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Classification of pains and interventional therapies in pain at children teenagers and young people

Autor: Doru Jurchescu Simona Jurchescu
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SUMMARY
Current orientation of intervention in human afections with various suff erings has led to fi nding important milestones for diagnosis and specifi c therapy of diseases accompanied by pain, including pain whose organic support is not identifi ed. We begin with a remembrance of the algeziological classifi cation that is followed by the principles of pain treatments. Medicine, doctors and pharmacists have appeared in all peoples in order to dominated and decrease the pain. Currently, pain therapy is practiced in classical medical clinics or in specialized services and clinics.
Beneficiaries are the sick – but also the medical staff in hospitals, outpatient clinics or in hospices with an internal disease profi l, pediatrics, oncology, surgery-orthopedics, gynecology-obstetrics, athletics pathology, rheumatology, dermatology, neurology and psychiatry, geriatrics, dentistry, otorhinolaryngology, ophthalmology.
Key words: pain classifi cation in childhood and adolescents, acute and chronic pain therapy, local or generalized pain, pharmacological medication, psychosocial measures to exclude pain fi xations

Classification of pain therapies is based on localization and pain character:
– the first criteria is the inclusion in the pathology of acute pain,
– the second is the diagnosis and therapy of chronic, intermittent or continuous pain, e.g. fibromyalgia, migraine or pain of the limbs, etc.
The following criteria refer to local pain, including: dental pain, eye pain, post-traumatic local pain, migraine, etc., in which, of old times, is used: heat, compression and hydrotherapy. In modern medicine, analgesic drugs are used in the series of peripheral sensory blockages: cocaine, novocaine, lidocaine, xylocaine, ultracaine, ozonotherapy, sonotherapy, etc.; and general analgesics including Paracetamol, Aspirin, Metamizole (Algocalmin), NSAI analgesics and Tramadol opioids, Fentanil etc. [5].
In acute pain there are many interventional iatrogenic therapies [8], so we describe:
– injections and join punctures for therapeutic and diagnostic purposes;
– ileosacral, cervical, thoracic or lumbar branches infiltration;
– injections in the neighborhood of the spine, cranial or peripheral nerves;
– organic or exogenous peripheral nerves blockages; etc.
Therapeutic medical guides and qualified physiotherapy are used. Acute medical treatment is flanked and supported by all the officially recognized physiotherapeutic procedures (manual therapies, functional mobilization therapies, spinal column management, medical training therapies).
The concepts of treatment for chronic pain provide:
– Review, supplement, update and prescribe somatic and psychosomatic diagnoses [8];
– Improving physical performance by developing an individual training-rehabilitation plan;
– Verifying additional therapies, updating doses, updating and clarifying somatic and psychosomatic diagnoses;
– Call for NSAI that can be administered at small ages: from 3 months onwards (Valoron) [9];
– Clarification of somatic, mental and psychosocial conditions of pain disorders;
– Reduction of physical limitations related to pain;
– Education and counseling on drug and nondrug medical treatment for self-care and selfcontrol;
– Clarification of individual mechanisms for the development of painful disease; Multimodal therapy [8] aims at:
– The pain medication therapy in accordance with the current findings of the algeolozical research of the pain pathology;
– Individual psychological therapy, cognitivebehavioral group therapy, relaxation procedures, eg:
z Progressive muscle relaxation or Schulz autogenous training,
z Biofeedback, z Cognitive training on pain neurology,
z Imagination techniques, z Dis-stress management,
z Assist-oriented training for solutions,
z Health, behavioral measures for family reintegration, school and work;
– Behavior towards individual kinetophysiotherapy and group motion therapy after functional analysis; – Additional physical measures;
– Tai Chi and water group;
– Shiatsu massage;
– EMG Biofeedback;
– Rehabilitation with “Rehabilitation” support/ case management [9];
– Establishment and development in the short and medium term of a treatment plan with concrete recommendations;
– Preparation at the end of treatment of a comprehensive report on professional results such as individual diagnosis, psychological point of view, therapeutic procedures;
– Chirotherapy associated in some cases [7].
Algeziologists specialize in basic therapies, combining them with complementary pharmacological therapies that predominate sedatives, anxiolytics, antidepressants, sleeping pills and opioids. Psychosociologists’ recommendations in pain therapy refer to the removal from the traumatic environment (family, school, collectivity) or from the natural disaster area (earthquake, flood, typhoon) or from anthropogenic disaster areas (war, bombing, revolutions, sporting events with mass accidents, etc.) [8].
Natural botanical treatments include aphitherapy and ginseng products, basil, sweet wood, sunflower, which is recommended based on the therapist’s knowledge and experience [4].
The first psychological intervention with therapeutic role is to listen to the patient who will describe his suffering, this model having a catharctic importance. Psycho-medical attitudes focused on children and adolescents are associated with games, kinetotherapy, melotherapy, open space activities: silviculture, floriculture, agriculture, zootechnics, etc., to create a sense of freedom and independence. It is recommended to find the solutions accepted by the subject in treatment along with the counseling by the family doctor and the pediatrician; knowledge of the details of each case [10].
CONCLUSIONS:
Modern Medicine and Pharmacology return to history and recognize the importance of pain study and treatment. The science of ALGEZIOLOGY has fully embraced the practices of acute and chronic pain sufferers, and the Neuropsychiatry of the child, adolescent, and youth is associated with pain control strategies. The authors present the possibilities of intervention in the pains of these ages, and we will also create an experience in this field.

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