Pain Management

Types of Pain and How to Manage It All

pain management guide

It’s pretty safe to assume that most people are not the biggest fans of pain. However, whether it’s something we enjoy or not, it’s one of the ways your body communicates with you.

Think about it like this: what if you were to put your hand on a hot stove- your hand would get severe burns on it, right? Pain is the way that your body lets you know that there is something wrong that needs your attention.

Still, pain- no matter whether the cause is a bee sting, a long-term sickness, or even a broken bone- is also a very unpleasant emotional and sensory experience.

Pain is the result of multiple different causes and people respond in their own individual ways to it. You may experience pain that you can push through and still function, while to someone else that same pain may be completely incapacitating.

Even though everyone experiences and responds to pain in different ways, it is possible to place pain into different categories. Following is a bit of an overview on the various types of pain and what characteristics distinguish them from each other.

Acute Pain versus Chronic Pain

There are several different ways that pain can be categorized. One is to separate pain into acute and chronic. Typically, acute pain is characterized by a sudden onset and lasts for a limited time.

In most cases, it is the result of damage to tissue such as organs, bone, and muscle. In addition, when acute pain sets in, it is most often accompanied by emotional distress or anxiety.

On the other hand, chronic pain typically lasts much longer than acute and is usually pretty resistant to any sort of medical treatment.

Chronic pain is usually connected to a long-term illness such as osteoarthritis. In some conditions, such as fibromyalgia, chronic pain is one of the characteristics that defines the entire illness. Finally, chronic pain can result from tissue damage- but in most cases is the result of damage to the nerves.

Both types of pain can be debilitating in some cases and both can have an effect or be affected by the state of mind of the individual who is suffering.

However, the nature of chronic pain being ongoing and in some cases, constant, makes the individual much more likely to develop or experience psychological consequences such as anxiety and depression- which can also amplify the pain- so it’s a vicious cycle.

Approximately 70 percent of individuals who suffer from chronic pain and are using medication to treat it will experience what is known as breakthrough pain.

This term refers to flares of pain that occur even when the medication for pain is being used on a regular basis. In some cases, it can be the result of some natural, seemingly insignificant event such as simply rolling over or walking down stairs.

Finally, in some cases, the breakthrough pain can be caused by the medication wearing off before it is time to take the next dose.

nerve pain management

Other Classifications for Pain

One of the other ways that pain is classified is by the type of damage that is causing it. The two main categories are: tissue damage- or nociceptive pain- and nerve damage– or neuropathic pain.

There is a third category: pain caused by psychological factors- or psychogenic pain. Typically, psychogenic pain has a physical origin- either nerve damage or tissue damage- but the pain is prolonged or increased by psychological factors such as anxiety, depression, or stress. In some cases, pain can be the result of a psychological condition.

Another way that pain is classified is the type of tissue- muscle pain or joint pain- or part of the body that is involved- chest pain or back pain.

Finally, there are certain types of pain that are known as syndromes, such as fibromyalgia, which is a myofascial pain syndrome- or where the pain is caused by trigger points located in the individual’s muscles.

Tissue Damage Pain

In most cases, pain is the result of some sort of tissue damage. The root of the pain is an injury to the tissues of the body. This injury can be done to soft tissue, bone, or even the organs.

The injury to the tissues can be the result of a disease such as cancer or can be the result of a physical injury such as a broken bone or a cut.

Pain caused by tissue damage can be a sharp stabbing pain, a throbbing pain, or even an ache. The pain can be steady and constant or can come and go depending upon the circumstances.

You might notice that the pain becomes worse when you move or even when you laugh- and, in some severe cases, you may notice that even taking a deep breath can cause it to become much more intense.

Pain resulting from damage to tissue can be acute or chronic. Some examples of acute tissue damage pain are sports injuries such as turf toe or a sprained ankle.

Some examples of chronic tissue damage pain are chronic headaches or arthritis. In some cases, the tissue damage can be caused by cancer or radiation- which leads to pain.

Nerve Damage Pain

Your nerves are much like electrical cables in your body. They transmit signals, even pain signals, both to and from the brain. When nerves are damaged, this can cause interference in the way the signals are transmitted and can result in abnormal pain signals.

For example, you may be experiencing a burning sensation somewhere on your body even though there is no heat being applied to that particular area.

Nerve damage can be the result of illnesses such as diabetes or the damage can be the result of some sort of trauma. There are specific chemotherapy drugs that can result in damage to the nerves.

In addition, nerve damage can be the result of HIV or a stroke, among many other potential causes. The pain resulting from nerve damage could be caused by damage to the central nervous system, referred to as the CNS, which is inclusive of the spinal cord and brain.

Finally, pain due to nerve damage could be the result of peripheral nerve damage. Peripheral nerves are those nerves in the rest of the body that send the signals to the CNS.

Pain that is the result of nerve damage is known as neuropathic pain and is typically described as a prickling or burning sensation.

Some people even say that it feels like electrical shock. On the other hand, there are those that describe it as a stabbing sensation or pins and needles.

Some individuals who are suffering from damage to the nerves are extremely sensitive to touch and/or temperature. Just a simple light touch, such as that of a bedsheet, can trigger the pain.

In most cases, neuropathic pain is a form of chronic pain. Some examples of pain that results from damage to the nerves include:

Central Pain Syndrome: this particular syndrome is characterized by a chronic pain that results from damage done to the CNS. This damage can be the result of MS, stroke, tumors, or several other conditions. Typically, the pain is fairly constant and can even be severe.

It can have an effect on a very small area of the body such as hands and/or feet or can have an effect on a larger part of the body such as the back and/or chest. Again, the pain worsens with touch, changes in temperature, emotions, and movement.

Complex Regional Pain Syndrome: this particular type of pain is also a chronic one. It follows a serious injury and is often described as a persistent burning.

There are specific abnormalities that you may notice in the area of the pain, such as changes in the color of the skin, swelling, or even abnormal sweating.

Diabetic Peripheral Neuropathic Pain: this pain is the result of nerve damage in the hands/arms and feet/legs due to diabetes. Individuals who are dealing with diabetic neuropathy usually experience various pains including tingling, stabbing, and even burning.

Postherpetic Neuralgia and shingles: the same virus that causes chickenpox also causes shingles. The infection is localized to one area.

The rash, and the pain that goes with it, can be quite debilitating and typically occurs only on one side, along the nerve pathway. Postherpetic neuralgia is complication of shingles in which the pain from the virus lasts for over one month.

Trigeminal neuralgia: this is a condition in which pain is caused by inflammation of the facial nerves. This pain is often described as an intense, lightning-like one and can occur in the lips, forehead, nose, cheek, scalp, eye, chin, nose, or gums on only one side of the face. This pain can be triggered by touching a particular area or by simply moving a certain way.

As you can see, there are various ways that pain is classified. Now, what are the options for treating pain?

over-the-counter drugs

Treatment Options for Pain

When you are in pain, there’s only one thing you want: relief. So, what are some of the best ways to manage your pain? First of all, you should know that there are a variety of options- including medications.

Some medications are available over-the-counter and others you will need to see your physician to obtain a prescription.

When it comes to treating pain with medications, you have options there as well: oral and topical. An oral medication is one that you take by mouth. A topical medication is one that you apply to your skin, including creams, ointments, and even patches.

When it comes to the patches, some of them will be placed directly on the area of the pain and others will need to be placed somewhere away from the site of the pain.

In addition to using medications to treat your pain, there are also other options that do not involve medications at all.

These can help to reduce the amount of medications you need (possibly even eliminate the need for it) and can help relieve some of your pain.

Some of the examples of non-medication pain relief include exercise- which is best done under the guidance of a physical therapist if possible.

Other alternatives include acupuncture, in which tiny needles are inserted into your skin on specific trigger points- this should be done only by a professional.

You shouldn’t try to do this on your own. You can also use a TENS, or Transcutaneous Electro-Nerve Stimulator. This is a machine that uses pads placed on your skin to stimulate the area of that is painful- and can help to reduce some symptoms of pain.

Finally, there are some other medical-related interventional techniques involving injections around and even into the spinal region.

This can involve superficial injections into the areas that are painful (these are called trigger point injections) or can involve procedures that are more invasive.

There are multiple different procedures involving injections from epidurals to treat pain in the neck, arms, legs, and back; facet injections that are put into the joints to allow movement of the back and neck; and injections that treat burning pain of the legs or arms due to Reflex Sympathetic Dystrophy, called CRPS, and Complex Regional Pain Syndrome.

Medical Treatments for Pain

As mentioned above, there are several different medication categories that have been used to treat chronic pain. If you have any questions regarding the side effects and/or dosage of these medications, you can speak with your physician, pharmacist, or pain management specialist. The most common medications can be divided into the following categories:

Nonsteroidal Anti-Inflammatory Drugs, or NSAIDs and Acetaminophen: when it comes to NSAIDs, there is a wide variety available- some of which are OTC (such as ibuprofen).

These medications can be extremely effective for treating acute bone and muscular pain as well as to treat some forms of chronic pain syndromes.

However, when they are taken in large quantities or for an extended period of time, they can cause some problems with blood clotting, gastrointestinal system, and even kidneys.

Another risk of taking these types of medications is bleeding ulcers. Acetaminophen can also be very easily obtained OTC, and you should be careful that you don’t take more than 4000 milligrams in a 24 hour period- liver failure could occur. Some of the opioid medications combine acetaminophen with other medications.

You should pay attention when taking other medications (prescription or OTC), as acetaminophen may be one of the ingredients- and when taking in conjunction with a prescription medication, it could cause you to overdose on acetaminophen.

Antidepressants: there are some of the old categories of these medications that can be quite effective for managing pain. These are typically the tricyclic antidepressants.

The pain relieving properties in these medications allow for a lower dose to be taken than is necessary for managing depression.

However, you should be aware that these medications are not to be taken “as needed” but every single day- whether you are currently experiencing pain or not.

These medications do have some side effects, which your physician may try to lessen- such as sedation- by telling you to take them at night before going to bed. Other side effects- such as dry mouth- can be lessened by drinking water or other fluids.

If a patient has a certain form of glaucoma, their physician may not prescribe this to them. Finally, these medications should never be taken in doses larger than is prescribed.

Anticonvulsant medications: these types of medications can be very effective for treating specific types of nerve pain (burning/shooting). This is another type of medication that should not be taken “as needed” for pain.

Even when you have a day (or more) that you feel you don’t need them because you’re not in pain, you still need to take them. Some of them may come with the side effect of drowsiness, which will improve over time.

Another side effect of this type of medication is weight gain. You should tell your physician if you have glaucoma or kidney stones, as there are specific medications in this category that should not be taken if those conditions are present.

Some of the newer anticonvulsants do not require monitoring of the liver, but caution must be used if they are given to a patient who has kidney disease.

Muscle Relaxants: these are usually used in the acute symptoms of a pain syndrome such as muscle spasms. The most common side effects of a muscle relaxant is drowsiness.

Opioids: when they are used correctly, they can be very effective for helping to control chronic pain. However, be aware that if you are experiencing nerve pain, they will be less effective and may require much higher dosages.

If you have pain all day and night, you will need a long-acting opioid. One of the most common side effects of these medications is constipation, which can be countered by drinking lots of liquids if mild- but if it is severe, will require the use of other medications.

Another side effect of opioids is drowsiness, but this will get better over time as your body gets used to the medications. If you are experiencing excessive drowsiness, you will need to speak with your physician.

Finally, there is the side effect of nausea- which can be quite difficult to treat and may require that your physician switch your medication.

Addiction to Opioids

What Are the Risks for Addiction to Opioids?

If you are taking your opioids as prescribed by your physician to treat your chronic pain, you are at a very low risk for becoming addicted to them.

Of course, there are some predisposing factors when it comes to addiction to these medications, including a history or even a family history of substance abuse or specific psychiatric disorders.

Following are some definitions for addiction, physical dependence, and tolerance.

Addiction: in addition to the psychological aspect of the behavior, addiction has a basis in genetics. Addiction is a craving for a particular substance as well as continued and compulsive use of that particular substance despite the fact that harm is being caused to the individual that is using the substance.

In addition to the psychological aspect and the genetic basis, there may be some environmental factors that are influencing that individual’s use of the substance.

Physical dependence: physical dependence to a particular substance is typically seen in the form of withdrawal after the substance has been stopped abruptly or the dosage reduced rapidly.

In addition, when an opioid antagonist is given to someone who is taking an opioid, physical dependence can be seen. It is considered to be a state of adaptation.

Usually, the withdrawal symptoms will last from about 24 to 72 hours after the substance has been taken away. Withdrawal symptoms include: abdominal pain, diarrhea, nausea, sweating, and vomiting.

This is not a sign of addiction and can be seen even after taking an opioid for only two weeks.

Tolerance: tolerance to a particular substance occurs after a long period of exposure to the substance. The effects of the substance progressively decrease in effectiveness.

If you have been given an opioid by your physician, make sure that you are taking it as directed in order to avoid any problems.

If you are still in pain even though you are taking an opioid, you should not increase your dosage or frequency without first speaking to your physician- he or she may wish to switch your medications.

You should not take a long-acting opioid “as needed” but on a daily basis- whether you are in pain or not. Constipation is one of the most common side effects of taking opioids, but you can use stool stimulants and softeners to treat this.

Acupuncture for pain management

Natural Ways to Manage Pain

If you are dealing with pain- whether chronic or acute- you may believe that you only have two options:

  • Deal with it
  • Take pills

However, these days, more and more people- even in the medical community- are turning towards more natural ways to relieve/manage pain.

There are a few natural alternatives such as acupuncture, hypnosis, and yoga that can be used to make you feel better.

In fact, being in pain is one of the common reasons that people turn to these alternative and complementary therapies. So, no matter what type of pain you are experiencing, here are some great ways to get relief without having to take medications.

Massage: massage is great for treating tension headaches, neck pain, osteoarthritis, back pain, discomfort related to surgery, and fibromyalgia.

The truth is that while a massage does feel great- it doesn’t end there. Massage has actually been proven to boost serotonin and endorphin levels and reduce levels of stress hormones.

Serotonin and endorphins are your body’s natural mood regulators and painkillers. In addition, it’s possible that a massage works at a molecular level, switching off the genes that are associated with inflammation.

In addition, massage is promising for patients that have just had surgery and are experiencing discomfort. In the studies, massage offers a significant decrease in pain as well as anxiety.

Cognitive-Behavioral Therapy (CBT): this is also referred to as the “talking cure” and can help you to redirect the way that you think about your pain, which reduces your stress (and therefore reduces your pain).

Experts say that this is likely the approach that works best for those who are dealing with chronic pain. In fact, this method of pain management is much more effective than other treatments for those who have wide-body pain.

This is because changes in lifestyle and reduction of stress not only help with reducing pain, but also help to deal with symptoms when they do flare.

Acupuncture: acupuncture is an ancient practice in which tiny needles are inserted into specific points in your body.

This is excellent for treating migraines, osteoarthritis, rheumatoid arthritis, chronic back pain, sciatica, fibromyalgia, and tension headaches.

The focus is helping to correct imbalances of energy in the body. Some research has shown that carefully placing needles at specific acupuncture points will affect the activity of adenosine, which is an amino acid that naturally occurs in the body following an injury of some kind to help your body ease pain.

Yoga: yoga is excellent for treating the pain associated with arthritis, migraines, and lower back pain. You may not realize this, but somewhere around 20 million Americans are currently practicing yoga because it helps promote relaxation.

However, research has proven that there’s much more to it than this. After two months of yoga practice, individuals who are suffering with low-back pain have reported that they have a 42 percent reduction in the pain and 46 percent reduction of depression.

While it’s not completely clear why it helps reduce pain, there’s more and more evidence pointing to the fact that yoga enhances your stress-coping mechanisms, which is vital because stress makes pain worse, which stresses you even more- it’s a vicious cycle.

Hypnosis/Guided Imagery: guided imagery and hypnosis are recommended for treating low-back pain and potentially can treat fibromyalgia.

While it may sound a little crazy, hypnotherapy is now being recommended by the pain experts for treatment of lower back pain.

Hypnotherapy induces a state of consciousness that is marked by an increased awareness, while at the same time a sense of deep relaxation.

Often, it is described as being like daydreaming. A hypnotherapist will guide you to focus on the thoughts of relieving your pain and overall healing.

When it comes to guided imagery, you will be guided by the therapist to direct your focus to images that are in your mind’s eye that can create positive changes in the body- including pain relief.

Meditation: meditation is great for managing symptoms and reducing chronic pain. Some experts state that they have seen this work quite well with coping with chronic pain.

If this is something that you wish to try, it is recommended that you try some very simple breathing exercises, which can lessen how you see your pain. Here is one:

  1. Sit/lie in a comfy position, placing the tip of your tongue just behind your upper teeth.
  2. Exhale through your mouth, making a “whoosh” sound.

Close mouth and inhale through your nose to a count of four.

  1. Hold the breath in to a count of eight.
  2. Exhale through your mouth (again, the “whoosh” sound) to a count of eight.
  3. Repeat the above cycle three more times.

Tai Chi and Qigong: these are great for treating the pain related to fibromyalgia, low-back pain, and even arthritis. Some say that the slow movements in these methods can be just as effective at relieving pain as taking pain killers.

Women who suffer from fibromyalgia report that they have less pain after practicing qigong- but more research is necessary to confirm these results.

When meditation and qigong are combined, the two have been proven to reduce pain just as well as prescription medication.

In addition, those who have fibromyalgia may reap benefits from practicing tai chi- even though the underlying mechanisms aren’t quite understood.

Herbal remedies: research is still equivocal and if you wish to take herbal treatments, you should speak with your physician before doing so.

Herbal remedies have been proven to reduce inflammation that contributes to pain. There are three main supplements that are most often used: fish oils, turmeric, and vitamin D.

Do-it-Yourself Pain Relief

The truth is that when you’re in pain, all you want is relief. If you take a medication, you’ll need to wait for it to take effect before you get relief. Natural remedies also take time to take effect sometimes.

However, there are a few things you can do for yourself that will help you to get almost instant relief.

Acupressure: as mentioned above, acupuncture is a great for relieving pain. Acupressure is the same concept, only without the needles. When you have muscle pain, you may notice marble-size, tender knots on your muscles.

These are known as trigger points and many of them correspond to points used in treatments such as sports massage or acupuncture.

Simply push on the knot with enough pressure to see your finger turn white for at least 45 seconds. Be aware that you will have pain at first, but the pressure will increase energy flow which will help to release the muscle and relieve the pain.

If the pain is in a hard to reach spot, you can apply the pressure using a tennis ball. Lie down on the floor, placing the ball near the area of the pain and roll it around until you locate the tender spot. Then, lie there for one to five minutes until you feel yourself relaxing.

Listen to relaxing music: one study revealed that simply listening to some music will help to improve the intensity of pain in those who have chronic back pain.

A separate study showed that individuals with cancer, listening to music for 30 minutes found that their pain reduced by 50 percent.

Turning on the music lessens the intensity of the pain because you’re being distracted by something pleasurable instead of always thinking about your pain.

Soak in the bath: your muscles contract due to a magnesium deficiency- which leads to pain. The diet of the average American contains 65 percent less magnesium than it did in decades past because these days, we’re eating more processed foods.

To get magnesium, we need to be eating peanuts, soy, bananas, avocados, and whole grains. In addition, it can be absorbed through the skin.

An Epsom salt soak can help to ease pain- simply add 2 cups of the salts to a bath and soak for at least twelve minutes several times each week.

Topical gels: you can rub on the relief with a topical gel, which will help to numb the nerve endings and increase the flow of blood to the area, which will promote quicker healing.

You can use topical treatments to treat arthritis, bruises, headaches, and more. The active ingredients of most topicals are camphor and menthol.

Get some exercise: as mentioned in the section above, exercise such as yoga, tai chi, qigong, and others can help to reduce your pain. One study revealed that individuals with fibromyalgia who participate in twice a week, hour long tai chi classes for a period of 12 weeks report a significant improvement of their pain levels.

Stress triggers adrenaline, which causes pain, which increases stress. Exercising will help you to relax. Even taking the time to do just 10 to 15 seconds of light stretching helps. When you feel pain coming on, stretch for about 10 seconds or until the muscle releases and slowly work to a one minute stretch.

Yoga Poses for Pain Relief

Yoga Poses that Promote Pain Relief

As mentioned earlier, yoga is a great way to promote pain relief- especially if you are looking for an alternative to medical treatments.

Yoga has been proven to be quite effective for treating chronic pain and improving range of motion, muscle strength and flexibility.

When performed the correct way, the fluid movements of yoga will allow swollen, painful joints to smoothly glide over one another, which increases strength and mobility without causing more wear and tear.

It is a great alternative to the weight-bearing exercises that could cause weak joints to become worse because it actually strengthens muscles, reducing tension.

Following are the five best poses for relieving back pain, knee pain, and much more. However, before starting this or any other program, you’ll need to speak with your physician first.

Cobra Pose

Try this pose for back pain. Start by lying face down and rest your forehead on the floor. Place your hands on either side of yourself about the middle of your ribcage.

Pull your legs together and press the tops of your feet into the floor. Reach back through your toes, which will lengthen your legs, and press evenly through your hands as you bring your elbows closer to your ribs.

Using your back, lift your chest and head, sliding your shoulder blades down and back. Take five to ten deep breaths and gently release back to the floor, turning your head to one side.

Supported Warrior Pose

This pose is excellent for knee pain. Simply stand tall, placing hands against the wall at shoulder height. Step your right foot forward so that your toes touch the wall and bend your elbows like you are trying to push the wall away.

Step your left foot approximately one to three feet behind you and slightly bend your left knee towards the floor. Hold for ten to fifteen breaths.

Then, slowly straighten your left knee while bending your right knee. Make sure that your knee does not extend past your ankle. Hold this for ten to fifteen breaths before switching leg positions.

Butterfly Pose

This yoga pose is great for treating hip pain. Start by sitting on a blanket on the floor and bring the soles of your feet together.

Keep your knees wide, forming a diamond with your legs. You should keep your back straight and your shoulders relaxed.

Breathe and gently drop the weight of your legs, allowing knees to lower toward the floor.  If necessary, you can place pillows or yoga blocks under your knees for support.

Rear Arm Lift with Strap Pose

This pose is great for shoulder pain and is also called the “Standing Yoga Mudra.” Stand tall with your feet hip-width apart.

Hold a strap in one hand and sweep both of your arms behind your back, pulling your shoulders in to grab the strap with both hands in a comfy position.

Walk your hands towards each other- this will create an opening in your chest and bring your shoulder blades closer. Be sure to breathe as you adjust your shoulders, increasing or decreasing tension.

Wall Plank Pose

This pose is best for easing shoulder and elbow pain. Start by facing the wall with your feet hip-width apart. Then, place your hands on the wall with your arms extended.

Lean forward, allowing your body to rest on your hands. Keep your arms and body in a straight line, bending your elbows and inching closer to the wall.

When your nose is touching the wall (or you reach become uncomfortable), push yourself back to standing.

As you can see, there are several ways that pain is classified and there are several ways to treat pain from managing it with medical assistance to managing it on your own.

You must find the way that works best for you and stick to it as long as it is working. If you find that it stops working after a while, you may need to find something else.




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