Managing Pain

Learn more at content.accenthealth.com/pain

At some point, everyone feels pain. It might be the result of an injury, surgery or overuse. Or it might be related to a medical condition such as arthritis or fibromyalgia. Whatever the cause, pain can interfere with your ability to sleep, work and enjoy life.

Pain often goes away quickly. But pain can also last for many months and sometimes years. This is called chronic pain. Today there are many options to help you find relief.

Talk with your doctor:

Whether this is your first visit or a follow up ask your doctor.

*What is causing my pain?

*How long should I expect the pain to last?

*Are there any lifestyle changes that might improve my pain?

*Are there any alternative therapies that might help?

*What should I do if there pain gets worse?

Tell your doctor if :

*The locations type or severity of your pain has changed since your last visit.

*You think your medications are causing any side effects.

*You are trying any alternative treatments like acupuncture or taking an herbal remedy.

What is pain?

Pain is an unpleasant feeling of discomfort, often caused by illness or injury.

Pain can serve as a warning that something is wrong. Pain can also help with healing. It tells you to avoid touching a wound or using a joint that’s on the mend. Pain can also be felt for no clear reason.

There are two main types of pain:

*Nocieceptive pain: This is that occurs when body tissue is injured. Examples include burns, sprains, broken bones or inflammation from an infection or arthritis.

When you band your finger, the signal starts at the very tips of the nerve cells, travels to and up the spinal cord and into a part of the brain called the thalamus.

The thalamus sends the signals out to several parts of the brain including those that control touch, emotion, physical reaction and memory.

*Neuropathic pain: This kind of pain, also called nerve pain, happens when the nerves themselves become irritated. Nerves that were once a mere messenger of pain become a source of pain.

Conditions that cause neuropathic pain include a “pinched nerve” (like sciatica), diabetes, shingles and multiple sclerosis.

Understanding types of pain:

Pain can be classified by how long it lasts:

*Transient pain: this is a sensation that accompanies a bang, bump or nick as well as the occasional headache. It lasts for a few seconds to a few hours.

*Intermittent pain: this type of pain comes and goes.

*Acute pain: Acute pain lasts from a few minutes to a few weeks. It usually results from disease, inflammation or injury. Examples include burns and sprains. Its cause can often be identified and treatment. It usually goes away once the injury or disease has healed.

*Chronic pain: Chronic pain lasts for months or eve n years. Conditions that cause chronic pain include arthritis, fibromyalgia, irritable bowel syndrome and others.

Diagnosing pain:

When diagnosing pain, the first and most important task is to rule out serious causes, such as heart disease or cancer.

Your doctor will typically ask several questions about your pain, including:

*When it started

*Its location

*Its intensity

*Other symptoms that accompany it

*Its impact on your daily activities

*Any treatments you’ve already tried

The doctor will perform a physical examinations. He or she may also order blood tests or imagining tests, like an x-ray, to help identify what is causing the pain. It isn’t always easy to identify the cause of pain.

Describing your pain:

Your doctor may ask you to rate your pain:

When your doctor asks you to describe your pain, try to use descriptive words such as:

*sharp/stabbing, dull, hot/burning, cold/freezing/sensitive, tender, itchy, shooting, stinging, numb, tingling, cramping/squeezing, radiating/spreading, throbbing/pounding, aching, and gnawing/biting.

Your doctor may ask these questions:

Is the pain steady or does it come and go? Does it get better and worse or stay the same? What relieves or worsens the pain? Is the pain better or worse at different times of day? Does it vary based on whether you are active or inactive?

Keep a pain journal:

Try to record the frequency, intensity and duration of your pain in a pain journal. It can help you and your doctor identify what triggers your pain and track whether or not it improves over time.

Medicines for pain:

When your aren’t in pain, it’s easier to work, care for family, participate in daily activities and enjoy life.

Analgesics:

Medications used primarily to relieve pain are called analgesics. Nonprescription or over the counter pain relievers are generally used for mild to moderate pain. Prescription analgesics are used for moderate to severe pain or pain that doesn’t respond to over-the-counter medications. There are two common classes of analgescis:

*Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain and also reduce inflammation. Some are available over the counter; some require a prescription.

*Acetaminophen helps relieve pain but does not reduce inflammation.

Anticonvulsants and antidepressants:

These drugs, mainly used to treat seizure disorders and depression are sometimes used to treat pain.

Opioids (narcotics):

Opioids relieve pain. But they must be taken with care because they can be addictive.

Other treatments:

Topical pain relievers are applied to the skin.

Creams and gels: These contain a wide variety of substances. Ones that contain salicylates reduce inflammation. Others contain “counterirritants,”such as menthol or eucalyptus, which provide a cooling or warming sensation intended to distract from the pain.

Corticosteriod shots:

These shots are injected into an inflamed part of your body such as a joint. The cortiscosteroid is usually mixed with a local anesthetic.

Nerve block:

Nerve block used drugs, chemical or surgical techniques to block the transmission of pain messages between specific areas of the body and the brain.

Surgery:

In some cases, surgery may be needed to relieve pain.

Treating pain without drugs:

Some nondrug treatments can relieve pain.

These may be used instead of medications or in addition to it:

Cold and heat:

*Cold can reduce swelling and decrease pain. Apply a store bought cold pack, a bag of frozen vegetables or ice cubes wrapped in a towel to the affected area-for no more than 20 minutes at a time, four to eight times a day.

*Heat can relax muscles and ease pain. Try moist compresses, hot packs, warm baths and showers, hot whirlpools and heat lamps to temporarily relieve pain. Don’t use heat or cold for too long.

Pain relieving devices:

Special devices can help support painful joints, relieve pressures on irritated nerves and soothe aches and pains. They include splints and braces canes, crutches, walkers and shoe inserts.

Longer-term pain relief options:

*Physical and occupational therapies:

Physical therapists use techniques and exercises to help ease pain and improve strength and range of motion. They customize programs to fit your goals. Occupational therapists help improve your ability to perform activities of daily living, such as dressing, bathing and eating.

*Exercise:

An exercise program can help relive chronic pain. It should include regular, gentle aerobic activity, stretching and range of motion exercises and strengthening exercises. Extra weight on joints can cause pain. If you are overweight, losing weight may help relieve pain.

*Alternative therapies:

Therapies that address the whole person, including the mind and emotions, can help restore a sense of control over pain. Some techniques include:

*acupuncture, biofeedback, breathing exercises, chiropractic, cognitive behavioral therapy, hypnosis, massage therapy, mediation, progressive muscle relaxation, yoga and tai chi.

Common kinds of pain:

Finding the right treatment often takes time and patience. Here are some of the most common types of pain:

*Shingles nerve pain:

Shingles is painful, blistering rash. For people, shingles pain remains long after the rash is gone. This continued nerve pain is called postherpetic neuralgia. Posttherpetic neuralgia is a difficult type of pain to treat. Certain medications may help.

A shingles vaccine is recommended for older adults. The vaccine reduces the risk of getting shingles. It also reduces the risk of postherpetic neuralgia if you do get shingles.

*Diabetic neuropathy:

Diabetic neuropathy is nerve damage caused by diabetes. It most often affects the nerves in the feet. In addition to pain, it also causes numbness. It increase the risk of serious foot injury. Keeping your blood sugar close to the normal range helps prevent diabetic neuropathy.

People experience pain differently based on the type of pain and how their brain responds.

*Low back pain:

Most people with back pain get better within a week or two with a combination of brief rest, cold packs and pain relief medication. But for some people, low back pain persists for weeks or months.

If you have or periodic bouts of low back pain, you may find relief with:

*exercise, including yoga and tai chi

*physical therapy, particularly back-strengthening exercises

*therapeutic massage

*topical pain relievers

*Abdominal pain:

Irritable bowel syndrome (IBS) can cause pain, diarrhea, bloating, cramps or constipation. Avoiding foods containing a group of poorly digested sugars and fibers called FODMAPs may help. Probiotic supplements might be worth trying, too.

Other approaches include cognitive behavioral therapy, antidepressants and mind-body relaxation therapies.

Other common kinds of pain:

Osteoarthritis:

Osteoarthritis causes stiffness and pain in the joints, especially the knees and hips. Osteoarthritis  develops when cartilage-the connective tissue that covers bones and acts as a cushion-deteriorates. Over time, the space between the bones narrows and the surfaces of the bones change shape. This eventually damages the joint. A combination of medicines, weight loss and physical therapy can help relieve osteoarthritis pain.

Fibromyalgia:

Fibromyalgia causes pain and stiffness in multiple tender points throughout the body . It leaves people feeling achy and fatigued.  People with fibromyalgia may be more sensitive to pain than others. Medications to decrease symptoms often include the same drugs prescribed for nerve pain, such as antidepressants and antiseizure medications.

Nondrug therapies, including alternating cold and heat; tai chi, yoga and other forms of exercise; acupuncture and therapeutic massage can also be helpful.

Additional types of pain:

Cancer Pain:

Pain often occurs when cancer spreads to or presses on bones, nerves or organs. The type of cancer you have and how far it has spread usually determines whether you have pain, the amount of pain you have and how it can be treated.

Migraine headaches:

Migraine headaches are intense, throbbing headaches that tend to affect one side of the head. They can be excruciating and debilitating. Many migraine sufferers also experience nausea and vomiting or become sensitive to light and sound.

Migraines are best managed with medications to:

*head off symptoms if you have a warning (aura) before the headache starts.

*relieve symptoms when you have a migraine

*prevent migraines from occurring

Avoiding migraine triggers also helps. These are foods, drinks, smells, activities or situations that can set off migraines.

Get more information on managing pain:

content.accenthealth.com/pain

Disclaimer: This information was taken from the AccentHealth pamphlet on Managing Pain and I give them full credit for the information. Please contact them for more information.