HEALTH & WELLNESS

Managing Pain

Pain is a very unpleasant and uncomfortable feeling that might be felt by you, at some point. Though most of us do not like this unpleasant feeling, it is one of the body’s ways of communicating a message. Pain might occur as a result of several things including surgery, labour (child birth), injury, or a medical condition such as cancer, arthritis or fibromyalgia. Whatever the cause, pain can interfere with your ability to function properly and your ability to sleep and enjoy life.


Although pain often goes away quickly, certain kinds can be chronic. Such types can last for several months and sometimes years and can be caused by nerve or tissue damage.

Make sure you ask your doctor the following questions if you are experiencing pain:
• What is causing my pain?
• How long should I expect the pain to last?
• Are there lifestyle changes that might relief the pain?
• Are there medications that might help?
• Are there alternatives therapies that might help?
• What should I do if the pain gets worse?

Make sure you tell your doctor:
1. The location(s), and severity of your pain.
2. How it may have changed since your last appointment.
3. If you are experiencing side effects from your drugs.
4. If you are trying any alternative treatments like yoga, acupuncture or herbal remedy.

What is pain?

Pain is a discomforting feeling often caused by illness, surgery, childbirth, or injury.

It is a form of communication that something is either wrong in your body or healing is occurring. Pain tells you to avoid touching a wound, overworking a particular area, or position yourself a certain way. Also, it can occur for no clear reason. Pain from tissue damage can be acute, such as a sprained ankle, or it can be chronic such as arthritis. The difference between acute and chronic pain is the time frame – chronic pain usually lasts much longer than acute pain.

There are two main types of pain:

1. Nociceptive pain. This type of pain is caused by damage to body tissue. Examples include cancer, burns, sprains, broken bones, or inflammation from an infection or arthritis. Usually, the pain feels sharp or aching. When you hit your finger on a hard surface, the signal starts at the very tip of the nerve cells, travels to and up the spinal cord, and into a part of the brain called the thalamus. The thalamus then sends the signals out to the several parts of the brain, including those that control touch, emotions, physical reaction and memory.

2. Neuropathic pain ( or nerve pain). Neuropathic pain occurs as a result of nerve damage. Nerves that were once a mere messenger of pain, between the brain and the rest of the body, become a source of pain. Conditions that causenerve pain include a “pinched nerve ” (like sciatica), diabetes, shingles, and multiple sclerosis. Also, cancer pain can be both nociceptive or neuropathic.

Understanding the types of pain

Pain can be classified by how long it lasts:

Transient pain: This is a short-lived pain that happens for a few hours only. Examples include occasional headache.

Intermittent pain: This class of pain ceases for a while, then comes back again. It happens on and off again.

Acute pain: Acute pain usually lasts from a few weeks to a few months, and is often as a result of disease, inflammation, or injury. It usually occurs suddenly, and is caused by something specific. Examples include surgery, dental work, burns, labour at childbirth, and sprains. Its cause can often be identified and treated. It usually goes away once the injury has healed.

Chronic pain: This lasts longer than six months, or even years. Conditions that cause chronic pain include headache, cancer, nerve pain, arthritis, fibromyalgia, back pain, irritable bowel syndrome, and so on. This sort of pain can cause stress on the body including tensed muscles, inability to freely move, and lack of energy.

Diagnosing Pain

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

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

When it started
Its locations
Its intensity
Other symptoms that accompany it Its impact on your daily activities

 Any treatments you have already tried such as yoga, acupuncture or herbal remedy

The doctor will perform a physical examination, and may order tests such as blood tests or imaging tests like x-ray, CT scan and MRI, to help identify the source of the pain. It isn’t always easy to identify the source of pain, and sometimes, it is easy.

Describing your pain

Your doctor will ask you to rate your pain. This is called a pain scale, and each individual is the best judge of his or her own pain score. 0 usually stands for no pain while 10 stands for unimaginable unspeakable Spain. 5 stands for very distressing pain. 

In addition to the pain scale, it is best to use the right words to describe your pain, try using words such as:

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  • Crippling

  • Sharp/Stabbing/Penetrating

  • Dull

  • Intense 

  • Itchy Shooting

  • Stinging

  • Numb

  • Tingling

  • Cramping/Squeezing/tightening

  • Radiating/spreading

  • Throbbing/pounding

  • Aching

  • Gnawing/biting

  • Heavy

  • Hot/burnin

  • Cold/freezing

  • Deep Sensitive

  • Tender

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 relives 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? Does is change as you move?

Keep a pain journal

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

Medicine for Pain

There are several ways to treat pain. We advise discussing with a doctor before taking any medicinal steps towards relieving pain.

Analgesics

Analgesics are medications used specifically to relieve pain. There are many kinds of analgesics some of which are available without a prescription, while some are available only with a prescription. Over-the-counter analgesics are usually used for mild 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 this medication:

  1. Nonsteroidal anti-inflammation drugs (NSAIDs) relieve pain and also reduce inflammation. Widely used NSAIDs include aspirin, ibuprofen, naproxen, and COX-2 inhibitors. Some are available over the counter while others require aprescription. Care must be taken with NSAIDs as some trigger allergies, internal bleeding, or kidney and liver issues.

  2. Acetaminophen helps relive pain but does not reduce inflammation.

Anticonvulsants and antidepressants.

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

Opioids (also called narcotics)

Opioid analgesics work by binding to receptors on cells mainly in the brain, spinal cord and gastrointestinal system to relieve pain. But they must be taken with care because they can be addictive. Also, they carry a greater risk of side effects than acetaminophen.

Other Treatments

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Cream and gels. These contain a wide variety of ingredients. The creams and gels that contain salicylate reduce inflammation. Others may contain “counterirritants,” such as menthol or eucalyptus, which provide a cooling or warming sensation intended to distract from the pain.

Capsaicin. Capsaicin is what makes peppers spicy. It reduces some kinds of pain when rubbed on the skin.

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

Nerve blocks. Nerve blocks use drugs, chemicals, 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 non-drug treatment can provide widespread relieve from pain.This option may be used instead of medication, 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 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 showers and baths, hot whirlpools, and heat lamps to temporarily relieve pain.

Don’t use heat or cold for too long.

Pain-relieving devices

Wearable and non-wearable devices or equipment can help support painful joints, relieve pressure on irritated nerves, and soothe aches and pains. They include splints and braces,canes, crushes, walkers, and shoe inserts. These devices are usually better for chronic pain.

Long-term pain relief options

Physical and occupational therapists

Physical therapists use techniques and exercises to help relieve pain and improve strength and range of motion. They customise programs to fit your goals.

Occupational therapists help improve your ability of perform activities of daily living, such as dressing, bathing, and eating.

Exercise

An exercise program can help relieve chronic pain. It should include regular, gentle aerobic activity, stretching and range-of-motion exercises, and strengthening and exercises.

Extra weight on joints can cause pain. If you are overweight, losing weight may help relieve pain.

Alternative Therapies

  • Acupuncture
  • Massage therapy
  • Chiropractic
  • Cognitive behavioural therapy
  • Progressive muscle relaxing