Pain Management

Pain management spine

Last Updated December 20th, 2021

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.

 

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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hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
biotin for hair
Biotin: One-stop-shop for shiny hair and an active body! What is common to bananas, eggs, sweet potatoes, and liver? These are delicious and rich in biotin ;…
Hydroquinone: Is it the best topical treatment for hyperpigmentation? Darkening of the skin due to high melanin levels is called hyperpigmentation.  Hydroquinone interferes with melanin production thus treating…
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…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
beta hcg test
Beta hCG Test A Beta hCG test measures the level of human gonadotropin hormones present in the blood that is primarliy…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
oral hygiene tips
6 shocking consequences of bad oral hygiene (and how to avoid them) Did you know bad breath is not just turning off, but also harms your body in ways you…
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…
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…
Bromelain: 11 reasons why you should start adding pineapple to your pizza! If you didn't love pineapples already, here are some of the top health benefits that bromelain can bring…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
How can berberine supplements help you live longer and healthier? Berberine is a turmeric look-alike herbal extract that is credited with numerous health benefits ranging from diabetes cure…
Goji berry: A traditional Chinese berry that packs the best of antioxidants Goji berry is an ancient berry that is considered to be power-packed with nutrients and antioxidants. Which means…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Experts reveal the safest ways to perform an enema at home The idea of pushing some up your rectal area might make you queasy but an enema could actually…
Inhale oxygen, exhale worries: The top breathing exercises and how to perform them Performing the breathing exercise is like becoming mindful of how you breathe.  Here is a list of breathing…
glucose-tolerance
Oral Glucose Tolerance Test – GTT Glucose tolerance test (or Oral GTT) is used to detect the onset of diabetes or prediabetes conditions. It…
Strep throat pain
Anti-Streptolysin-O Test The ASO or Anti-Streptolysin-O is a blood test designed to check for the presence of streptococcus bacterial infection…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
yoga health benefits
How to practice yoga for astounding health benefits Can a 5000-year-old system be the ultimate body healer? Did you know yoga can make you smarter and…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
Oil of Oregano: The one-stop essential oil you’ve been looking for Are you plagued by a weak immune system? High body inflammation accompanied by pain and infections? Why not…
Shilajit: A miracle Himalayan herb for an active and happy life The Himalayas contain more wonders than you thought. Shilajit is a miracle herb that is widely used in…
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…
Exercises or diet? Find out the healthiest way to gain weight Tired of being called skinny all the time? Looking for healthy ways to beef up? Why not try…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
How seitan proved to be a blessing in disguise for vegans worldwide Can only meat-eaters enjoy delicious juicy steaks and burgers? With seitan, the best meat substitute available today,even vegans…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
leptospira Igm test
Leptospira-IgM Test A Leptospira-IgM test is a blood test which is carried out to detect anti-Leptospira IgM antibody. Leptospirosis is…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
piles
Best treatment for piles in Bangalore All you need to know about piles and piles treatment in Bangalore - the types of treatment available,…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
The Shepherd's diet
Facts about the Shepherd’s diet Kristina Wilds promoted Shepherd's diet, a Christian-based diet that highlights Jesus Christ's diet as mentioned in the Bible.
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…

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