The survey indicated that around 85 per cent GPs lacked knowledge about modern methods for pain relief such as interventional pain modality. - Photo by Reuters

KARACHI: While backache is the most commonly reported pain at clinics across the city followed by knee joint pain and headache, most general practitioners (GPs) in the metropolis have been found unaware about the role of anaesthetists in pain management and modern pain relief technologies, a survey showed.

Around 400 GPs from 18 towns of Karachi participated in the survey, Knowledge about pain clinics and pain physician; a cross sectional survey of Karachi, Pakistan, which was recently conducted at the Department of Anaesthesia of the Aga Khan University and Hospital (AKUH).According to the study, the highest number of patients (70.8pc) visit GPs for backache, followed by knee joint pain, headache and neck pain.

The study showed that about 52.6 per cent GPs had seen patients with a history of chronic pain and 92.7pc GPs were aware that a pain clinic was operating in the city.

The survey indicated that around 85 per cent GPs lacked knowledge about modern methods for pain relief such as interventional pain modality in which pain is relieved by injecting drugs / radiofrequency near pain producing nerve.

The most common method recommended for pain management was oral medicine (93.9pc), followed by injection while 42.1pc GPs asked for investigation. Referral was done in 32.6 cases only.

A neurologist was referred to in 51.6pc cases, followed by a general physician having training in pain management (42.3pc).

Internet / scientific literature were major source of information in the survey. It was also found that GPs, who were attending regular educational programmes, were well aware about new disciplines and modern way of treatment.

Speaking to Dawn, Dr Gauhar Afshan, principal investigator, heading the pain clinic anddepartment of anaesthesia at the AKUH, said that it was unfortunate that most GPs were unaware about modern techniques for management of pain that affected a large segment of society.

Pain, she said, had a profound impact on the quality of life and was a major health problem worldwide. Chronic pain posed a massive disease burden, affecting an estimated 20 per cent of adults and up to 50 per cent of the old age population.

Chances of depression

'A WHO study found that people who live with pain are four times more likely to suffer from depression or anxiety. Under-treatment of pain is a poor medical practice that results in many adverse effects.

'Unrelieved pain after surgery/trauma increases heart rate and blood pressure and places patients at risk of heart attack, stroke, bleeding and other complications.

Relief from pain had been acknowledged as a universal human right by the World Health Organisation (WHO), she said, adding that pain management should be individualised, holistic and organised through a multi-disciplinary approach.

'The management of pain is currently regarded as an anaesthesia sub-specialty, though experts from other disciplines can also learn the subject. In Pakistan, a very few institutions offer a separate service for pain management,' she said.

The sixth South Asian Regional Pain Society (SARPS) Congress being held from Jan 13-15 would help a great deal in creating awareness about modern pain management, she said.

'The event comprises a number of pre-conference workshops that would be held across the country, besides a symposium on common pain problems, scientific oral and poster presentation (original research) art competition and discussion programmes,' she concluded.