[MUSIC] [MUSIC] [MUSIC] National statistics from many countries around the world show that the most frequent comorbidities associated with chronic pain They are anxiety and depression. And it's not hard to explain this situation because of the implications of this condition both in the nervous system and in the behavior of individuals. To evaluate the results of these two conditions in humans suffering from pain and specifically neuropathic pain, We are going to have the expert, Dr. Carlos Morales. Doctor Morales, please tell us briefly about your professional career. >> Thank you very much. My name is Carlos Morales, I am a clinical psychologist, I have a master's degree in clinical psychology and health and I have in multidisciplinary pain management work, experience of more than ten years, in addition to a job with chronic pain management about six or eight years before starting to work here in the unit. >> We understand from your description that you very often see patients as well of chronic neuropathic pain. Tell us a little more about this situation. >> I have the opportunity to see patients with neuropathic pain in the area inpatient and in the outpatient setting. The condition that neuropathic pain patients have is the management of the use of medications, the impact it has on your quality of life, the difficulties you present at a personal or family level that implies having this pain condition. >> We often wonder what mental conditions and what impact emotional has chronic neuropathic pain in these patients. >> Mental disorders associated with neuropathic pain usually or what the evidence shows us, they are associated with anxiety and depression. They are patients who do not understand or who are very distressed or who worry a lot because of the symptoms that their condition generates or because they have been suffering this pain or enduring this pain. This is what most impacts their quality of life and what deteriorates them in his psychoemotional part. >> One of the forms of treatment for patients with chronic pain neuropathic corresponds to the group of opioid drugs. There is great concern in society about the phenomena of addiction, dependency and even death. In the group of patients that you see has been able to detect any of these conditions and there is, in your experience and knowledge, some red flags to alert us about Who could abuse opioid drugs and other substances? >> The red flags that can be had for the management of opioids, in addition to its side effects, is the misuse that has been given to it at the family level at the of alcohol, other types of substances or improper handling of medications. This indicates to us that a patient can have a high, medium, low risk of misuse of medications, in this case opioids. What we most want is to teach them what those effects are that they can have for that they can have a good treatment and an adequate follow-up by their specialist. >> Frequently, patients presenting with neuropathic pain They tend to be isolated. Could you tell us some strategies? of coping with neuropathic pain that we could recommend to patients? >> Neuropathic pain, unfortunately as it is not seen in patients, they do not have clear symptoms that can be perceived in their body, patients assume or worry that their family does not believe them or they tire of telling them or they exhaust the family to complain a little about something that is not being seen. This is what leads them to move away a bit. When these patients walk away, what they do is lose their support network or their family network. And what we most want to rescue is that the whole family learn not only from the condition they are having, but also that they may have the tools enough so that they can help you in times of pain, you are acute or at times when they need to ask for help to do different things. An important part is also managing your daily activities. The part in which they do not stop doing their activities is what I like the most. can protect them or help them cope with low mood so they don't lose the way to go out, friends, study, work, because in any case having neuropathic pain you have to understand that life goes on, but some modifications must be made so that they can have the best quality of life possible in the face of the condition they are having. >> Characteristically, patients with chronic conditions they often resort to self-medication when they do not find the proposed analgesic goals, as is the case of neuropathic pain. Do you have any recommendations? to increase adherence to this type of treatment? >> What is intended is to fill them with pain management tools non-pharmacological so that they do not abuse or misuse medications, in this case, the ones that most concern us, which are opioids. Nor that they reach self-medication or that they do some practices that can make your condition more chronic. There is a part in non-pharmacological management, which are the tools that we want to offer patients so that they they can perform a series of exercises that allow them to self-regulate their emotions so that the pain does not increase. What does this consist of? In generating for them some guidelines, teachings, where they can realize that the pain is not something that will accompany them all their lives or that will be for all their lives, but it comes as in waves that some moments are going to be sharp and the tools that we offer them is so that they can download them at that time. >> In chronic conditions, such as neuropathic, the patient often makes the pain symptom the axis of his life. It is important to detect and plan actions of coping so that this frankly catastrophic situation does not occur. What could you recommend to patients? >> Well, the first recommendation is for doctors, Let's be empathic with patients and understand that they are in pain. The second, for patients it is great to start to realize that pain, although it is present in all areas of your life, you still have areas that are very important to you, health, family, the economic part, the work part. And although in all it is not going to perform in the best possible way, you can prioritize what activities you can do, which ones have to be immediate, which ones can take a little longer, what you can do when you have a little more controlled pain, let the pain be minor, or the ones you can stop doing that you know will cause you pain. It means that one must, as a patient, begin to know a little more about its symptoms, to be able to recognize it, to be able to know yourself how far you can tolerate pain and keep track of your medications, go to your appointments, try to be with specialists as close as possible so that you can feel good, supported and that if the specialist is not there, his family is, his friends are. And don't stop going out because whoever loses doing the activities, whether there is pain or not, it is you. [MUSIC] [MUSIC] [MUSIC] [MUSIC] [MUSIC] [MUSIC
