Pain is an unpleasant feeling or sensation signaled from the nervous system to alert a person to a possible or incurred injury. More people seek medical care for pain than any other medical problem and affect more than 115 million Americans. The two general categories for pain are acute and chronic. Acute pain is short term and resolves once the area affected is healed. Chronic pain is long term (over 3 months) and can linger even after the affected area is “healed”, although residual organ or nerve damage may be present. There are literally hundreds pain syndromes or disorders, from the most benign, such as a pin prick, to the most severe, such as cancer pain.
The best way to diagnosis pain is from the patient’s own description. There are no devices or tests that can determine the amount of pain someone experiences. However, there are tests and procedures that can help determine the cause of the pain. Typically, physicians order imaging tests, such as an MRI or X-ray, to discover if organ or tissue damage is the cause of the pain. Pain response to treatment is determined by the patient’s account of relief and activities of daily living.
The goal of pain management is to improve function and the patient’s quality of life. There are many options at the physician’s disposal to treat pain. Physical therapy and low impact exercises may be used to help reduce pain. Acupuncture, electrical stimulation, chiropractic manipulation, lifestyle modification, psychotherapy, and relaxation techniques can also be used. For patients with extreme pain, medication or surgery may be the best option.
Capsaicin is used in many muscle rubs to topically relieve pain. Analgesics are first line oral treatments for mild to moderate pain. Celebrex may be used for arthritis related pain. Anticonvulsants and antidepressants can also be used to treat neuropathic pain. Anti-migraine medications are used to treat severe headaches and migraines. Benzodiazepines and muscle relaxers can aid in patient relaxation and to stop the discomfort of spasms. Opioids are reserved for severe pain that is resistant to other treatments.
Surgery is a last resort for pain not controlled by other therapies for most patients. Surgery has its own set of risks and benefits, and should be evaluated by the patient and their physician.