Pain is a discomfort for the patients and the caregivers. The moment pain disappears the patient and his bystanders feel better, also the doctors. But, there are certain situations wherein the pain
disappears but the pathology advances.
Here are some examples wherein the patient feels better but pathology advances:Peritonitis:
In the initial stage of peritonitis, there will be pain, tenderness and rigidity of the abdominal wall. But this stage will be followed by a stage wherein no pain is felt and the patient feels better. But this is followed by a dangerous stage that may be fatal.Appendicitis:
Hyperesthesia and pain in the Sherren's triangle is prominent in gangrenous
appendicitis, and if this sign disappears it indicates bursting of gangrenous appendix, which is a dangerous situation.Renal stones
: Some times the pain disappears, but when we take the sonography, the stone size is doubled with severe hydronephrosis.Dengue fever:
In patients suffering from dengue fever, the temperature and other discomforts dissappear temporarily. And the next stage follows that can go into dengue hemorrhagic fever or dengue shock syndrome.Ulcers:
In a case of foot ulcer, if the patient says that pain is disappeared, suspect nerve involvement in the form of diabetic neuropathy.Pericarditis and pleurisy:
Here when the effusion starts, the pain as a result of rubbing of the two layers disappear. But the effusion can be dangerous if not managed properly.Malaria:
In intermittent fever also patient feels better for a while, which will be followed by a severe paroxysm.
I have also seen amelioration of sufferings in case of bedridden patients, a few days/hours before death.
Hence, do not give over-importance to the words of patient and his bystanders, but always rule out the advanced pathology by clinical examination and necessary investigations.