Health News
Health News
November 20, 2019
Managing Pain

We all have to deal with pain at times.  No one enjoys experiencing pain, but in certain circumstances, it serves a purpose by alerting us to a problem.  When pain persists for a long period of time, it can be debilitating to a person’s quality of life and requires treatment.    

Pain can result from a sudden injury or the onset of an illness.  It could signal a minor injury, such as a bruise or scrape or a more serious one, such as a broken bone.  A sore throat is often an indication that you’ve caught the common cold and it’s time to slow down and give your body some rest.  But a sore throat that does not go away could be a sign of something serious, such as cancer.  Much like an indicator light in your car, some types of pain play an important role in our health by letting us know something is not right with our bodies. 

Pain is the most common reason that people see a doctor and it affects more people than heart disease, cancer and diabetes combined.  Pain is also the leading cause of disability and a significant driver of health care spending.  Pain that does not go away is called chronic pain, a condition that impacts some 50 million Americans.  Pain can also flare up suddenly and then disappear; this is known as acute pain.  

Pain can lead to other health problems.  For example, if a person experiences pain that limits mobility, the resulting lack of exercise can contribute to an unhealthy body weight, cardiovascular issues, diabetes and hypertension.  It’s not uncommon for constant or frequent pain to negatively impact someone’s mental health and contribute to feelings of depression.    

Because pain affects so many people and can have such a serious impact on a person’s quality of life and productivity, there are physicians who specialize in the treatment of pain.  Pain management specialists have special training in evaluation, diagnosis and treatment of various types of pain, including acute pain, chronic pain and pain related to cancer. 

Pain management specialists work with patients suffering from a wide array of conditions, including cancer, migraine headaches, sciatica, lower back pain, fibromyalgia, neck pain and many others. 

Determining the Cause of Pain 

Many times, the cause of pain is evident to the patient and doctor.  If you have suffered an injury or are experiencing an illness, it is not unusual for some pain to be associated with it.  When the cause of pain is obvious, such as a sprained ankle or an ear infection, your physician will focus on treating the underlying cause while giving you some way to manage the pain.  That may be as simple as an over-the-counter medication or maybe a prescription drug. 

Managing pain associated with an injury may also involve immobilizing the impacted area or limiting movement – a sling or joint brace can help relieve pain while also helping the injured area heal.  When an injury is healed or an illness is cured, the accompanying pain should also disappear.

If the cause of pain is not clear, your physician will likely order tests to help determine the source of the pain, as well as to rule out serious conditions.  For example, if a patient is experiencing chest pain, it could simply be a symptom of acid reflux.  It could also indicate a serious blockage in a blood vessel and high risk of a heart attack.  Diagnostic tests through physical examinations, imaging and lab tests help to identify – as well as rule out – causes of pain. 

When pain does not go away, it may be because the underlying cause is not curable.   Osteoarthritis is a common example of a condition for which there is treatment, but no cure and one that can cause chronic pain. 

Cancer-related pain is considered to be in its own category.  “There are many aspects of cancer – the disease itself, complications and cancer treatment – that can cause or worsen pain,” says Dr. Vinay Dalal, a pain management specialist.  “Pain can also be an obstacle to cancer treatment.  Because the pain management must work in conjunction with the treatment for the cancer itself, it can be complicated and often requires an individualized treatment plan.”

Managing Pain

Pain management specialists have a variety of strategies available to reduce their patients’ pain.  Of course, medication is one of the most common treatments for pain.  For example, someone who suffers chronic headaches may respond well to certain prescription medications, depending on the type of headache he or she is experiencing.  “Medication doesn’t always eliminate pain, but in many cases, will help to reduce both the frequency, duration and intensity of pain episodes,” explains Dr. Tom Ratino, a pain management specialist.

Your pain management specialist will carefully evaluate medication options, balancing the efficacy of combating pain with any potential side effects.  For example, some over-the-counter medications can be effective at alleviating muscle aches and back pain, but prolonged use can have negative side effects on the digestive system. 

Sometimes, opioids have a useful role to play in pain management.  For patients battling cancer, an opioid may be necessary to make the pain manageable.  In the wake of a severe injury or surgery that is causing acute pain, an opioid prescription for a limited amount of time may be the most appropriate remedy. 

However, because they are highly addictive, opioids are dangerous to take for an extended length of time.  Additionally, when people take opioids on a long-term basis, a resistance to the drug may develop.  This resistance can lead to the urge to take even more of the opioid to feel a meaningful effect, creating a dangerous cycle that may lead to an overdose.  Therefore, even though opiate drugs can be quite effective at reducing or eliminating pain, physicians are careful about prescribing them because they are so addictive.    

There are several other strategies a pain management specialist may use to help manage pain.  Some examples include:

  • Steroid injections into the area of the body where the pain originates, reducing inflammation and pain.
  • Injection of a local anesthetic, numbing the pain for a period of time.
  • Blocking the peripheral nerves that are responsible for the feeling of pain.  
  • Radiofrequency ablation, a minimally invasive procedure that destroys the nerves causing the pain.
  • Spinal cord stimulation, which may help mitigate lower back pain.

Another strategy is to help the patient better cope with pain.  For example, cognitive behavioral therapy helps the patient understand how he or she reacts to pain.  This program aims to refocus the patient’s thoughts and energies, preventing the pain with interfering with every aspect of their lives. 

Physical and occupational therapy is often an important part of a pain management treatment plan, depending on the cause of the illness or injury.  Particularly for someone with an orthopedic injury, getting stronger and learning how to move in a way that does not exacerbate the pain is essential. 

Life Doesn’t Have to Be Painful

If you’re one of the 50 million Americans who suffers from chronic pain, remember that your pain does not have to define your life.  While it is not always possible to cure pain, a pain management specialist can help you mitigate and manage your pain so it does not interfere with your life unnecessarily. 

“No one should have to live in a constant state of pain,” says Dr. Timothy Ratino, a pain management specialist.  “Pain management specialists are here to work with your primary care provider to develop a plan for you and help you overcome the pain.  And as we continue to make medical advances, we’ll develop new and even better treatments to help people cope with pain and live their lives to the fullest.”

This article contains information sourced from:

The U.S. Centers for Disease Control and Prevention

The American Society of Regional Anesthesia and Pain Medicine

The Mayo Clinic

The National Institutes of Health