Understanding Pain

Pain is both a physical and emotional experience caused by real or potential injury or damage to the body. It is often best described as a complex three-way warning system. First, acute pain warns of injury. Second, pain warns against further injury by causing the body’s movements to withdraw from the source of injury. Finally, pain leads to a period of reduced activity, enabling injuries to heal more efficiently.

Pain is often difficult to measure because the severity of the pain does not always reflect the severity of the injury. Some people feel extreme pain from relatively small injuries, while others show little or no pain even after suffering a severe injury. Pain can also be present even though no injury is apparent, or pain can linger long after an injury appears to have healed.

The Bonati Institute’s Nerve Pathways help trace radiating pain back to its source in the spine.

Communicating

Since each person perceives pain a little differently, and responds to pain differently, it is essential that you communicate as much about the exact nature of your pain to medical professionals, including:

Location

Where is the pain? Does the pain spread or move to any other place? Can you point to it?

Quality

What does the pain feel like? Is it sharp, dull, burning, searing, aching, cramping, or shooting?

Intensity

Is the pain constant, or does it come and go? A 1 - 10 pain scale is a reliable tool to help you measure your pain and to set goals for relief. How would you rate the pain on a scale of 1 - 10? (1 being no pain at all and 10 being the worst you've ever had)

Mechanics

• How did the pain start?
• How long have you had this pain?
• What kinds of activities make the pain better or worse?
• Is it better or worse when you walk, sit, stand, or lie down?

Therapies with Medicine

The complexity of human pain often requires a combination of pain therapies with medicine and without medicine to achieve relief. In addition to the body’s own mechanisms, humans have devised many different ways to manipulate the body’s ability to control pain. Drugs that relieve pain, known as analgesics, usually interfere with pain impulse transmission in the nervous system. Narcotic analgesics, such as codeine, have chemical structures that are similar to the pain-blocking neurotransmitter endorphin. Other drugs that relieve pain alter the way damaged nerves transmit information. Non-steroidal anti-inflammatory drugs, such as aspirin and ibuprofen, are analgesics that reduce pain by inhibiting the synthesis of prostaglandins, the body chemicals that intensify pain and cause inflammation.

Medications prescribed by a physician may be used alone or in combination with other medications and can be administered in a variety of ways, including:

• Tablets or liquids, taken orally, with pain relief usually occurring 45 – 60 minutes after administrations.
• Injections or infusions administered by a nurse through an IV or tube into the vein
• Skin patches which provide a gradual and consistent dosage
• Epidural injections administered by a physician through a small tube in the back. This treatment works well for surgeries on the back, hip, and leg, and for chronic pain and can control pain by injecting drugs that temporarily deaden the nerves that are transmitting pain signals.

Managing your medication

• It is important for your healthcare team to know which prescription and non-prescription medications, alternative therapies or herbal supplements you take.
• It is a good idea to keep a current list of all medications in your wallet.
• It is also important to know how and when you take your medications, and to know which medications cannot be taken together.
• Your pain medication will work best when you take it on a regular schedule (by the clock).
• Taking medicine regularly, as your doctor tells you, will help keep the pain under control. Do not skip a dose of medicine or wait for the pain to get worse before taking your medicine. The goal is to prevent the pain. Once you feel the pain, it is harder to get it under control.
• Ask your healthcare provider or nurse how and when to take extra medicine. If some activities make your pain worse, you may need to take extra medicine before these activities.