Pain Management

Pain relates to a sensation that hurts – making you feel discomfort, distress or agony. Pain can range from mild to extreme, and may be anything from a dull ache to a sharp stab. In some cases, pain is located in one part of the body, while in others it may be widespread.

Pain can be caused by a wide range of injury and disease, such as tissue damage, arthritis or back problems. It is usually the body’s way of signaling to you that something is wrong and needs attention. While the experience of pain varies from person to person, there are two commonly classified types of pain.

What types of pain are there?

According to the American Academy of Pain Medicine , health professionals categorise different types of pain as either acute or chronic.

• Acute pain is short-term pain, which starts suddenly and is usually short-lived. A range of factors, such as surgery, broken bones, and burns or cuts, may bring about acute pain. In most cases, it disappears when the underlying cause of pain has been treated or has healed. Unrelieved acute pain, however, might lead to chronic pain.
• Chronic pain, on the other hand, is long-term or persistent pain and is generally somewhat resistant to medical treatment. Chronic pain persists longer than 3 months, often despite the fact that an injury has healed. Pain signals remain active in the nervous system for weeks, months, or years. This type of pain is usually the result of an injury or disease, such as back problems or arthritis. Because of the nature of chronic pain – the fact that it's ongoing and in some cases seems almost constant – it makes the person who has it more susceptible to psychological consequences such as depression, anxiety, anger and fear of re-injury. At the same time, research indicates that psychological distress can amplify the pain.

If you are experiencing acute or chronic pain, see your doctor. Your doctor will talk to you about your symptoms and ask about your history of illness, injury or surgery. Various techniques are also available to determine the cause of pain, such as pain measurement tools and imaging tests. With this information, your doctor will help to design a treatment plan based on your individual needs.

Depending on its severity and cause, pain can be treated in a number of ways. These may include one or more of the following:

• Drug therapy: There are a number of drugs designed to treat pain. However, before taking drugs for pain relief, discuss it with your doctor so that you choose the safest and most effective option. This could include:
  • Nonopioid Analgesics: Nonopioid analgesics, such as aspirin or paracetamol, are not addictive and are generally used for mild to moderate pain.
  • Opioid Analgesics: Opioid analgesics, such as morphine and codeine, are mainly used for severe pain. These are the strongest painkillers and are commonly used after surgery, broken bones, burns, and various other situations. Taking opoids for long periods is addictive.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These may be obtained either over-the-counter or as a prescription medication. Low dosage NSAIDs are effective for headaches, muscle aches, fever, and minor pains. At a higher dose they help to reduce joint inflammation. 
  • Other medications: Other drugs, such as muscle relaxers and some antidepressants, are also used for pain.
• Alternative treatments: Alternative treatments, including acupuncture, herbal remedies or guided imagery, are often effective at relieving pain. For details, see Pain Relief Without Drugs or Surgery.
• Electrical stimulation: Procedures involving electrical stimulation, including transcutaneous electrical stimulation (TENS), are sometimes used to diminish pain. During TENS, a low-voltage electrical current is delivered through electrodes that are placed on the skin near the source of pain. The electricity from the electrodes stimulates the nerves in an affected area and sends signals to the brain that scramble normal pain signals.
• Physiotherapy: Physiotherapy is a type of therapy that helps restore movement and function when someone is affected by illness, injury or disability. For pain management and relief, physiotherapy may be passive or active. Passive therapies are typically effective for treating pain in the initial weeks after an injury, and include the use of hot or cold packs or massage. Active physiotherapy includes strengthening exercises, and is often continued for a longer period. Active treatments help relieve chronic pain by building or reconditioning your muscles so that they can move more normally. For more information, go to About Physiotherapy.
• Surgery: Although not always an option, surgery may be required to relieve pain, especially pain caused by back problems or serious musculoskeletal injuries.

The right treatment choice for you will depend on a number of factors, such as the location, intensity and type of your pain, as well as the impact it has on your lifestyle. Discuss these with your doctor for the most effective treatment plan.

Pain, especially chronic pain, can have a huge impact on your physical and emotional state, and your ability to partake in and enjoy daily activities. Read these tips to help you live with and manage your pain:

• Exercise:  It’s natural to be hesitant if exercise is painful and if you’re worried about doing more damage. But there is no need to fear or avoid exercise, even if you live with chronic pain. In fact, moderate exercise, such as walking or swimming, helps to stretch stiff and tense muscles, ligaments and joints, which can lessen pain. It is also great for improving your mood and self-esteem.
• Relax: Persistent pain is a stressful experience, but it is important to find ways to relax the mind and body. Not only can stress make the pain worse, but it also causes other physical and emotional side effects. Give some relaxation techniques, like deep breathing, meditation or yoga, a go.
• Socialise: Don’t let pain mean that you lose contact with your loved ones. Spending time with family and friends is not only good for your health, it can take your mind off the pain and help you feel much better.
• Get involved:  The American Chronic Pain Association encourages all who suffer from persistent pain to become an active partner in their own health care. This means, you should understand your treatment plan, engage with your doctor, and take all-round ownership of your pain relief. The accountability will keep you motivated to continue improving your overall health and quality of life.
• Stay positive: Living with chronic pain is just as much an emotional issue as a physical one. However, feeling anxious, depressed and grumpy can make the pain even worse, sending you further down the spiral of negativity. Recognising how your emotions affect your pain, and vice versa, can help relieve your pain and make everyday living more enjoyable. Some people find it useful to seek help from a counsellor, psychologist or hypnotherapist to discover how to deal with their emotions in relation to their pain.
• Breathe correctly: When pain is intense, it’s natural to panic and start taking shallow, rapid breaths. Breathing slowly and deeply can provide relief. By remaining relaxed, you prevent any muscle tension or anxiety from worsening your pain.
• Create a sleep routine: Many people living with chronic pain experience sleep problems. Go to bed at the same time each night, and wake up at the same time each morning for the best chance at regulating your sleep. Adequate sleep makes you feel better in general and can alleviate the pain you experience during the day.

If you are keen to fnid out more, we have collected a list of leading associations that can help you managing your pain:

• The American Academy of Pain Management
• The American Academy of Pain Medicine
• The British Pain Society
• International Association for the Study of Pain
• Partners Against Pain, ‘Caregiver Cornerstones: A Resource for Family Caregivers Caring for People Living With Pain’ (Publication)