Pain Management – All of us have experienced pain. It is one of the most common signs that people seek medical attention for. However, it is also one of the most misunderstood or ineffectively treated.
One reason for this is because the experience of a painful event can vary from one person to another. We will discuss the most common pain types and provide some tips on how to treat them. There is no one-size-fits-all approach.
Pain can be described as an unpleasant or unfavorable sensation that occurs in the body.
There are many causes and types of pain. To help you manage your pain, we have grouped them into eight categories.
- Acute pain
- Chronic pain
- Breakthrough pain
- Bone pain
- Nerve pain
- Phantom pain
- Soft tissue pain
- Referred pain
- Acute pain
It happens suddenly and lasts only a few days.
It’s usually caused by an injury or event, such as:
- A broken bone
- Car accident or another type of accident
- A fall
- Cuts and burns
- Dental work
- Childbirth and labor
- Surgery
Chronic pain
Chronic pain refers to pain that persists for more than six months and is felt most days. Although it may initially be acute pain, chronic pain can last for many years. Chronic pain can be mild or severe. It is often associated with conditions like:
- Arthritis
- Back pain
- Cancer
- Circulation problems
- Diabetes
- Fibromyalgia
- Headache
Chronic pain can seriously affect a person’s life quality and make it difficult to return to work or engage in physical activity. It can lead to depression and social isolation in some cases.
Breakthrough in Pain
People who have been prescribed medications for chronic pain relief such as arthritis, cancer or fibromyalgia may experience breakthrough pain.
A pain flare is also known as breakthrough pain. It can occur during periods between doses of pain medication, exercise, physical activity, sickness, stress, and coughing. Although the pain can be severe, the exact location is almost always the same as chronic pain.
Bone pain
This refers to a sensation of tenderness, aching, or discomfort that occurs in one or more bones during exercise or rest.
Bone pain can be caused by conditions that alter the bone’s structure or function, such as cancer, infection, mineral deficiencies, sickle cell disease, osteoporosis, and leukemia. Many women who are pregnant experience pain in the pelvic girdle.
Nerve Pain
Nerve pain can be caused by nerve inflammation or nerve damage. It is often described as a shooting, burning, or stabbing sensation & It may also be known as neuralgia, neuropathic pain, or simply nerve pain. Also, It can sometimes be described as an electric shock and is often more severe at night.
Nerve pain can cause severe problems in a person’s daily life, affecting their work, sleep, and physical activity. Nerve pain can make them very sensitive to cold, and they may feel pain when touched. People with chronic nerve pain may also experience anxiety and depression.
Persons with neuropathic pain can feel pain from touch and cold, as well as pain when they are exposed to stimuli that are not usually painful.
The following are common causes of nerve pain:
- Alcoholism
- A spinal cord injury, nerve damage, or brain injury
- Cancer
- Circulation problems
- Diabetes
- Herpes zoster (shingles)
- Limb amputation
- Multiple sclerosis
- Stroke
- Vitamin B12 deficiency.
Phantom Pain
Phantom pain refers to pain that feels like it’s coming from an area of the body that is not there. It is common for people who have lost a limb. However, it is not the same as phantom limb sensation which is typically painless.
Although doctors used to believe that phantoms were psychological problems, they now recognize that these sensations are actually pain sensations that originate from the brain and spinal cord. Although it can improve over time, managing phantoms may be difficult for some people.
Soft Tissue Pain
It is a condition that causes pain or discomfort due to inflammation or damage to the muscles, tissues, and ligaments. This can be caused by swelling or bruising.
- Neck or back pain
- Bursitis
- Fibromyalgia
- Rotator cuff injury
- Sciatic pain
- Sports injuries such as strains and sprains
- Temporomandibular Joint (TMJ) Syndrome
- Referred pain
It is pain that feels like it’s coming from one place but is actually caused by injury or inflammation in another organ or structure. A heart attack can cause pain in the neck, left shoulder, and right arm. A constant feeling of pain radiating to the back from the stomach or pancreas injury can indicate inflammation. Pain in the shoulder blade can be caused by a ruptured spleen.
Referred pain occurs because of a network interconnecting sensory nerves that supply many tissues. The brain can mistakenly interpret an injury in one part of the network as if it were in another area.
How can I manage my pain?
There are many types of pain-relieving medication, and each one works differently. The following categories can be used to group most medications:
Nonopioids are a type of medicine that isn’t similar to morphine (an addictive opioid), but which isn’t addictive.
Weak opioids are a medication that is very similar to morphine (an opioid), but is not as strong (eg codeine, tramadol).
Combination opioids: These include a combination of a nonopioid with a weak opioid, or a strong opioid (eg acetaminophen or hydrocodone).
Strong opioids: A medicine like morphine or a similar to morphine which has the potential for addiction (eg, Fentanyl/morphine, Oxycodone).
Other (eg, Ketamine)
Adjuvant treatment: A medicine that relieves pain by relieving inflammation, or by improving other systems (eg. cannabidiol and capsaicin cream, gabapentin).
Nonpharmacological (drug-free) treatments, such as counseling or psychotherapy.
The effectiveness of a pain-relieving medication for a particular type of pain will determine the choice. Side effects may also consider.
It is important to monitor the effectiveness of pain medication and any side effects. If the pain persists or the treatment is not effective, the dosage or choice should modify.
Certain types of pain, such as cancer-related pain, can take an unpredictable course. They can be very severe and long-lasting depending on the treatment and progression of the disease. This is why pain management must be flexible.
Some people may experience more than one type.
It is possible to improve the effectiveness of pain medication by changing how it is delivered. For example, switching from oral treatment to a patch or subcutaneous pump.
Traditionally, experts recommend a stepwise approach for pain management. This involves starting with acetaminophen (NSAIDs) and moving on to a weak opioid (such as codeine, dihydrocodeine, or tramadol) before switching to a stronger opioid (such as fentanyl morphine or oxycodone).
This “Pain Ladder”, however, was created in 1986. Other medications, which are not analgesics, can also be used to relieve pain. Opioids should be only used to treat certain types of pain because they can lead to addiction. A modified 3-step pain management ladder is now available, but it should always be adjusted to the type of pain.
Pain Management for Specific Types
Although some medications may be more effective than others for certain types of pain, factors such as genetics, co-existing conditions, and interacting medications or supplementation can have an impact on the effectiveness of a medication. There are many treatment options available for different types and types of pain.
Acute pain: Nonopioids, weak opioids, and opioids.
Chronic pain: Nonopioids, weak opioids, and opioids. Capsaicin cream, antidepressants, and opioids are all options.
Breakthrough pain: Short-acting opioids, nonpharmacological treatments like acupuncture and relaxation techniques.
Bone pain: Nonopioids, Bisphosphonates and Opioids, Opioids, Surgery, Nutritional Supplements, Surgery
Nerve pain: Antidepressants, Anticonvulsants, and Capsaicin Cream, as well as non-pharmacological treatments like cognitive-behavioral therapy.
Phantom pain: Nonopioids, antidepressants, and anticonvulsants; ketamine; nonpharmacological treatment such as acupuncture (rTMS), or repetitive transcranial magnet stimulation (rTMS).
Soft tissue pain: Nonopioids, corticosteroids, and nonpharmacological treatment such as ice or physiotherapy.
Referred pain: Nonopioids, cold/warm compressions, nonpharmacological treatment such as massage, transcutaneous electrical nerve stimulation (TENS), and nonopioids.
