What do you do when you experience pain?
If you’re Malaysian, chances are you will power through it and continue with your daily activities like a trooper!
According to the Global Pain Index (GPI) 2020 study, 85% of Malaysians experienced some form of pain last year, with 80% saying they felt the need to persevere through it instead of seeking treatment.
Globally, 73% of respondents said they were tough and could handle their pain.
The toughness level was highest in Russia (82%), while India, Malaysia and Poland came in next at 80%.
The Japanese market ranked lowest at 37%.
Even though 32% of Malaysians experienced pain on a weekly basis and more than half of them (53%) were in pain for several hours, with 68% rating their pain as very severe, a whopping 60% choose to delay treatment.
Headache was cited as the top cause of pain (89%).
“Interestingly, even if they can endure pain, 74% feel their emotions are impacted by pain.
“Yet, they’re less likely to medicate and would rather wait to get treatment or not get treated at all.
“This is phenomenal behaviour as all measures are higher in Malaysia than the global average,” says GlaxoSmithKline (GSK) Consumer Insight lead (South-East Asia and Taiwan) Shawn Roy.
“The apparent reason could be cultural, and our belief in natural or alternative solutions, as there are some barriers concerning taking pills, which come from the perception that drugs are not safe,” he adds.
The GPI 2020 international study was commissioned by GSK Consumer Healthcare to investigate people’s pain experiences globally, how it impacts their daily life, and to understand and assess how people manage their pain.
Carried out online in January, the quantitative study surveyed 19,000 respondents aged 18 to 65+ years from 19 countries, including Malaysia (1,000 respondents).
Although we had a high incidence of pain in 2019, we ranked second lowest in the world in terms of seeking treatment among the countries surveyed.
Only 48% took pain medication, compared to 65% globally.
The go-to sources for pain medication in Malaysia are: 72% from pharmacies, 48% from doctor’s prescription, 31% from local drug stores, 23% from local general stores (i.e. supermarket), and 5% through online shopping.
The majority of us though (74%) apparently prefer to just rest and sleep it off.
“The numbers are pretty significant as it correlates with the Health Ministry’s 2019 National Health and Morbidity Survey (NHMS), which reported 35.1% of adults aged 18 years and above have low health literacy.
“Given the data presented in this study, it is very important to provide accessible and easy-to-digest health information with verified sources on the right channels to empower and improve the community’s health literacy,” says GSK Consumer Healthcare Malaysia general manager Bryan Wong.
Parents more proactive
Participants with children were more active in treating their pain; obviously because they have more responsibilities and duties to perform.
They were more likely to take medication (52%), seek advice from healthcare professionals (46%) and seek information about how to treat pain effectively (36%).
For childless participants, less than two in five treated their pain immediately.
If the pain was mild, they’d rather just live with it (31%) than take medications, with 29% worrying about drug dependency and 25%, side effects.
Adds Roy: “Seven in 10 parents found their ability to care for their children was affected while they were in pain, with more than half of them (56%) believing it impacted those around them as well.
“Research has shown that long periods of unrelieved pain can lead to adverse psychological and physical complications.
“In fact, the GPI 2020 showed that 67% of Malaysians believed pain decreases their quality of life – it immobilises them from being able to focus, limiting their ability to be productive or sociable.
“This effect of delayed or untreated pain poses a negative impact on the patient’s day-to-day lifestyle (72%), and also affects society and the country’s economy.”
The Malaysian Employers Federation’s Man-Days Lost and Absenteeism Survey 2019 found that more than 10.7 million days were lost due to sick leave.
According to consultant anaesthetist and pain management specialist Dr Gopinathan Raju, Malaysians’ low health literacy rate is alarming given the fact that we are a developing nation, where people are expected to know about basic health issues.
“We don’t know about taking care of our own health because of age or socioeconomic status.
“People are not familiar with medical terms, don’t know about diseases and don’t know where to seek help.
“They prefer to suffer and wait out the pain because they worry that the diagnosis will be a serious illness.
“This misconception and fear keeps them from consulting a doctor so they don’t update their knowledge,” he says.
What is pain?
The International Association for the Study of Pain defines pain as, “An unpleasant sensory and emotional experience associated with actual or potential tissue damage.”
Says Dr Gopinathan: “Pain is very subjective and we all experience it in a very different way.
“It cuts across biological, psychological and social factors.
“A person’s report of an experience as pain should be accepted as such and respected.
“Pain is known as the fifth vital sign and most developed countries accept (freedom from) pain as a human right.
“Not only is pain physical, suffering emotionally is also a type of pain.”
He adds: “Pain is the commonest presentation of patients who come in to the hospital, and as doctors, our job is to treat them.”
Duration-wise, pain can be classified as acute or chronic.
Acute pain occurs at the onset of injury, e.g. when you fall or sustain a cut.
It is a sharp and stabbing sensation, which can last up to three months.
Chronic pain lasts beyond three months (e.g. headache, back pain, cancer pain, arthritic pain, etc).
The sensation can be described as pins and needles, dull or burning.
“Patients with acute pain will have a rapid heartbeat and appear anxious, sweaty and afraid, while with chronic pain, they are withdrawn and depressed.
“In chronic pain, we have to treat the emotional component to treat entire picture of pain,” Dr Gopinathan explains.
Pain can also be generally categorised as nociceptive pain and neuropathic or nerve pain.
While nociceptive pain is related to the nociceptive sensory nerve, which senses and reacts to external factors that may harm or threaten the body, nerve pain is due to an injury or malfunction of the nervous system.
Whatever the pain type, it is treated using a variety of pain-relieving methods, such as medications, non-drug methods (ice packs, rest, physiotherapy), interventional pain procedures (to block pain impulses), and as a last resort, surgery.
Painkiller myths
The most common and widely-used drug to treat pain is paracetamol (also known as acetaminophen).
It is available as both an over-the-counter (OTC) and prescription pain and fever relief medicine for all age groups, including pregnant women, young children and the elderly.
Dr Gopinathan says: “Paracetamol is a class A drug that ranks first for suitability and is among the top pain relievers worldwide.
“It has been around for more than 100 years, is versatile and comes in the form of tablet, capsule, liquid and injection.
“All doctors use it to treat mild to moderate pain.”
Despite the safety and efficacy of paracetamol in healthy individuals, there are a lot of myths surrounding it.
“When somebody tells you a drug is not good, you must know where the information is coming from – is the source credible and is it based on evidence published in medical journals?
“Consult a doctor for medical advice instead of self-medicating.
“Keep in mind that what you or your friend think is right may not be right from the medical point of view.”
The anaesthetist debunks some of the common myths:
“Paracetamol is processed in the liver, takes an hour to work and keeps working for around three hours.
“It’s excreted through the kidneys via the urine and doesn’t accumulate or last more than one day in your body.”
“Paracetamol is a very well-tolerated drug, has a low rate of side effects and rarely causes interaction with other medicines.
“There are no bad drugs, only bad users.
“If you don’t take a medicine in the right dose, you’re not going to get the effects, but if you take it at a higher dose, you will get the side effects.
“So sometimes, it’s the patient who is at fault or the doctor who fails to tell the patient about this.
“In the correct dose, paracetamol doesn’t harm the body.”
“Your body will not build resistance to paracetamol.
“When used as directed, it stays effective at the same dose each time.
“When you are in pain, the effects of medicine depend on the dosage.
“You will never be addicted as paracetamol doesn’t work like other stronger meds, e.g. opioid where you need a higher dose the next time as your body becomes used to it.
“For an adult above 50kg, the maximum safe dose of paracetamol is 4g per day, or 1g every six hours.
“If you have a headache, take 1g or 1,000mg at one go for faster relief if you are healthy.
“For patients with renal impairment, consult your doctor.”
As 31% of the survey respondents said they would avoid taking drugs and 35% preferred natural solutions such as traditional and complementary medicines (TCM), Dr Gopinathan comments: “There is no right or wrong when it comes to TCM.
“You are welcome to try it as long as it is safe and you are not consuming anything.
“Some TCM practitioners like to give herbs to drink, and because you don’t know what it contains, it can interact with Western medicines.
“All these are temporary measures, not permanent solutions.
“If you’re comfortable, carry on, but remember that they don’t cure.”
Recognising the gap and low health literacy level in Malaysia, GSK Consumer Healthcare Malaysia is collaborating with Watsons Malaysia to roll out the Know Your Medicine, Find the Right Relief campaign this month (September 2020).
The month-long campaign aims to educate and increase Malaysians’ access to knowledge about medicines that will help in their pain management journey.
Says Dr Gopinathan: “If the pain bothers you, please address it as it’s a sign that something is wrong.
“In clinics, we have a pain scale out of 10: one to three is mild pain such as a headache, but you can continue to work; four to seven is moderate pain such as a toothache and you may or may not be able to work; and eight to 10 is severe pain where you cannot continue with work.
“For mild pain, take a simple pain medicine; if moderate, seek help; and if severe, go to the hospital.
“Don’t procrastinate and suffer in silence.”
Already a subscriber? Log in
Get 20% OFF The Star Digital Access
Cancel anytime. Ad-free. Unlimited access with perks.
