Learning about pain

One of the best things about being involved in a new and rapidly expanding area of veterinary medicine is the opportunity to get involved in discoveries at the forefront of the field and try to answer some of the new questions that our expanding knowledge creates. I recently had the privilege of attending a course on neuroscience discoveries in the field of persistent pain and their implications for its management. Most of the other delegates work with human patients, and as ever many were initially surprised to find vets in their midst- even our human medical counterparts are not always aware of the current developments in veterinary rehabilitation. However, events like this are a great way to open discussion and foster co-operation between professions with different areas of expertise and definitely encourage wider thought around the subject. While there are some relatively straightforward ways in which experience in the human field can help shape our approach to animal patients in persistent pain, such as understanding previously misunderstood physiological responses elsewhere in the body, explaining strange phenomena such as phantom pains in missing limbs, and appreciating the importance of the animal’s environment- including its owners- on the patient, other aspects will as ever prove harder to apply. Some current techniques in human pain management are heavily reliant on teaching the patient to understand their brain’s responses to what it perceives as threats to the body, identifying trigger factors specific to themselves, and learning to manage them in a graded and controlled way. How will we transfer this knowledge to our animal patients without presuming a lot that we cannot prove, and how will we measure if our efforts are succeeding? How far is it reasonable to go in order to gain evidence that might improve future treatment of our patients? We can’t answer all of these questions straight away- but I think it’s important that we’re trying to.