PAIN
not be best choice for pain relief when the pain affects a widespread or extended area, or if it affects more than one part of the patient’s body.
WHAT IS THE PHYSIOLOGICAL RESPONSE TO PAIN?
Pain stimulates pain receptors and this stimulus is transferred via specialised nerves to the spinal cord and from there to the brain. The pain stimulus is processed in the brain, which then sends an impulse down the spinal cord via appropriate nerves which command the body to react.
Nociceptors are the specialised sensory receptors responsible for the detection of noxious stimuli, transforming the stimuli into electrical signals, which are then conducted to the central nervous system.
Distributed throughout the body (skin, viscera, muscles, joints, meninges), they can be stimulated by mechanical, thermal or chemical stimuli. Inflammatory mediators are released from damaged tissue and can stimulate nociceptors directly. They can also act to reduce the activation threshold of nociceptors so that the stimulation required to cause activation is less.
The pain sensation, however, is only one part of the nociceptive response, which may include an increase in blood pressure, an increase in heart rate and a reflexive withdrawal from the noxious stimulus. If pain cannot be alleviated, psychological factors such as depression and anxiety can intensify the condition.
HOW DOES THE BODY REACT TO PAIN?
Pain transmission is a result of complex peripheral and central processes. It is both a sensory and emotional experience and patients’
REFERENCES
1 The Lancet.
https://www.thelancet.com/pdfs/journals/lancet/PIIS0140- 6736(16)31678-6.pdf
2.NHS Digital Figures.
3Opioids Aware.
https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids- aware
4 British Medical Association. 5 IRI Data
6 Cochrane Collaboration.
http://www.cochrane.org/CD007400/SYMPT_ topical-nonsteroidal-anti-inflammatory-drugs-chronic-musculoskeletal- pain-adults
22 - SCOTTISH PHARMACIST
past experiences, fears and anxieties can play an important role. It has a biologically important protective function and the sensation of pain is a response to injury or disease, and is a result of normal physiological processes within the nociceptive system.
Genetic and environmental factors contribute to sensitisation resulting in chronic pain in some individuals even after healing has taken place. Nociceptors not only signal acute pain but, when chronically sensitised, contribute to persistent pathological pain disorders from previous injury or ongoing disease.
There are many types of pain management and each of them have their own benefits, drawbacks and limits. A common difficulty in pain management is communication. People experiencing pain may have difficulty recognising or describing what they feel and how intense it is.
The misuse and unnecessary prescription of opioid painkillers are issues of serious concern. We are fast becoming a society dependent on drugs for pain relief and too many people are quietly self-harming with their overprescribed opioid painkillers.
With such alarming statistics, those prescribing these medicines need to ensure they are not doing more harm than good. Healthcare professionals are increasingly being advised to encourage patients to try other forms of treatments, such as counselling, exercise and physiotherapy. Topical analgesic therapy is nonetheless a potentially valuable strategy in the management of a variety of conditions associated with acute or chronic pain, including acute soft tissue injuries, chronic musculoskeletal pain and various neuropathic pain disorders.•
NPA IN FOCUS Janice Oman
Scotland Representation Manager
It’s been a busy time for the NPA. We have launched a new report on access to care, provided resources to help our members get to grips with GDPR and elected a new board and new chair.
The See you Sooner report outlines proposals for improving access and highlights the Scottish minor ailments scheme as an example to follow elsewhere in the UK.
A new survey reveals that nine out of ten people believe that more NHS services should be available in local pharmacies ‘to relieve pressure on GPs and make NHS services more convenient for patients’. To view the report online, go to npa.
co.uk/seeyousooner.
ELECTION RESULTS
Ballots in seven NPA Board regions have resulted in five new NPA members being elected to the board of management. The new Board will serve for a four year period with Nitin Sodha as chair. Nitin who replaces Ian Strachan, is the Managing Director of Knights Chemists, was first elected to the NPA Board in 2007 and has served as Vice Chair since 2014. Noel Wicks continues as the board member for Scotland.
MEMBER FORUM ON GENERAL DATA PROTECTION REGULATION (GDPR) AND TRAINING MANUAL
Earlier this month the NPA organised an event for Scottish members which focused on GDPR. We know members are really concerned about GDPR and our resources are very comprehensive and are continuously getting updated.
A GDPR training manual has been created staff awareness. Members of the pharmacy team
must have an understanding about the GDPR, its principles, and the roles, responsibilities and processes of organisations. The following documents which can be accessed via the NPA website have been developed to help comply with this requirement:
• Pharmacy team training manual
• Multiple-choice question (MCQ) assessment questions
• MCQ assessment answers Certificate of completion
The training manual is expected to take 90 minutes to complete. Once you have worked through the training manual, you will be given a short multiple-choice question (MCQ) assessment for you to complete to demonstrate your understanding. We are also having evening events open to all staff on GDPR on 5 June in Glasgow and on 6 June in Edinburgh. Send me an email on
j.oman@
npa.co.uk.
KEEP UP TO DATE WITH OUR EMAIL COMMUNICATIONS
If you are a pharmacy owner or superintendent pharmacist in NPA membership and would like to sign up to receive our superintendent alerts email communicationservices@
npa.co.uk quoting your NPA membership number, your name, your role at the pharmacy and the email address you wish to be subscribed. If you want to get weekly email updates about the latest news in Scotland go to
www.npa.co.uk/news-and-events/ subscribe and fill out the form making sure your select ‘Scotland’ and ‘Weekly News’ to ensure we send you the most relevant information.
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