Back pain symptoms may be relieved with pain medication or pain killers.

The World Health Organization recommends a pain ladder for managing analgesia. It was first described for use in cancer pain, but it can be used by medical professionals as a general principle when dealing with analgesia for any type of pain. Generally, the drugs are classified for pain mainly include, Opioid medication scan provide short, intermediate or long acting analgesia depending upon the specific properties of the medication and whether it is formulated as an extended release drug. Narcotics also referred to as opioid pain relievers used only for pain that is severe and is not helped by other forms of painkillers. When used rigorously and underneath a doctor's direct care, these medications are often effective at reducing pain. Narcotics work by binding to receptors into the brain that blocks the sensation of pain. When used rigorously and underneath a doctor's direct care, they'll be effective at reducing pain. Antidepressant medication for treatment of depression as well as other different disorders that will occur alone or together with depression, like chronic pain, sleep disorders, or anxiety disorders. Antidepressants are medication used for the treatment of major depressive disorder and different conditions, chronic pain and neuropathic pain. Anticonvulsants or anti-seizure medications, work as adjuvant analgesics. In different words, they can treat some forms of chronic pain even if they're not designed for that purpose. whereas the most use of anti-seizure medication is preventing seizures, anticonvulsants do seem to be effective at treating certain forms of chronic pain. These include neuropathic pain, like peripheral neuropathy, and chronic headaches like migraines.

NSAIDs are among the most common pain relievers in the world. NSAIDs or nonsteroidal anti-inflammatory drugs are among the most common pain relief medicines in the world. Every day more than 30 million Americans use them to soothe headaches, sprains, arthritis symptoms, and other daily discomforts, according to the American Gastroenterological Association. And as if that wasn't enough, in addition to dulling pain NSAIDs also lower fever and reduce swelling. NSAIDs work on a chemical level. They block the effects of special enzymes specifically Cox-1 and Cox-2 enzymes. These enzymes play a key role in making prostaglandins. By blocking the Cox enzymes, NSAIDs stop your body from making as many prostaglandins. This means less swelling and less pain. A few different types of NSAIDs are available over the counter: Aspirin (Bayer, Bufferin, Excedrin); Ibuprofen (Advil, Motrin IB); Naproxen (Aleve). Opioid analgesics have been used as medicinal agents, especially for the treatment of acute and chronic pain. Morphine is the most commonly used opioid analgesic in the postoperative period, but some practitioners prefer other agents, such as hydromorphone.Opiate pain relievers are strong medicines that can be very helpful in treating pain, especially after an injury or surgery. They are safest when you use them exactly as your doctor prescribes. But there is a risk of addiction when you take them for more than a few days. Drugs like codeine, fentanyl, hydrocodone, hydrocodone/acetaminophen, meperidine are commonly used opioid analgesics for pain. Less common side effects include: Ulcers of the oesophagus, Heart failure, Hyperkalaemia, Reduced kidney function, Bronchospasm, Skin infections.

Pain relieving drugs, otherwise called analgesics, include nonsteroidal anti-inflammatory drugs, acetaminophen, narcotics, antidepressants, anticonvulsants, and others. NSAIDs and acetaminophen are available as over-the-counter and prescription medications, and are frequently the initial pharmacological treatment for pain. These drugs can also be used as adjuvants to the other drug therapies, which might require a doctor's prescription. NSAIDs include aspirin, ibuprofen Motrin, Advil, Nuprin, naproxen sodium, and ketoprofen, Orudis KT. These drugs are used to treat pain from inflammation and work by blocking production of pain-enhancing neurotransmitters, such as prostaglandins. Acetaminophen is also effective against pain, but its ability to reduce inflammation is limited. Narcotics handle intense pain effectively and are used for cancer pain and acute pain that does not respond to NSAIDs and acetaminophen. Narcotics are classified as either opiates or opioids and are available only with a doctor's prescription. Opiates include morphine and codeine, which are derived from opium, a substance naturally found in some poppy species. Opioids are synthetic drugs based on the structure of opium. This drug class includes drugs such as oxycodone, methadone, and meperidine. Although antidepressant drugs were developed to treat depression, it has been discovered that they are also effective in combating some chronic headaches, cancer pain, and pain associated with nerve damage. Antidepressants that have been shown to have analgesic (pain reducing) properties include amitriptyline Elavil, trazodone and imipramine. Anticonvulsant drugs share a similar background with antidepressants. Developed to treat epilepsy, certain anticonvulsants were found to relieve pain as well. Drugs such as phenytoin and carbamazepine are prescribed to treat the pain associated with nerve damage.

Non-pharmacological approaches may contribute to effective analgesia and are often well accepted by patients. Some simple measures which are sometimes recommended eg, hot or cold packs have not been well studied. Complementary therapies for pain are often sought out by patients, and require evaluation for their potential role in the palliative care setting. Patient education about managing cancer pain has been studied. A systematic review shows that educational interventions can have a modest but clinically significant impact on pain, and that this is an underutilised strategy. Non- pharmacological methods used in pain management can be classified in different ways. In general, they are stated as physical, cognitive, behavioural and other complementary methods or as invasive or non-invasive methods. Meditation, progressive relaxation, dreaming, rhythmic respiration, biofeedback, therapeutic touching, transcutaneous electrical nerve stimulation, hypnosis, musical therapy, acupressure and cold-hot treatments are non-invasive methods. The most famous and common method among the invasive methods is acupuncture. It is considered that these methods control the gates that are vehicles for pain to be transmitted to the brain and affect pain transmission or the release of natural opioids of the body such as endorphin.

There are several causes of cancer pain, however usually cancer pain happens once a tumour presses on nerves or body organs or once cancer cells invade bones or body organs. Cancer treatments like therapy radiation, or surgery conjointly might cause pain. Cancer pain is acute or chronic. Acute pain is owing to injury caused by AN injury and tends to solely last a brief time. For instance, having an operation will cause acute pain. The pain goes once the wound heals. Within the in the meantime, painkillers can typically keep it in check. Chronic pain is pain caused by changes to nerves. Nerve changes might occur owing to cancer pressing on nerves or owing to chemical produced by a tumour. It may also be caused by nerve changes owing to cancer treatment. The pain continues long once the injury or treatment is over and may vary from delicate to severe. It is there all the time and is additionally referred to as persistent pain. Chronic pain is tough to treat, however painkillers or alternative pain management strategies will usually with success management it.

There are several causes of cancer pain, however usually cancer pain happens once a tumour presses on nerves or body organs or once cancer cells invade bones or body organs. Cancer treatments like therapy radiation, or surgery conjointly might cause pain. Cancer pain is acute or chronic. Acute pain is owing to injury caused by AN injury and tends to solely last a brief time. For instance, having an operation will cause acute pain. The pain goes once the wound heals. Within the in the meantime, painkillers can typically keep it in check. Chronic pain is pain caused by changes to nerves. Nerve changes might occur owing to cancer pressing on nerves or owing to chemical produced by a tumour. It may also be caused by nerve changes owing to cancer treatment. The pain continues long once the injury or treatment is over and may vary from delicate to severe. It is there all the time and is additionally referred to as persistent pain. Chronic pain is tough to treat, however painkillers or alternative pain management strategies will usually with success management it.

Chronic pain may be a growing downside among paediatric and adolescents, with some epidemiologic studies indicating that roughly half-hour of youngsters and adolescent’s expertise pain that lasts for three months or longer. The foremost common paediatric chronic pain complaints mainly migraine repeated abdominal pain, and general contractile organ pain, together with limb pain and back pain. Chronic pain is usually related to practical incapacity. Within the paediatric population this incapacity most often manifests as college impairment, problem maintaining social contacts, slashed participation in recreational activities, impairments in health connected quality of life, and a rise in health care utilization. As a result, these patient’s actual high prices on the health care system.

Orofacial pain is a general term covering any pain which is felt in the mouth, jaws and the face. Orofacial pain is a common symptom, and there are many causes. Orofacial pain has been defined as "pain localized to the region above the neck, in front of the ears and below the orbitomeatal line, as well as pain within the oral cavity, pain of dental origin and temporomandibular disorders". It is estimated that over 95% of cases of orofacial pain result from dental causes (i.e. Toothache caused by pulpitis or a dental abscess). However, some orofacial pain conditions may involve areas outside this region, e.g. temporal pain in TMD. Toothache, or odontalgia, is any pain perceived in the teeth or their supporting structures (i.e. the periodontium). Toothache is therefore a type of orofacial pain. Craniofacial pain is an overlapping topic which includes pain perceived in the head, face, and related structures, sometimes including neck pain. All other causes of orofacial pain are rare in comparison, although the full differential diagnosis is extensive.

The nurse’s primary commitment is to the health, welfare, comfort and safety of the patient. Self-awareness, knowledge of pain and pain assessment, and knowledge of the standard of care for pain management enhances the nurse’s ability to advocate for and assure effective pain management for each patient. When advocating for the patient, it is crucial that the nurse utilize and reference current evidence-based pain management standards and guidelines. The role of nurse is responsible and accountable to ensure that a patient receives appropriate evidence-based nursing assessment and intervention which effectively treats the patient’s pain and meets the recognized standard of care.

Neuropathic pain caused by impairment or disease affecting the somatosensory nervous system. Neuropathic pain can be contrasted to nociceptive pain that occurs when someone experiences an acute injury. This type of pain is typically short-lived and generally quite responsive to common pain medications in contrast to neuropathic pain. Neuro-orthopaedic service offers the latest advances in diagnosis and treatment to patients whose arms or legs are impaired by brain injury, stroke, anoxia, central nervous disorders, or orthopaedic conditions.

Acute pancreatitis is an inflammatory condition of the pancreas that is painful and at times deadly. Despite the great advances in critical care medicine over the past 20 years, the mortality rate of acute pancreatitis has remained at about 10%. Inflammation of the pancreatic tissue can be divided into chronic and acute inflammation depending on the degree of resolution of the tissue inflammation. Over 80% of all cases of acute pancreatitis are due to gallstones or the alcohol abuse. Severe abdominal pain is the hallmark symptom of patients suffering from acute pancreatitis as well as of chronic pancreatitis. The successful treatment of patients with acute pancreatitis has three prerequisites:

1) an adequate and early fluid resuscitation,

2) proper nutritional support and

3) an adequate pain management.

Anesthesiology is the practice of medicine dedicated to the relief of pain and total care of the surgical patient before, during and after surgery. Anaesthesia by definition is the loss of sensation with or without the loss of consciousness. The American Society of Anesthesiologists define anaesthesiology as "the practice of medicine dedicated to the relief of pain and total care of the surgical patient before, during and after surgery." Anaesthesia or anaesthesia is a state of temporary induced loss of sensation or awareness. It may include analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), or unconsciousness. A patient under the effects of anaesthetic drugs is referred to as being anesthetized. The practice of anaesthesiology is broad and transcends the operating room as well.  Anaesthesiologists are experts in pain medicine. They help patients with chronic disease live better lives through pain management treatments for every day. General anaesthesia suppresses central nervous system activity and results in unconsciousness and total lack of sensation. Sedation suppresses the central nervous system to a lesser degree, inhibiting both anxiety and creation of long-term memories without resulting in unconsciousness. Regional anaesthesia and local anaesthesia, which block transmission of nerve impulses between a targeted part of the body and the central nervous system, causing loss of sensation in the targeted body part. Anaesthesiologists frequently relieve pain for patients before, during and after surgery. However, some specialized anaesthesiologists specifically treat chronic pain unrelated to surgery. These anaesthesiologists have the education and training to accurately diagnose, evaluate and treat chronic pain patients through a comprehensive approach including medication and pain procedures. The treatment of chronic pain can be complex, due to the strength of pain medication and the anatomy and delicate structure of the spine and nerves upon which chronic pain interventions are performed.

The elderly population comprises the fastest growing segment of the world's population. As patients age, the incidence and prevalence of certain pain syndromes increase. Pain may be underreported as some elderly patients incorrectly believe that pain is a normal process of aging. A comprehensive pain assessment includes a thorough medical history and physical examination, review of systems and pertinent laboratory results, imaging studies, and diagnostic tests. Pain physicians should have a broad range of understanding of the pharmacologic and physiological changes that occur in the geriatric population. The present review on pain management in the elderly focuses on relevant information for the pain clinician. Included are appropriate pain assessment, physical examination, pathophysiologic changes in the elderly, pharmacokinetic and pharmacodynamic changes, and present pain management modalities.

Pain is described by the patient mostly in terms such as stabbing, burning, tearing, squeezing, etc. Acute pain is accompanied by a stress response consisting of increase in blood pressure, tachycardia, pupillary dilatation, and high plasma cortisol levels. This may be accompanied by local muscle contraction. Four broad categories of pain are generally nociception, pain perception, pain behaviours. Chronic pain affects 20% of the European population and is commoner in women, older people, and with relative deprivation. Its management in the community remains generally unsatisfactory, partly because of lack of evidence for effective interventions. Good epidemiological research on chronic pain provides important information on prevalence and factors associated with its onset and persistence. Improving our understanding of associated factors will inform our clinical management, limiting severity, and minimizing disability.

To prepare for any chronic pain coping technique, it is important to learn how to use focus and deep breathing to relax the body. Pain control techniques mainly involves altered focus. This is a favourite technique for demonstrating how powerfully the mind can alter sensations in the body. Focus your attention on any specific non-painful part of the body and alter pain sensation in that part of the body. Dissociation as the name implies, this chronic pain technique involves mentally separating the painful body part from the rest of the body, or imagining the body and mind as separate, with the chronic pain distant from one’s mind. Sensory splitting: this technique involves dividing the sensation into separate parts. Mental anaesthesia: this involves imagining an injection of numbing anaesthetic (like Novocain) into the painful area, such as imagining a numbing solution being injected into your low back. Mental analgesia building on the mental anaesthesia concept, this technique involves imagining an injection of a strong pain killer, such as morphine, into the painful area. Alternatively, you can imagine your brain producing massive amount of endorphins, the natural pain relieving substance of the body, and having them flow to the painful parts of your body.

Inflammation is a process by which the body's white blood cells and substances they produce protect us from infection with foreign organisms, such as bacteria and viruses. However, in some diseases, like arthritis the body's defence system the immune system triggers an inflammatory response when there are no foreign invaders to fight off. In these diseases, called autoimmune diseases, the body's normally protective immune system causes damage to its own tissues. The body responds as if normal tissues are infected or somehow abnormal.

Globally pain management devices market is valued at an estimated USD 3.08 Billion in 2016 and is projected to grow at a CAGR of 8.5% during the forecast period of 2016 to 2021. Several factors, such as the mounting demand for long-term pain management among the geriatric population, large patient population base, adverse effects of pain medications, progress of novel pain management device, conventional compensation scenario for spinal cord stimulation (SCS) devices in established countries, and high proven efficiency of pain management device for the treatment of chronic pain are driving the growth of the global market.

This report covers three major pain management device types, namely, neurostimulator devices, ablation devices, and analgesic infusion pumps. The neurostimulator devices segment is expected to witness the highest growth and account for the largest share of the pain management devices market in 2016. This can be attributed to the advantages of neurostimulator over alternative therapies for managing chronic pain. Also, the long-term cost efficiency and technological developments in neurostimulator devices are contributing to the growth of this market segment.

Based on application, the global pain management device market is segmented into neuropathic pain, cancer pain, facial pain & migraine, musculoskeletal pain, and others. The neuropathic pain application segment is estimated to witness the maximum growth during the forecast period, principally due to the presence of substantial clinical evidence in the favour of high efficacy of pain management device in neuropathic pain treatment, favourable reimbursement scenario, development of novel neuropathic pain management device, large patient population base, rising geriatric population across the globe, and side effects of drugs used to treat neuropathic pain.