Pain Management

Pain is generated or brought about by different medical conditions, surgery or injury. Pain management programs include pain-relieving medication, occupational or physical therapy and alternative treatments such as acupuncture. Although pain can occur to anybody, it is most prevalent among older people, and women are more susceptible than men.

Pain can range from a dull, mild and disturbing ache to a severe, stabbing and pounding sensation and can be felt in a contained area of the body or can be widespread. The most frequently mentioned pain is back pain, which can also include pain in the shoulder, neck and head.

Pain is divided into two categories: acute and chronic. Acute pain starts suddenly and does not last for a long time. It is usually associated with an injury sustained by tissue, bone or other parts of the body or discomfort resulting from a temporary ailment or sickness. Chronic pain continues for an abnormal length of time such as at least three months and can last for more than one year. Chronic pain can be the result of an injury sustained in a car, work or sport accident or a long drawn-out illness. People who have severe back pain due to problems with their discs can suffer their entire lives unless they have surgery.

Untreated and unrelieved pain can adversely affect the body. It can cause elevated levels of the stress hormones cortisol and adrenaline. It can cause an increase in blood pressure and heart rate along with an increase of carbon dioxide and a reduction of oxygen in the blood. Untreated pain can be the direct cause of anxiety, fatigue and depression.

A number of drugs can be taken to manage pain, both prescription medications and nonprescription over-the-counter products. Paracetamol, officially known as acetaminophen, is a relatively safe pain killer that does not cause irritation or side effects. Aspirin and nonsteroidal anti-inflammatory drugs such as ibuprofen are widely used pain drugs that help to eliminate inflammation. Stronger prescription drugs can be taken for moderate to severe pain. Those can include opiate drugs such as morphine and codeine, which can be taken in various strengths. As a last resort, local anesthetics must be used. The type of pain medication to be taken depends upon the severity and intensity of the pain and its precise location.

Numerous nondrug pain-management plans are available, including different treatments and therapies. Physical therapy is the most popular. The therapy administered by an osteopath or physiotherapist includes a strict regimen of exercises, stretching and walking designed to relieve pain. The program that the specialist will design depends on what part of the body hurts and the severity of the pain.

Hot or cold therapy includes hot or cold packs placed on the painful area. Hot packs are beneficial in cases of musculoskeletal injuries; cold packs are used to reduce swelling. Acupuncture, part of traditional ancient Chinese medicine, is a method of pain management that entails insertion of long thin needles into certain points of the body to restore balance, encourage the body to release endorphins, which are pain relieving compounds, and stimulate the body to heal itself.

Massage therapy is most helpful when the injuries are sustained by the soft tissue; it is not used when there is pain in the joints. Transcutaneous electric nerve stimulation therapy (TENS) is a tiny electrical current delivered via electrodes through the skin that prompts a pain-relieving reaction from the body. Cognitive behavioral therapy (CBT) teaches and trains people to change how they view themselves and how they approach pain. A change in a person's outlook about himself or herself and self-esteem and a different attitude toward pain can help a person manage chronic pain and enjoy a more pleasant life.

Pain Management: Selected full-text books and articles

The Management of Anxiety By Diana Keable Churchill Livingstone, 1997
Librarian's tip: "Pain Management" begins on p. 160
Mosby's Complementary Alternative Medicine: A Research-Based Approach By Lyn W. Freeman; G. Frank Lawlis Mosby, 2001
Librarian's tip: Discussion of pain management begins on p. 186
Attitudes toward and Knowledge of Chronic Pain: A Survey of Medical Social Workers By Sieppert, Jackie D Health and Social Work, Vol. 21, No. 2, May 1996
Peer-reviewed publications on Questia are publications containing articles which were subject to evaluation for accuracy and substance by professional peers of the article's author(s).
The Nature of Suffering and the Goals of Medicine By Eric J. Cassell Oxford University Press, 2004 (2nd edition)
Understanding Chronic Pain By Angela J. Koestler; Ann Myers University Press of Mississippi, 2002
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