Journal of Emergency and Internal Medicine

Interdisciplinary approach in pain management: physical analgesia and phantom pain

Joint Event on 8^th Edition of International Conference & Exhibition on Pain Management, Physiotherapy & Sports Medicine & 9^th Edition of International Conference on Internal Medicine & Patient Care
March 18-19, 2020 London, UK

Ivet Koleva

Medical University of Sofia, Bulgaria

Keynote: J Emerg Intern Med

Abstract

Pain is an unpleasant sensory and emotional experience, associated with actual or potential tissue damage (International Association for the Study of Pain). Physical analgesia is the application of physical modalities for pain management (electric currents, magnetic field, light; cryo- and thermo-agents; mineral waters and peloids; manual therapy, analytic exercises and soft-tissue techniques (different types of massages, stretching and post-isometric relaxation); reflectory methods. In the multi-disciplinary and multi-professional team for pain management a lot of medical specialists and health professionals are included. Different types of pain are described. In clinical practice, post-amputation pain is a challenge for professionals. Most of amputees feel residual limb (stump) pain, phantom sensations, phantom pain. In the pain management of amputees, various medications and physical modalities are applied. We present some results of our own clinical experience, with the purpose to prove the impact of some contemporary physical modalities (Deep Oscillation and Laser therapy) in the pain management. The goal was to realize a comparative evaluation of drug, physical and combined analgesia in the complex rehabilitation of patients after trans-femoral amputation suffering from stump pain and phantom pain. The comparative analysis of results shows a significant improvement of: pain (Visual analogue Scale, evaluation of stump tenderness), autonomy in everyday activities and depression (scales of Zung, McGill Quality of life questionnaire). Physical analgesia has not adverse effects and side consequences, and can be applied in combination with other therapies (promoting medications’ analgesic effect). We consider that the complex algorithm for pain management must include systematic drugs (and vitamins), rehabilitation complex and patient education. The synergy between different physical modalities is the logical base for prescription of complex rehabilitation program, comprising one or two of every group of physical factors: pre-formed modalities, thermo- or cryo-agents, physio-therapeutic and ergo-therapeutic procedures. In conclusion, we recommend our complex pain management programme.

Biography

Ivet Koleva is a medical doctor, specialist in Physical and Rehabilitation Medicine (PRM) and in Neurology. She published several articles in Bulgarian and international peer-reviewed scientific journals,. She is author of several books and monographs. She defended three scientific theses: for Phylosophy Doctor in Medical Sciences – on the topic Physical Prevention and Rehabilitation of the Diabetic Polyneuropathy; for PhD in Pedagogics – Contemporary Educational Methods in the Rehabilitation Field; for Doctor Es Medical Sciences - Neurorehabilitation algorithms for patients with socially important invalidating neurological diseases.