Abstract | Bol je neugodno osjetilno i emocionalno iskustvo udruženo s akutnim i mogućim oštećenjem. Ima zaštitnu ulogu jer štiti organizam od mogućih oštećenja, te pomaže da održimo funkciju organa, organizma kao cjeline. Bol je jedan od svjetskih zdravstvenih problema, a najčešći uzroci boli su ozljede, kirurški zahvati, zloćudne bolesti te hormonski poremećaji. Uobičajena podjela boli je na: tjelesnu, duševnu i tjelesnu psihogeno uzrokovanu. Tjelesna bol je simptom zbog kojeg se bolesnici najčešće obraćaju zdravstvenoj službi, bol je upozoravajući mehanizam koji obaviještava da je došlo do ozljede tkiva ili disfunkcije pojedinih organa. Duševnu bol često nazivamo i patnjom. To je stanje duboke žalosti često vezana uz strah, tjeskobu i ostale negativne emocije koje se javljaju nakon nekoga, za pojedinca, nenadoknadivog i značajnog gubitka. Odnos između boli i ozljede nije jednostavan, tj moguće su : ozljede bez boli, boli bez ozljede, boli nerazmjerne težini ozljede, boli nakon izlječenja ozljede. Ozljede bez boli- neki ljudi rađaju se bez osjetljivost na bol. Ovaj vrlo rijedak genetski poremećaj poznat je pod nazivom analgezija. Boli bez ozljede- česte su kod tzv. psihogenih boli kod kojih se bol javlja nakon psihičke napetosti i gdje ne postoje nikakva organska oštećenja. Boli nerazmjerna težini ozljeda- može se javiti kod neznačajnih tjelesnih procesa koji nemaju veliku tjelesnu važnost za ukupno zdravlje pojedinca, a izazivaju vrlo jake boli. Bol nakon izlječenja ozljede- vrlo je česta nakon ozljeđivanja živaca, a poznati primjeri ovakve boli su fantomska bol i kauzalgija. Kauzalgija je vrlo jaka bol žareća tipa koja nastaje kao posljedica nakon ozljeđivanja koja uzrokoju oštećenja perifernih osjetilnih živaca. Fantomska bol se javlja kod ljudi kojima je amputiran dio tijela (noga, ruka, dojka). Bolesnici osjećaju bol u dijelu tijela koji im je amputiran, dakle više ne postoji, i toliko jasno doživljavaju bol da im se čini kako taj dio tijela još uvijek postoji. Osim što uzrokuje zdravstvene, fizičke i psihičke poteškoće, bol značajno utječe i na gospodarske prilike pojedinca i drušva u cjelini, stoga veliku pažnju treba posvetiti njenoj prevenciji i izlječenju. Liječnikova je obveza otkriti uzrok boli i ublažiti/otkloniti bol. Pristup liječenju kronične boli, katkad i akutne, je multidiscipliniran i treba primjenjivati farmakološke i nefarmakološke metode liječenja (fizikalna terapija, TENS, ultrazvuk, laser, vježbe, toplina i hladnoća), a ponekad i komplementarne metode liječenja boli (akupunktura, kiropraktika i druge). Iako je ostvaren veliki napredak u liječenju kronične boli, još uvijek mnogo bolesnika pati zbog loše procjene boli i liječenja. |
Abstract (english) | Pain is an unpleasant sensory and emotional experience associated with acute and possible damage. It has a protective role because it protects the body from damage and helps to maintain organ function, the organism as a whole. Pain is one of the world's health problems, the most common causes of pain are injury, surgery, malignancy, and hormonal disorders. Delineation of pain is to: physical, mental and physical psychogenic caused. Physical pain is a symptom for which patients most often asked for medical help, the pain is a warning mechanism to inform that there is a tissue injury or dysfunction of individual organs. Mental pain and suffering often called. It is a state of deep sadness often associated with fear, anxiety and other negative emotions that occur after someone, for the individual, irreparable and significant loss. The relationship between pain and injury is not simple, that is possible: injury without pain, without injury, pain disproportionate to the severity of injury, pain after healing of injuries. Injuries without pain - some people are born without sensitivity to pain. This very rare genetic disorder is known as analgesia. Pain without injury - common in so-called. psychogenic pain where the pain occurs after mental tension and where there are no organic damage. Pain disproportionate the difficulty of injury- may occur in insignificant physical processes that do not have great physical significance for the total health of the individual, and cause very severe pain. The pain after healing injury - very common after injuring nerves and known examples of such pain are phantom pain and causalgia. Causalgia is very severe pain, burning type that occurs because of injury of damage causing their peripheral sensory nerves. Phantom pain is common in people who are missing the lower part of the body (leg, hand, and breast). Patients feel pain in a body part that they amputated therefore no longer exists, and so clearly perceived the pain that they feel that the body is still there. In addition to causing health, physical and mental difficulties, pain significantly affects the economic situation of the individual and society at large, so big attention should be paid to its prevention and cure. The doctor's obligation is to disclose the cause of pain and mitigate / eliminate pain. Access to treatment of chronic pain, sometimes acute, is multidisciplinary and should be administered pharmacological and non-pharmacological treatments (physical therapy, TENS, ultrasound, laser, exercise, heat and cold), and sometimes pain treatment methods (acupuncture, chiropractic and other) . While there has been great progress in the treatment of chronic pain, many patients are still suffering because of poor pain assessment and treatment. |