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Pain is your body's way of warning you that something is wrong. If you step on a sharp object or put your hand on a hot stove, the pain lets you know right away that you are hurt and need to protect yourself. You may have pain from an injury, after surgery, or from a health problem like cancer, osteoarthritis, low back pain, headaches, or fibromyalgia.
Your body feels pain through nerves in your skin and organs. These nerve endings send pain signals to your brain.
Pain can affect:
You can have more than one kind of pain at the same time. For example, cancer can cause pain in your bones and your organs.
Pain feels different for everyone. Something that doesn't bother one person might feel very bad to someone else.
Pain can feel sharp or dull. It may throb or burn. It may be in one part of your body, such as with a headache or a stomach ulcer. Or you may feel pain all over, like when your muscles ache from intense exercise or the flu.
Some pain may be so mild that you can ignore it until it goes away. But other pain may be so bad that you can't do your daily activities without medicine or other treatment.
Pain may last for a short time or a long time. It may come and go or it may be constant.
Pain that starts quickly and lasts for a short time is called acute pain. Examples include pain from an injury, a headache, childbirth, or right after surgery.
Pain that goes on for months or years is called chronic pain. You may have this pain from an injury that doesn't heal or from a health problem like low back pain, very bad headaches, or diabetic neuropathy.
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Learning about pain:
Living with pain:
Controlling your pain can help you to:
Long-term pain that isn't controlled can take the joy from your life. You may not be able to work. Physical activity may be too painful or exhausting. You may have a hard time sleeping at night, which can make you tired and cranky. Your outlook on life may change and strain your relationships with family and friends. You may become depressed and anxious. Controlling pain can help with all these things.
Many different treatments can ease pain. Medicines are the most common treatment. But to feel better, you will need to do more than take medicine, such as reducing your stress level or changing how you think.
You also can try physical therapy, relaxation, acupuncture, and other ways to feel better. Talk with your doctor about what mix of treatments might work best for you.
Your treatment depends on several things, including:
If you have pain for a long time, your treatment may change over time.
Medicines can help you get better and can even save your life. But they can also be dangerous, especially if you don't take them the right way. Be safe with medicines. Read and follow all instructions on the label.
Several types of medicines can be used to treat pain. Most of these medicines can treat more than one kind of pain. So you may need to try a couple of medicines to see which works best for you. Your doctor will work with you to find the right types and dosage of medicine. You may take more than one kind of medicine at the same time.
Types of pain
Nonsteroidal anti-inflammatory drugs (NSAIDS):
Opiate pain relievers:
Serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants:
Selective serotonin reuptake inhibitor (SSRI) antidepressants:
Tricyclic and tetracyclic antidepressants:
NMDA receptor antagonists:
All medicines have side effects. For more information, see the Side Effects of Pain Medicines section of this topic.
Learn more about:
You may want to try other ways to help you relax and ease pain. These may include:
For more information, see the topic Complementary Medicine.
Stress can make pain worse. It can tighten your muscles, which can cause headaches and pain in your neck, shoulders, and back.
Try these methods to reduce stress and pain:
For more information, see the topic Stress Management.
How you think can affect how you feel. You may be able to reduce your pain by stopping negative thoughts. You can change what you say to yourself about your pain. To help your outlook, try the methods described in these topics:
For more information, see the topic Stop Negative Thoughts: Choosing a Healthier Way of Thinking.
Pain can get worse slowly. So it can be hard to tell if your pain is getting worse, especially if you've had it for a while. But you can look for signs that your pain is worse. You may notice that:
Using a pain scale and a pain diary can help you know how much pain you're having. These tools also can help you tell your doctor what your pain feels like so that he or she can help you. You can use these tools for short-term or long-term pain.
Health professionals often use a pain scale to find out how much pain a person has. The scale is from 0 to 10, with "0" being no pain and "10" being the worst possible pain.
To use a pain scale, write down how strong your pain is and when it comes and goes.
Use a pain diarypain diary(What is a PDF document?) to keep a record of your pain. Write down what pain medicines you're taking and how well they are working.
Also write down anything else you're doing to control your pain.
Note the details of your pain so you can tell your doctor. Is it burning? Throbbing? Steady? How long does it last?
Take your diary and pain scale and any questions with you when you see your doctor. Talk to your doctor anytime you have new pain or your pain gets worse.
All medicines have side effects. But many side effects can be managed so that you can still take the medicine. Talk to your doctor if you have any side effects. Your doctor may change your dose or the type of medicine you take.
This medicine may cause:
These may cause:
No one younger than 20 should take aspirin. It has been linked to Reye syndrome, a serious illness.
These may cause:
Because of the chance of side effects, doctors usually try to prescribe steroid medicines only for a short time.
Opiate pain relievers are strong medicines that can be very helpful in treating pain, especially after an injury or surgery. They are safest when you use them exactly as your doctor prescribes. But there is a risk of addiction when you take them for more than a few days. The risk is lower if you follow your doctor's instructions on how to take them. Your risk is slightly higher if you or someone in your family has a history of substance abuse. If you are worried about addiction, talk with your doctor.
If you are taking a long-acting opiate pain reliever, make sure you know how to use it safely.
The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk with your doctor about these possible side effects and the warning signs of suicide.
For more information, see the topic Dealing With Medicine Side Effects and Interactions.
The best way to control your pain is to follow your treatment plan and give it time to work.
Some treatments may take a few days or weeks to improve your pain. You and your doctor can talk about how long you should stay on a medicine or other treatment.
It's very important to take your medicines exactly as your doctor prescribes. Following your doctor's advice will help you get the right amount of medicine with as few side effects as possible. It also will help you and your doctor know if a medicine is working for you.
Make sure to tell your doctor about any medicines or herbal supplements you take. Your other medicines and supplements could mix in a bad way with your pain medicines. This could keep the pain medicine from working as well as it could.
Make the most of your pain medicines by following these rules:
Only you can tell how much pain you have and whether it's getting better or worse. Talk to your doctor anytime you have new pain, your pain gets worse, or your treatment isn't controlling your pain.
Some people may think they're weak if they tell their doctor about their pain. Or they worry that they're bothering their doctor.
You're not weak. And you're not bothering the doctor. Your doctor wants to help you. But to help you, he or she needs to know how you really feel.
Call your doctor if:
For more information, see: the topic Work Closely With Your Doctor.
Needing other people for emotional support is a normal part of life. You may have to lean on family and friends if you're getting over an injury or surgery or if you live with pain much of the time.
It can be hard sometimes to ask for help. But don't be afraid to reach out. Other people can help you—and they may be eager to help. Along with your family and friends, you can seek support from:
For more information, see the topic Support Groups and Social Support.
Other Works Consulted
Washington State Department of Labor and Industries (2011). Work-Related Complex Regional Pain Syndrome (CRPS): Diagnosis and Treatment. Olympia, WA: Washington State Department of Labor and Industries. Available online: http://www.lni.wa.gov/ClaimsIns/Providers/TreatingPatients/TreatGuide/default.asp.
February 5, 2013
Anne C. Poinier, MD - Internal Medicine & Nancy Greenwald, MD - Physical Medicine and Rehabilitation
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