Pain Management

Pain management spine

Last Updated February 20th, 2019

Overview of pain management

Daily stress, diseases, environmental and psychological factors can collectively give rise to different symptoms in the human body. These symptoms are mainly manifested as pain and discomfort. According to the intensity of the clinical condition, “pain” and the other complications may persist for a long time. Effective “pain management” techniques are critical for the alleviation of the existing symptoms. In this context, one should remember that medications are not the only means of pain management. The various techniques will be discussed in details in this article.

What is pain?

Pain management massagePain is defined as the sensory manifestation of tissue damage in the body. It is closely linked with physiological, psychological and environmental factors. Different types of pain require different management techniques.Pains are broadly classified into two categories depending on the degree and the duration of the pain. These are acute pain and chronic pain. These will be discussed in two separate sections.

Acute pain

Acute pain is the type of pain that occurs due to a major or minor inflammation, injury and tissue damage. It does not last for a long time. Acute pain is usually self-limiting in nature and resolves within a few days to some weeks. The degree of damage is not very severe.

Types of acute pain

The different types of acute pain are listed below-

  • Acute illness: This is typically the pain arising from some forms of acute illnesses. A few examples are- Myocardial infarction, Renal colic, and Appendicitis.
  • Perioperative pain: This is the type of pain experienced by a patient undergoing surgical procedures. The pain, in this case, arises mainly from nasogastric or chest tubes, associated drains, indwelling catheters or syringe points. The types of surgeries in which this pain is prevalent are- orthopedic surgeries, vascular surgeries, abdominal surgery, chest surgeries, head and neck surgeries.
  • Post-traumatic pain: This occurs after some traumatic incident like a car accident or accidental fall from a height and a lot more. This type of pain may be localized or generalized, depending on the intensity of tissue damage.
  • Burns: This type of acute pain results from minor burns or first degree burns. Accidental exposure to fire, thermal sources or some injurious chemicals (explosives) can cause this type of pain.
  • Procedural pain: Procedural pain results from some long-term treatment such as suturing, bone marrow biopsy, placement of catheter or chest tube and circumcision.
  • Obstetric pain: This type of pain is usually experienced during labor and childbirth. Childbirth via cesarean section does not cause as much pain as childbirth via vaginal delivery.

Chronic pain

Chronic pain is relatively long-lasting in nature. It results from certain chronic diseases that do not resolve even on medical intervention.

Types of chronic pain

Chronic pain is classified into the following types according to the source of origin of pain-

  • Arthritis pain: It arises from the pain, swelling, and inflammation of the different joints in the body.
  • Lower back pain: Lower back pain results from vertebral disc dislocations, muscle spasms and trapped nerves in the spine.
  • Fibromyalgia pain: It is a type of musculoskeletal pain which occurs along with stiffness, swelling and tenderness at different locations in the body.
  • Peripheral neuropathic pain: It is often experienced as a constant throbbing pain. It occurs due to damage or injury to the peripheral nervous system.
  • Headache: Different types of headache such as a migraine, cluster headache etc leads to persistent pain.

 

Management of pain

Coping with different types of pain involves strategic pain management programs. These will be discussed in separate sections.

Management of acute pain

Pain management spinePatients and their caregivers should have knowledge of the pharmacological and non-pharmacological methods of the management of acute pain. The non-pharmacological techniques are described below-

Physical methods: Doctors recommend immobilization for acute illnesses, perioperative pain and procedural pain. Different physical therapy techniques such as stretching and relaxing, vibration and Transcutaneous Electrical Nerve Stimulation (TENS) are applicable for the trauma patients. Application of heat or cold and Electroanalgesia are effective for the patients suffering from perioperative pain. Counter-irritation techniques such as massage, application of pressure or scratching produce good results in patients undergoing long-term treatments (procedural pain). For the patients of burn injuries, elevation of the affected limb and avoidance of repeated dress changes are recommended.

Psychological methods: Relaxation techniques and proper education of the patient helps alleviate acute illness, perioperative pain, trauma, and burns. Acupuncture techniques, biofeedback and hypnosis are effective for perioperative pain. Psychotherapy and distractions are helpful in the recovery process of trauma patients. Imagery and music relaxation are the best distractive therapies for the “burn injury” patients. 

The pharmacological techniques of acute pain management are described below-

  • Adjuvant analgesics (Eg: Local anesthetics)
  • Opioids
  • Oral non-opioids (Eg: Paracetamol and Non-Steroidal Anti Inflammatory Drugs)
  • Topical agents (Eg: local anesthetics)
  • Epidural anesthesia or intrathecal opioids (for perioperative pain)
  • Local neural blockade (for trauma)
  • Epidural analgesia or local anesthetics (for burns)
  • Spinal analgesia (for obstetric pain)

 

Management of chronic pain

The non-pharmacological techniques will be discussed first-

  • Arthritis: Applied heat or cold therapy, low impact aerobic exercise, TENS, acupuncture.
  • Lower back pain: Cryoanalgesia, exercise, TENS, vibration and brace.
  • Fibromyalgia: Gentle aerobic exercise, stretching, heat massage, vibration, TENS.
  • Sickle cell disease: Heat or cold massage, hydration, ultrasound, acupuncture
  • Peripheral neuropathy: Skin and foot care, TENS, psychotherapy, biofeedback, relaxation.
  • Headache: exercise, relaxation, biofeedback.

The pharmacological techniques are as follows-

  • Arthritis: Paracetamols, NSAIDs (ibuprofen, naproxen), corticosteroids.
  • Lower back pain: Paracetamols, NSAIDs, COX-2 inhibitors.
  • Fibromyalgia: Opioida, TCA (Amitriptyline).
  • Sickle cell disease: Anxiolytics, Sedatives, NSAIDs, Paracetamol.
  • Peripheral neuropathy: AEDs (gabapentine, carbamazapine),NSAIDs, Paracetamol.

 

Diagnosis

Doctors recommend CT scan, MRI scan and Ultrasonography as general tests for any kind of pain. Detailed diagnosis is done based on the severity of the symptoms.

 

Treatment and prevention

Pain management hot packOnce you are aware of the nature of the pain (chronic or acute) follow the doctor’s instructions on how to make it better. Certain home remedies like cold compressions and heat pads and mild exercise can help relieve the pain. Having too many unprescribed medications for your pain can have a negative effect on the liver and kidney and slowly lose its effect on your body. Being careful about the medications that you take is very important as in case of morphine it could lead to addiction.

Preventions :

  • Exercise – The best way to ease or prevent a backache is to exercise. Taking a walk around the park or at home. This also helps keep your joint fluid. Exercise helps in weight management, as the weight around the back can put a strain on your back.
  • Eat healthy – Eating the right kind of food and in right quantity helps in maintaining the weight. This, in turn, will not put any strain on your back, joints etc. hence, reducing pain.
  • Posture – Maintaining a proper posture can go a long way, as sitting in a wrong position can strain the muscles and the bone. Causing a lot more pain.

Facts

  • Back pain is the most common pain condition. 27% of Americans state that back pains are the most common pain conditions followed by migraines which come up to 15%.
  • In the 19th century, physician-scientists discovered that opiates such as morphine could relieve pain.

Facts

  • Chemist Felix Hoffman developed aspirin from a substance in willow bark. Aspirin remain the commonly used pain reliever.
  • According to the National Center of Health Statistics (2006), approximately 76.2 million, one in every four Americans, have suffered from that lasts longer than 24 hours.

Facts

  • Morphine is said to be the most common pain reliever, it belongs to the opium family. It was discovered between 1803-1805. It is used most commonly as an immediate pain reliever in cases of heart attacks and childbirth.

Related Conditions

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Dos and Don'ts

Dos
  • Focus on the pain to try and understand the kind of pain that it is – chronic or acute.
  • Figure out a way to take care of the pain – medication, therapy or mind-techniques.
  • In case of chronic pain, visit the doctor to diagnose the cause and figure out the course of treatment.
Don'ts
  • Lift any heavyweights.
  • Indulge in high impact activities that can lead to or increase muscle pain.
  • Ignore any pain that lasts longer than 3 months.

 

 

 

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8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
Salt dangers
Sodium chloride: The wonders and dangers of the simple table salt Sodium chloride is a salt containing sodium and chlorine ions at a 1:1 ratio. It is edible and…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
quinoa salad
Quinoa : A prodigious superfood you need to include in your diet today! Quinoa - what is so special about this native South American grain that has taken the world by…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
The complete “what to eat” guide for gluten intolerance Does eating breads and pastas often makes you nauseous? Gluten intolerance is a common reason why you might…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…