Acute Pain is a Vital life-saving Signal: Chronic Pain is a Vindictive life-damaging Signal
As a profession, we must be as exacting as possible to prevent sustained or chronic pain.
The Philosophy of recognising the issues of Neuropathic and/or Chronic pain and working to prevent or re-calibrate the response to prevent chronic pain can be as life-changing and often as life-saving as other therapeutic interventions. We must therefore be proactive and pre-emptive in our application of pain relief.
Pain is a multi-step process so Pain relief, therefore, must be multi-modal: but multi-modal must not mean only multi-drug therapy. If, as a profession, we are going to have multimodal pain management within a ‘Standard of Care,’ then that care must include non-pharmaceutical interventions. PBM may not be a primary chemical or a pharmaceutical drug, but for many PBMT is regarded 1,2 as a ‘Drug-Therapy Equivalent.’
PBM is a scientifically, down to the micro-cellular levels, proven analgesia modality and hence is a powerful tool to arrest and suppress pain and to ward off chronic pain.
PBMT elicits the same end effects as a mainstream drug therapy by impacting the inflammatory cascade at similar points i.e., decrease in COX2 and Bradykinin levels etc., but achieves that result cua improved intrinsic anti-inflammatory signalling that is generated by better cell metabolism and improved microcirculation at the level of the injured tissue.
PBMT is easily woven into existing pain protocols and should be an absolute ‘Requirement of Care,’ not considered an alternative only when a case fails to respond to previous standards of care.
Neuropathic pain.
We have not paid enough attention to Neuropathic pain/Allodynia in our vet patients. “Pain is not just about the pain you feel, but also about how that pain makes you feel…” The brain ‘dresses’ and then ‘expresses’ that pain uniquely in each individual.
As a survivor of chronic pain, I am keen to prevent as many veterinary patients from progressing into a chronic or neuropathic pain scenario. The freedom I get, when PBM releases me from the cage of chronic pain is a freedom that we as Vets should be offering to our patients. The Joy I see PBM therapy bring my veterinary patients- now freed from the virtual cage of pain that is life with unresolved pain-has converted me from a sceptic to an avid proponent of this pain management therapy tool.
We have excused our neglect of considering neuropathic pain in our vet patients as neuropathic pain being a self-reporting condition, so then animals can’t self-report. I disagree. Animals do report back to us that they have neuropathic pain. All it requires is to have an observing and informed mind and suddenly the ‘clinically silent’ presenting case is actually screaming from the roof-tops that it is registering pain, especially allodynia. The animal that: is no longer lame, but still withdraws from contact or inexplicably guards one part of its body, a sweet animal becoming aggressive, a confident animal suddenly fleeing from the lightest touch, an animal who verbalises when a wind blows on its skin or if a blanket is placed on an external body part, these animals are flagging their allodynia
PBM induces normalisation of the microcirculation and interrupts the vicious cycle that originates develops, winds up and maintains pain. Normal physiological conditions of the tissue are then restored which means we have given the patient a head-start in reducing the risk of chronic or neuropathic pain.
As clinicians, to be serious about pain relief, we must expand our therapeutic tools; We have to move beyond the drug cupboard if we are serious about pain relief.
PBM treatment modality is a powerful ally in the drive to suppress pain and ward off chronic pain. If you are uncompromising about pain relief, it the time to add PBM therapy to your therapeutic armoury.
At Vets1Laser, we are passionate about putting Veterinarians at the forefront of Laser /PBM therapy.
Contact Dr Aine at [email protected] to share and discuss any thoughts or knowledge on all things Laser.