Pain Management - An Interdisciplinary Approach

What Is Pain?

Pain is a common symptom to seek medical attention. The term describes any unpleasant sensation or response from the body when the body feels something not comfortable. It serves as a warning mechanism consisting of physiological and psychological responses to stimuli. Some people may have a high pain tolerance, while others may have a low tolerance. Therefore, pain is a warning mechanism.

The most common causes of pain may include:

• Injury.

• Medical conditions include cancer, arthritis, and back problems.

• Surgery.

• Headache.

• Toothache.

• Stomach ache or cramps.

• Muscle cramps or strains.

• Bone fractures.

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• Sore throat, cuts, burns, or bruises.

What Are the Types of Pain?

Pain may be in the bone, nerve, soft tissue, or other body parts.

There can be various categories of pain:

• Acute Pain - Pain is a normal response to an injury or medical condition. Acute pain starts suddenly and may last for a short period. This pain is usually caused by specific events such as a broken bone, a fall, burns or cuts, labor, or an accident.

• Chronic Pain - This pain continues and may last longer than three to six months. Sometimes the pain may have started initially as acute pain and may continue long after the injury has healed. Chronic pain is associated with arthritis, back pain, cancer, diabetes, headache, circulation problems, or fibromyalgia. Chronic pain can severely affect quality of life of a person and may lead to depression or social isolation.

• Bone Pain - Bone pain can cause tenderness, discomfort, or aching in one or more bones that may be present during exercise and rest. This pain is commonly associated with diseases affecting bone function or structure, such as cancer, a fracture, infection, mineral deficiency, leukemia, sickle cell anemia, or osteoporosis.

• Nerve Pain - Nerve pain is usually a sharp, shooting, burning, or stabbing pain caused by nerve damage or inflammation. The pain is described as an electric shock and is often worse at night. The slightest touch may trigger the pain, and people experiencing it are often sensitive to cold. Common causes that may cause nerve pain include alcoholism, cancer, diabetes, herpes zoster, multiple sclerosis, stroke, vitamin B12 deficiency, circulation problems, or limb amputation.

• Soft Tissue Pain - This type of pain or discomfort may result from damage to the muscles, tissues, or ligaments and is associated with swelling or bruising. Some common causes of soft tissue pain include neck or back pain, sciatic pain, bursitis (inflammation of sacs that cushion the tendons and bones), fibromyalgia, sports injury, and temporomandibular joint syndrome.

• Referred Pain - This pain may feel like it comes from one location but may be due to inflammation in other tissue or structure. It happens because there is a network of interconnecting sensory nerves supplying different tissues. For example, pain is often felt in the neck, left shoulder, and right arm during a heart attack.

How Does Pain Affect Our Body?

Continuous pain can cause other symptoms like nausea, dizziness, weakness, or drowsiness. Pain also affects emotions like anger, depression, mood swings, or irritability and can impact relationships, jobs, and independence. In addition, chronic pain may limit everyday activities and affect body function.

How to Diagnose Pain?

To diagnose the origin of pain, the health professional needs to do a physical examination and take the medical history.

The doctor may ask questions such as

• When did the pain start?

• How did it start? When is it more intense?

• Whether it is mild, moderate, or severe?

• Do you have any other symptoms?

• How does the pain affect your life?

• What triggers the pain?

• Do you have any diagnosed health conditions?

• Have you experienced an injury or illness recently?

• Has there been a recent change in your diet or exercise routine?

• What medications or supplements are you taking?

It may be required to undergo a few tests to confirm the potential cause of pain, like blood tests, urine tests, stool tests, or cerebral spinal fluid tests to confirm any signs of infection or other illnesses.

• An endoscopy is done to detect any signs of damage in the respiratory, gastrointestinal, urinary, or reproductive tract.

• Imaging tests such as X-ray, computerized tomography (CT scan), magnetic resonance imaging (MRI scan), and ultrasound scan to check signs of damage in the muscles, ligaments, tendons, bones, nerves, or other internal organs.

• A biopsy may be done to collect for analysis.

• Psychological tests to check for signs of depression.

• Nerve function tests check the working of the nerves.

How to Manage Pain?

Treatment of pain depends on the underlying cause. Understanding the cause is an effective way to cope with the pain and improve the quality of life.

The critical strategies for pain management include:

Use of Medicines -

• Acute Pain - Acute pain generally may go away once the cause has been treated and usually involves taking medication like Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetics, and opioids to treat pain and fever. Pain caused by injury may require medication or surgery or heal with time. Infections causing pain may resolve on their own or might need medication.
• Chronic Pain - Chronic pain such as arthritis, chronic migraine, and cancer are difficult to manage, especially if it is functional with an unknown cause. They may be prescribed over-the-counter pain relievers, anti-inflammatory drugs, opioids, and antidepressants.

Physical Therapies - Heat or cold packs can reduce swelling and relieve chronic muscle or joint injuries. In addition, hydrotherapy and exercise relax and rehabilitate the injured muscles. Physical therapy also addresses the root cause of pain or movement limitations and brings long-term relief. It involves treatment modalities such as massage, joint manipulation, dry needling, or electrical stimulation.

Psychological Therapies - Cognitive-behavioral therapy, relaxation therapy, and meditation are valued strategies to self-manage chronic pain. It helps change how one thinks, feels, and behaves about pain. The most common psychological treatments are talk therapy, relaxation training, stress management, and pain coping skills training.

Mind and Body Techniques - Mind, emotions, and attention play an important role in the experience of pain. Simple exercises involving deep breathing exercises, meditation, positive thinking, and yoga can help to take the mind off the pain. Acupuncture aims to restore the balance within the body and encourage healing by releasing natural pain-relieving compounds.

Community Support Groups - Many non-profit associations aim to offer pain management information for people with persistent pain. The dedicated organizations empower, educate, connect, and advocate for people living with chronic conditions that cause pain. Look for a primary care physician or health professional in the neighborhood. It may help to do practical activities and seek advice on new coping strategies and skills.

How to Manage Persistent Pain?

Specific pain cannot be quickly relieved and may persist for an extended period. Some of the ways to handle such persistent pain may include:

• Find out as much as possible about the condition so one may not worry unnecessarily about the pain and discomfort. It is essential to focus on improving day-to-day functions.
• Take steps to prevent or ease depression. Do not increase the pain medications without talking to the doctor. Improves physical activity, eats healthy foods, and takes the necessary rest.
• Discussion with family and friends lets them know when one needs their support. Seek advice on new coping strategies and skills from a healthcare professional such as a psychologist.

Conclusion:

Pain is a sign of a severe disease or condition. Before beginning any new medication, speaking with the doctor is essential to ensure they are safe and will not worsen the pain. If a person is experiencing severe pain, difficulty breathing, or chest pain, it is advised to seek immediate medical care.