Pain Management

What Is Pain Management?

Individuals who are suffering from chronic, debilitating pain are good candidates for a specialized pain management plan. The primary care physician who performs the initial medical examination typically makes a referral to another clinician or center that specializes in pain management. Generally, a team will be put together in order to develop a comprehensive plan that focuses on helping patients regain their mobility and previous quality of life in addition to addressing the painful symptoms. However, the team will want to first confirm whether a patient’s level of pain necessitates a specific treatment regimen.

It is important to be able to experience pain, as it alerts the body of a problem that needs to be addressed. Therefore, physical pain functions as a motivator that causes an individual to identify what is responsible for the pain and to treat it if it is serious or becomes chronic. Pain may be persistent or acute as well as generalized (hard to pinpoint) or specific. Acute pain is characterized as the abrupt occurrence of pain and discomfort that is mild, moderate, or severe. This type of pain is generally the result of a specific injury that individuals can usually recall. Chronic pain, on the other hand, typically persists for several weeks or months, and in some cases, years.  It may also range from mild to severe, but it is often harder to pinpoint unless a specific event occurred that may be responsible for the pain such as a car accident or an illness. Pain must persist for at least three months in order for it to be deemed as chronic.

Causes Of Pain

Pain sensations are believed to develop from nociceptor, psychogenic, or environmental (injury, fall, car accident, etc.) sources. Nociceptor refers to sensory nerves and psychogenic refers to physical or emotional factors. Nerve damage as well as mental or physical stress can lead to the development of pain.

Pain that occurs due to environmental factors such as an injury or trauma often results in damage to structures in the body and sometimes nerves. Nociceptor pain, however, originates from nerve tissue damage and it often causes symptoms that are very distinct from trauma-induced pain. For instance, nerve damage often causes numbness and tingling in addition to pain. Injuries or the irritation of additional structures such as bones, tendons, muscles, and blood vessels may also affect nerves and cause the development of nociceptor pain. Confirmed psychogenic pain, on the other hand, has not been shown through clinical evidence to be associated with nerve damage. In such cases, the pain is the result of tissue damage or chemical imbalances, especially if mental stress is responsible for the pain.

Regardless of how the pain originates, pain signals are transmitted to the brain and this results in the actual painful sensation. The signals travel along nerves until they reach specialized cells in the brain that help the body assess the degree of the pain as well as the location where it is coming from. If an individual is unable to tell a physician where the pain is being felt, there are different types of diagnostic tools that can be used to determine the cause of the pain. These include computed tomography (a CT scan), magnetic resonance imaging (MRI), a nerve conduction study, or electromyography.

Pain Management Approaches

After the source of the pain has been accurately identified, the treatment plan that is recommended generally consists of pain relievers and a physical therapy program. Physical therapy involves showing patients how to avoid further injury by engaging in strengthening exercises, improving their posture, and even learning proper lifting techniques. Some of the most common causes of chronic pain are injuries that occur during repetitive movements (e.g., lifting) or having poor posture.

The following strategy is commonly proposed for pain management:

• Pain medication (e.g. nonsteroidal anti-inflammatory drugs or muscle relaxants)
• Physical therapy
• Steroid injections
• Spinal cord stimulation
• Alternative therapeutic approaches (e.g. acupuncture or massage therapy)

Pain relievers, especially muscle relaxants such as acetaminophen, help relieve pain by causing tense muscles to relax, while anti-inflammatory drugs such as ibuprofen decrease painful inflammation. This type of treatment along with physical therapy is often useful toward reducing a patient’s recovery period as well as the risk of further injury during recovery.

Another treatment approach that has proven to be effective at alleviating pain is steroid injections. Steroid injections involve administering steroids and an anesthetic into the epidural space near the spine. Nerve roots, which are located in the epidural space, are the targets for steroid injections because pain signals originate at the nerve roots. Steroid injections produce long-lasting pain relief that usually starts shortly after a patient has undergone the procedure.

Spinal cord stimulation is a slightly more invasive approach than steroid injections that also targets nerves. It involves the implantation of a device that emits electrical pulses that control pain signal transmission from nerves that may be contributing to a patient’s pain.

Acupuncture is another alternative method for treating pain that involves inserting needles into specific parts of the body in order to reduce pain, muscle stiffness, and spasms. Massage therapy, which focuses on enhancing blood flow to regions where tension and inflammation may be causing pain, may also be a treatment option. As a last resort, surgery may be recommended if none of these approaches are effective or if the painful condition is so severe that it necessitates surgery.

Conclusion

Chronic pain and intense, acute pain is a common health problem that may be caused by numerous conditions such as a traumatic injury, infection, certain diseases, and cancer, to name a few. Depending on the type of pain that is being experienced, poor posture, not exercising regularly, lifting objects improperly, and smoking may cause the pain to worsen. Physical activity, if performed in the wrong way, can aggravate the painful condition as well.

Common pain management approaches that are initially recommended include pain relievers and physical therapy. If these methods are ineffective, alternative methods such as steroid injections, spinal cord stimulation, massage therapy, or surgery may be recommended.

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References

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