Non-Conventional Pain Management for Sickle Cell Disease

Abstract

Sickle cell disease is a congenital blood disorder affecting hemoglobin molecule. It leads to a rigid, sickle like shape red blood cell. Most people with sickle cell disease have severe painful episodes called vaso-occlusive crises. However, the frequency, severity, and duration of these crises vary tremendously. The pain is classified into two types, nociception pain which is intact peripheral or central nervous system and neuropathic pain which is initiated by dysfunction of the peripheral or central nervous system. Despite the pain being the most common complication of sickle cell disease, there is a lack of novel pain treatments. Pain killers including opioid have continued to be the main stay of therapy over the past several decades. A non-conventional treatments for pain were applied effectively to avoid the serious systemic side effects of the pharmaceutical pain killers.

Sickle cell disease in Nigerian children: A cross-sectional study on parental awareness and home management of pain

“…Furthermore, a higher percentage of adults with SCD experience chronic, debilitating pain which may prompt them to seek alternative means of pain control. 9,11,26 The use of Non-steroidal anti-inflammatory drugs (NSAIDs) as the medication for pain relief were in the majority (47.0%) in this study, which is not surprising, given its proven efficacy and recommendation for use in mild to moderate painful episodes. 3,12,15,16 On the other hand, it was found that massage was the most frequently used CAM among the respondents (50.0%).…”

“…[1][2][3] Amongst other complications, persons living with SCD experience pain which has been found to be the most consistent and characteristic feature. [9][10][11] The spectrum of clinical expression is however heterogenous, varying in intensity, frequency, duration and affected sites. 3,9,12 Pain in SCD is classified as episodic (acute) or persisting (chronic).…”

“…3,9,12 Pain in SCD is classified as episodic (acute) or persisting (chronic). [9][10][11][12][13] Episodic pain occurs during vaso-occlusive events due to activation of nociceptive nerve endings in ischaemic bones or the mesenteric vessels of the abdomen. 9,10,12,13 On the other hand, persisting pain can result from tissue damage due to avascular necrosis or chronic leg ulcers, as well as subopti-mal treatment of recurrent acute painful episodes.…”

“…9,12 While episodic pain is commoner in younger children, adolescents tend to experience more of persisting pain. 11,12 The attendant negative consequences associated with these painful episodes include decreased school attendance, social functioning, physical activity/mobility and negative psychosocial consequences. [10][11][12]14 One of the core principles of management of pain in SCD include adequate analgesia with drugs such as paracetamol (acetaminophen), Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) and opioids.…”

“…11,12 The attendant negative consequences associated with these painful episodes include decreased school attendance, social functioning, physical activity/mobility and negative psychosocial consequences. [10][11][12]14 One of the core principles of management of pain in SCD include adequate analgesia with drugs such as paracetamol (acetaminophen), Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) and opioids. 3,9,12,15 Recent guidelines on pain management have also recommended the use of non-pharmacologic methods including Complementary and Alternative Medicine (CAM).…”