Often the cause of pain is obvious, a broken leg, or a bruise. But there are times when the source of pain is unseen, for example a slipped disc. Occasionally it is very difficult to find the exact cause of a person’s pain.
Health professionals use different terms for different types of pain.
•Short-term pain is called Acute Pain. An example is a sprained ankle.
•Long-term is called Persistent or Chronic Pain. Back trouble or arthritis are examples.
•Pain that comes and goes is called Recurrent or Intermittent Pain. A toothache could be one.
Many acute pains are like an alarm telling us something is wrong. Most minor ones are easy to treat; others may be a sign of something more serious. For example the pain of a broken leg will make us rest the leg until it heals. Here the pain is helpful.
By contrast chronic pain often serves no useful purpose. Medical assessment and diagnosis does not usually lead to the pain going away and over time it may affect what we can including ability to work and sleep patterns may be interrupted. It can affect mood and relationships with our family and friends too.
Pain signals from injury normally travel to the brain via specialised nerve fibres and the spinal cord.. These nerves also process the pain signals. All together they work like a very powerful computer.
Sometimes this computer system can go wrong. The messages get confused and the brain cannot understand the signals properly. Thia is one reason for chronic pain, which can be very difficult to treat because we cannot just re-boot the system.
Pain usually causes strong emotions and these can interact with our other feelings. If we are angry, depressed or anxious, our pain may be worse.Alternatively if we are feeling positive and happy, our pain may be less and we are able to cope better. This shows that pain is never “all in the mind” or “purely in the body” – it is a complex mix depending on many factors.
A slight pain can become amplified.rather like in a football crowd: one person starts a chant or a song and very quickly the whole stand has joined in. When this happens with pain, doctors call it central sensitisation and is one of the reasons why the severity of pain experience may have little relationship to the size of the cause of pain.. The ‘chant’ can last for hours, days or even years.
One of the ways in which pain signals are regulated within the nervous system is by the release of tiny quantitiies of neurotransmitter chemicals -, over one hundred types have been discovered.
The balance of neurotransmitters in the nerves can affect the amount of pain that is experienced. By doing something that we enjoy like having a good laugh or exercising, we can strengthen our ‘good’ neurotransmitters and so limit pain. However, if we are depressed or moody, lack motivation and are not active the bad neurotransmitters take over and our pain can get worse. Pain killers are sometimes used to strengthen these ‘good’ neurotransmitters.
Many of the modern techniques used by medical people have helped us to understand and treat pain better. But there is still a lot that needs to be learned.
Pain doctors understand that pain is a very personal experience with only the person in pain being able to say how much pain they are in..
Assessment of a patient’s pain by healthcare professionals needs to be thorough and include many aspects health, emotions and functioning in life.
The Society for the Study of Pain is theNigeria chapter of the International Association for the Study of Pain (IASP) supporting medical professionals working together to provide better understanding and treatment of all forms of pain.
SSPN organises regular educational events about pain for medical professionals and patients. It manages scientific conferences and training events. Together with other organisations it lobbies for better healthcare resources for pain.
SSPN provides general information about pain. This includes
The type of painkiller required will depend on the cause of the pain. The best way to find the most effective painkiller for you and your pain is to talk to your doctor, pain nurse or pharmacist. They can give you individual and detailed advice.
You can veiw our guide to over-the-counter painkillers HERE.
There are a number of techniques that can help with managing your pain. Some are:
A pulled hamstring, a broken bone or an arthritic joint are examples of musculoskeletal pain. It is pain that is felt in the muscles or bones (skeleton) of the body.
This is pain that results from actual injury and damage to tissues including inflammation. The pulled hamstring, broken bone and arthritic joint are all damaging (noxious) situations.
This is pain that results from damage to the nerves – muscles and bones may not be directly affected.
Sciatica where a nerve is irritated or compressed in the bottom of the back giving pain down the leg,
Shingles where virus damage to a nerve causes extremely painful sensitivity of the area of skin supplied by that nerve.
Diabetes and Multiple Sclerosis can damage the nerves at multiple points resulting in more widespread pains.
A pain is referred when somebody gets a pain in one part of their body, but the cause is in another part of their body. Strange but true!
Pain in the left arm caused by a heart attack, and sciatica are both examples of referred pains.
Epidural steriod injections are one of a number of procedures or injections that may be offered for some types of nerve pain originating in the spine. The doctor offering you the injection should give you detailed information about it if this treatment is being considered.
This is difficult to answer for an individual.
In general, X-rays take a picture of the bones. They are used for diagnosing cancer, tumours, rheumatoid arthritis and osteoporotic collapse.
An MRI scan is also a picture of the body and is more useful for examining the soft tissues such as muscles and nerves.
However scans and x-rays often do not show the cause of a pain and they may identify changes that are of no relevance so they must be selected, interpreted and explained to patients carefully.