ACUTE PAIN: PAIN MANAGEMENT

Every person experiences pain at one time or another. Pain may be related to an injury, a surgical procedure or a medical problem. Pain can come from an illness or can be the result of a combination of factors. Each person experiences pain in an individual way. Different kinds of pain may cause a variety of pain-related problems.

There are many ways to treat pain. Treatment often depends on identifying the cause of the pain. Sometimes simple therapies are not enough to treat persons with a difficult pain problem. For these patients, there are doctors who specialize in treatment of pain. These physicians may have backgrounds in a variety of medical specialties.

The November 12, 2003, issue of JAMA is a theme issue devoted to articles about pain and pain management.

Types of Pain

· Acute — injury, inflammation, surgery, childbirth

· Chronic — pain problems of long duration

· Neuropathic — from diseases of the nerves or from injury to nerves

· Cancer — pain related to malignant disease or tumors and their effects on the body

See your doctor if you experience a pain problem that is unusual for you. Early diagnosis and treatment of pain problems can lessen their effects on the body and the mind. Because pain also has emotional effects, your doctor may suggest ways other than medications to help you manage your pain problem.

Pain Treatments

· Rest or exercise

· Heat or ice

· Physical therapy

· Nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen)

· Opioid (narcotic) medications taken by mouth, injection or rectal administration

· Antidepressant medications

· Stress reduction

· Nerve block (injection of anesthetic around a nerve)

· Transdermal (through the skin) medications

· Epidural (space outside the spinal cord covering) or spinal (space inside the spinal covering) injections

· Implantation of pumps (for medications) or spinal cord stimulators

· Psychotherapy (talking with a mental health professional)

Fear of addiction to narcotic medications stops some persons from treating their pain adequately. Narcotic medications, when used properly under the supervision of your doctor, may be useful in treating severe pain, cancer pain or difficult chronic pain problems.