Pain Management 101: What You Need to Know

Almost everyone has experienced pain in some form, such as a headache or stubbed toe. There are many different types of pain and many ways to treat them, but it may be difficult to know which treatments to try or how to keep the pain at bay. Fortunately, pain management can offer relief.

Categorizing Pain

To manage pain, it first needs to be described accurately. One way to categorize pain is duration, which is used to describe pain as either acute or chronic. Acute pain doesn't last long, but it's often severe. Chronic pain lasts a long time or constantly recurs and can range from mild to severe. It may occur after an illness or injury, or it may begin as acute pain and become chronic over time.

Besides acute and chronic pain, there are two main categories of pain determined by cause: nociceptive pain, which is caused by tissue damage, and neuropathic pain, which is caused by nerve damage. Nociceptive pain is further broken down into radicular and somatic pain. Radicular pain stems from nerve root irritation and radiates into the lower extremity, such as the arm or leg. Somatic pain is confined to the back or thighs.

A third category, psychogenic pain, refers to pain that originated as nociceptive or neuropathic pain but is prolonged by psychological factors such as depression or anxiety. Symptoms of psychogenic pain may include headaches and stomach or back pain. Pain may also be categorized as idiopathic, meaning it has no apparent cause.

What Is Pain Management?

The purpose of pain management is to evaluate, diagnose, and treat different types of pain. It often involves a multidisciplinary approach and includes doctors from different specialties, such as neurology and anesthesiology. Psychiatrists may also be on hand to help patients work through the emotions that come with dealing with pain.

Some of the questions your physician will ask you include how your pain impacts your daily life, what your pain level is on a scale of 1 to 10, and what you're currently doing to manage your pain. They may also ask what types of treatments you've tried in the past and how well they worked, if at all.

Types of Pain Management

Medications to treat pain include nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen like Tylenol, and steroids, which can be administered via injection, such as an epidural, to treat back pain. Opioid medications are also an option, but health care providers are beginning to shift away from narcotics because of the potential for misuse. For low back pain in particular, the American College of Physicians recommends using opioids only when other treatments have failed.

Nonpharmacological approaches to treating pain include massage, physical therapy, acupuncture, exercise, relaxation techniques, and heat. A study published in the Journal of the American Osteopathic Association found that superficial heat can help diminish pain and decrease muscle spasms. A study published in FP Essentials, a journal of the American Academy of Family Physicians, found that guided imagery, muscle relaxation, hypnosis, stretching, and other nonpharmacological approaches were effective for pain relief.

Depending on the severity of the pain, one type of treatment may be more effective than another. A combination of treatments may also be beneficial. Before starting any treatment, have an honest conversation with your physician or physicians about your hopes for the program and any concerns you might have. If there is anything that you don't feel comfortable with, or if there is a treatment that you would like to try, be sure to tell your physician. If they're unable to help you, you can ask for a referral. The ultimate goal is for you to feel better, so you want to work with someone who will respect your wishes and make informed decisions.