Everyone experiences pain from time to time. Pain serves an important purpose by letting us know something is wrong with our body. But when pain is persistent and won’t go away, that means it’s time to get checked out.
Pain is the most common reason people see a doctor, affecting more people than heart disease, cancer and diabetes combined. It 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 overweightness, cardiovascular issues, diabetes and hypertension. Constant or frequent pain can negatively impact mental health and lead to 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. Privia Medical Group North Texas has several pain management specialists who serve patients across the Dallas/Fort Worth area.
Determining the Cause of Pain
Many times, the cause of pain is evident to the patient and doctor. 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 pain reliever.
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 subside.
If the cause of pain is not clear, your physician will likely order tests to identify the underlying issue. This is necessary, because similar-feeling pain can have many possible causes.
For example, if a patient is experiencing chest pain, it could simply be a symptom of acid reflux. On the other hand, it could indicate a blockage in a blood vessel and elevated 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 an example of a condition for which there are treatments, but no cure.
Cancer-related pain is 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 in Fort Worth. “Pain itself may also be an obstacle to cancer treatment. Because the pain management must work in conjunction with the treatment for the cancer, it can be complicated and 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 the frequency, duration and intensity of pain episodes,” explains Dr. Dalal.
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. Acetaminophen is helpful for fever and the occasional headache – but overuse can damage the liver.
Opioids for Pain
Opioids are a class of powerful drugs used to relieve pain. Some common prescription opioids include oxycodone, hydrocodone, morphine and methadone.
In some situations, 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 causes 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 for a long time, resistance to the drug may develop. This resistance can create an urge to take even more of the opioid to feel a meaningful effect, fueling 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.
Texas law regulates the prescription of opioids to better protect patients from becoming addicted or overdosing:
- Opioid prescriptions for acute pain are limited to a maximum of 10 days with no refills
- Prescribers must check a patient’s prescription history in the Prescription Monitoring Program (PMP) database. Texas pharmacies are also required to use this database to record all controlled substance prescriptions they have filled.
- All controlled substances may only be e-prescribed, i.e., no written prescriptions
- Continuing education requirements for prescribers
Other Pain Management Tools
There are many 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 from interfering with every aspect of their lives.
Physical therapy is often an important part of a pain management treatment plan, depending on the type of 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 a Pain
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 pain so it does not interfere with your life unnecessarily.
“We don’t want anyone to live in a constant state of pain,” says Dr. Dalal. “Pain management specialists are here to work with your primary care provider to develop an individualized plan that will help you overcome – or at least effectively manage – your pain. If you find yourself experiencing frequent pain, make an appointment to see your physician. We can help you!”
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
This article contains information sourced from:
The American Society of Regional Anesthesia and Pain Medicine
