Ways to treat acute and chronic pain

Dr. Abdullah bin Moha-mmed Kaaki is head of anesthesia and intensive care of the Faculty of Medicine at King Abdulaziz University in Jeddah. He also works as a consultant anesthetist and is the head of the university’s Scientific Council, which oversees the fellowship training in Saudi Arabia for anesthesia and intensive care.
His scientific interests focus on developing ways to treat pain and train medical personnel in the field of pain treatment and improving the curriculum applied at various universities around the Kingdom to include pain treatment.
Arab News interviewed the doctor about the concept of pain and what can be offered to patients through this specialization as well as the novelty of what is known as pain medicine.
Your research interests are focused on acute and chronic pain and ways to treat it. Can you shed light on the meaning of acute and chronic pain, and on how far you have reached in your efforts in this area?
Acute pain is that of post-surgery or pain caused by an illness and can be a symptom of a disease. It lasts for a short period ranging from hours to days, varying from mild to severe pain. Chronic pain can continue up to weeks and even months or years. It then becomes a disease that affects the patient, his family, and the community at large. Pain is difficult to treat and requires special attention. Examples are lower back pain, neuropathy associated with diabetes, cancer and other tumors, migraine headaches, and pain due to herpes zoster.
As a doctor specializing in this area, besides the treatment of patients to alleviate their pain, I work hard to increase awareness among the medical community on pain and methods of diagnosis and treatment. I also try to increase the awareness of society in general on medicines for pain, and what this specialty can provide its patients. The establishment of the Saudi Society of Pain Medicine last year is a step towards that, and has turned my dream into reality. The society held the first world conference of pain medicine and methods of treatment, which was attended by a large group of interested parties.
Your aim is to develop the curriculum applied at various universities and medical schools in the Kingdom to include a method for treating pain. What is the importance of this program, and have you achieved this goal?
Although pain medicine has been known in the United States since the 1940s, the knowledge on that area of practitioners in the medical field in our country is still limited, resulting in unnecessary pain for patients. That is why educating practitioners in the medical field on pain, its types and its consequences as well as how to diagnose and treat pain is one of the most important ways to increase awareness. Thus, the inclusion of approaches to the treatment of pain in the education curriculum of medical colleges is required and indispensable. As a result, I was keen that pain medicine is part of the platform for teaching anesthesiology at King Abdulaziz University, and hopefully we will continue to pace the curriculum and teach this in various universities.
Within your scientific efforts and practical development of methods for the treatment of pain, what results have you reached in this area? And what can we expect in the future?
Many ways have been provided to treat acute and chronic pain. Thanks to the drugs developed and advanced equipment such as nerve stimulation, high frequency thermal apparatus and fixed pumps planted under the skin instead of just theorizing and treatment with injections for chronic pain, it has become possible in most cases to make the patients' lives more comfortable. In addition, several researches have been conducted in the field of pain medicine. The Prophet, peace be upon him, told us that God Almighty did not come down with the disease, but with its medication, and sent down to us glad tidings that the pain must be treated. I think the future will carry many surprises for us.
The quick opening and expansion of a number of medical schools across the Kingdom has led among some people to the fear that this would be at the expense of quality and skill in education and training of (future) doctors. What is your opinion on this?
The hike in the number of medical schools in all parts of the Kingdom is a step necessitated by the increase in the number of students as well as in the need for medical services in various regions of the Kingdom. This was a fortunate move, but we must ensure that skills are perfected, so that the huge numbers of doctors are not without the desired level of skill. We must assure a high level of education and be careful to provide higher training, which is an indispensable requirement in all colleges around the Kingdom. Furthermore, we must have a mechanism that enables us to follow up and ascertain whether the quality and workmanship are implemented, either through the Ministry of Higher Education or through any other means.
Some people see the problem patients and visitors face in crowded hospitals, such as the long waiting lists for appointments with doctors, as a result of a lacking administrative organization. For instance, a citizen can open several medical files for himself and his family in more than one hospital, and he visits all of them. Others believe opening more hospitals to meet the population increase is important to solve the problem. What causes, from your point of view, the crowded hospitals?
I think this situation is the result of several factors: exploitation of patients of medical services, increased pressure on practitioners in the medical field, the incompatibility of the increase in medical services with population growth, and the involvement of several government sectors in the provision of medical services.
From time to time, we hear news of the death or permanent disability of some patients because of an error in anesthesia. What causes these errors and why are they increasing?
Undeniably, there can be complications due to anesthesia, but most such cases are the result of the failure of some practitioners in the field of anesthesia, the lack of knowledge of the patient’s condition, or the lack of medical education. Sometimes, these cases can be blamed on negligence. However, I don’t think there is an increase in the occurrence of such cases, but a growing spotlight on this issue, and an increase in media interest might be the real reason behind it.