Pain is one of the most common human experiences. Yet pain has never been fully accepted as a medical problem. One reason may be because pain is a subjective and highly individualized experience. You can measure pain even though you can't touch it, feel it (unless it's your own), image it or prove its existence. Even a pinprick creates differing sensations of pain for different people.
Nevertheless, chronic pain affects millions of Americans. Pain is the body's way of sending a warning to the brain that something is wrong. Aches are felt when pain messages, carried by chemicals called neurotransmitters, travel from the nerves along the spinal cord to the brain. In the brain, pain messages are meshed with thoughts, emotions and expectations that shape our interpretation and response to pain.
Both emotions and drugs can change the perception of pain because both affect neurotransmitter levels. Both emotions and chemicals also alter the amount of endorphins, the body's natural pain relievers, which block the relay of pain messages to the brain. Depending on your mood and mental state, pain messages can be slowed, strengthened or stopped entirely. For example, fear, anger and worry can heighten pain or make you momentarily not notice it, while calming, positive thoughts can ease it.
There are two main types of pain. Nociceptive pain basically represents pain associated with a pain receptor. This kind of pain is a signal to the body that it's being damaged in some way that needs immediate attention. Trauma, infection or illness can cause nociceptive pain. Toothaches, sprains, backaches or a broken bone are other common causes. Although unpleasant, most injuries resulting in nociceptive pain are short-lived and are easily treated with rest or medications.
Neuropathic pain refers to pain that is not associated with specific pain receptors and probably represents damage to or sensitization of the nervous system (this is when pain becomes the disease process itself, rather than representing a "warning" of underlying pathology). It is constant, often lasting for months after an injury or trauma, and can be disabling. Examples of neuropathic pain are the chronic pain that can linger after shingles or the pain that people with diabetes sometimes experience when nerve damage occurs. Diabetic neuropathies can cause pain, tingling or numbness in the hands, arms, feet and legs and also can affect other organ systems, including the digestive tract, heart and sex organs.
You may also hear pain referred to as "acute" and "chronic" pain. Acute pain is short-lived and usually diminishes as your body heals. Chronic pain persists for at least six months after your body has healed. Sometimes it is difficult to pinpoint where chronic pain is coming from. Because it persists, chronic pain can interfere with daily life and lead to depression, anxiety, anger and low self-esteem.
Because pain can be difficult to pinpoint and treat, primary care physicians increasingly turn to specialists to help those whose pain persists. And health care professionals also are working to tailor treatments specifically to the individual and to encourage better self-management of pain.
Diagnosis
It isn't always easy to talk about pain. Some people think that complaining about pain is a sign of weakness. Studies on gender differences show that women are more likely to complain of pain and seek treatment for it than men.
Often, you can successfully treat your pain yourself with common over-the-counter (OTC) pain-relief medications or by making lifestyle changes.
For example, if you smoke, you should quit or ask your health care professional for guidance on how to quit. Smoking makes pain worse. Studies, especially for low back pain, have consistently shown that patients who smoke have a harder time recovering, regardless of the treatment offered, than nonsmokers and that smoking can affect the healing of injured discs. Also, there is some evidence from pharmacological studies that smoking interferes with the absorption and blood level of various medications, including analgesics.
If you have attempted to treat your pain or tried to make lifestyle changes and these approaches didn't relieve your pain or it became worse, you should seek help from a health care professional. Pain is a message that something is wrong, so don't wait more than a few days or a week to make an appointment. In fact, delaying an evaluation and treatment can make many acute pain problems worse.
The American Pain Society endorses the standards set by The Joint Commission for the assessment and management of pain, which affect all patients in hospitals, nursing homes and clinics. Health care facilities must:
It isn't always easy to talk about pain. Some people think that complaining about pain is a sign of weakness. Studies on gender differences show that women are more likely to complain of pain and seek treatment for it than men.
Often, you can successfully treat your pain yourself with common over-the-counter (OTC) pain-relief medications or by making lifestyle changes.
For example, if you smoke, you should quit or ask your health care professional for guidance on how to quit. Smoking makes pain worse. Studies, especially for low back pain, have consistently shown that patients who smoke have a harder time recovering, regardless of the treatment offered, than nonsmokers and that smoking can affect the healing of injured discs. Also, there is some evidence from pharmacological studies that smoking interferes with the absorption and blood level of various medications, including analgesics.
If you have attempted to treat your pain or tried to make lifestyle changes and these approaches didn't relieve your pain or it became worse, you should seek help from a health care professional. Pain is a message that something is wrong, so don't wait more than a few days or a week to make an appointment. In fact, delaying an evaluation and treatment can make many acute pain problems worse.
The American Pain Society endorses the standards set by The Joint Commission for the assessment and management of pain, which affect all patients in hospitals, nursing homes and clinics. Health care facilities must:
- Recognize the right of patients to appropriate assessment and management of pain.
- Screen patients for pain during their initial assessment and, when clinically required, during ongoing, periodic reassessments
- Educate patients suffering from pain and their families about pain management
Prevention
Communicating with your health care professional about your pain symptoms is vital to maintaining a healthy lifestyle. Ask questions about your condition, including side effects for both short-term and long-term medication use. Ask about all your pain management options—medical and nonmedical alternatives. Whenever possible, try to avoid activities that may cause pain or injury or that worsen already existing pain symptoms.
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