Pain is a very common condition. The occurrence of pain rises as people get older, and women are more likely to experience pain than men.
Types of pain
There are 2 main types of pain:
- Acute pain –: A normal response to an injury or medical condition. It starts suddenly and is usually short-lived.
- Chronic pain –: Continues beyond the time expected for healing. It generally lasts for longer than 3 months.
Pain may be anything from a dull ache to a sharp stab and can range from mild to extreme. You may feel pain in one part of your body or it may be widespread.
Pain Management Strategies
Studies suggest that a person’s emotional well-being can impact the experience of pain. Understanding the cause and learning effective ways to cope with your pain can improve your quality of life.
Key pain management strategies include
- Pain medicines
- Physical therapies (such as heat or cold packs, massage, hydrotherapy, and exercise
- Psychological therapies (such as cognitive-behavioral therapy, relaxation techniques, and meditation)
- Mind and body techniques (such as acupuncture)
Causes of pain
The most common causes of pain in adults include:
- Injury
- Medical conditions (such as cancer, arthritis and back problems)
- Surgery.
How pain affects the body
Pain is a complex protective mechanism. It is an essential part of evolution that protects the body from danger and harm. The body has pain receptors that are attached to 2 main types of nerves that detect danger. One nerve type relays messages quickly, causing sharp, sudden pain. The other relays messages slowly, causing a dull, throbbing pain. Some areas of the body have more pain receptors than others. For example, the skin has lots of receptors so it is easy to tell the exact location and type of pain. There are far fewer receptors in the gut, so it is harder to pinpoint the precise location of a stomach ache. If pain receptors in the skin are activated by touching something dangerous (for example something hot or sharp), these nerves send alerts to the spinal cord and then to part of the brain called the thalamus. Sometimes the spinal cord sends an immediate signal back to the muscles to make them contract. This moves the affected body part away from the source of danger or harm. This is a reflex reaction that prevents further damage from occurring. It happens before you feel pain. Once the ‘alert!’ message reaches the thalamus, it sorts the information the nerves have sent, taking into account your previous experience, beliefs, expectations, culture, and social norms. This explains why people have very different responses to pain. The thalamus then sends the information on to other parts of the brain that are linked to a physical response, thought, and emotion. This is when you may feel the sensation of pain, and think ‘That hurt! What was it?’, and feel annoyed. The thalamus also contributes to mood and arousal, which helps to explain why your interpretation of pain partly depends on your state of mind.
Managing Pain Without Medicines
Many non-medicine treatments are available to help you manage your pain. A combination of treatments and therapies is often more effective than just one.
- Your pain is more likely to be well managed
- You are less likely to need larger doses of medicine
- You can reduce your risk of side effects.
Medicines for chronic pain are best taken regularly. Talk to your doctor or pharmacist if your medicines are not working or are causing problems, such as side effects. These are more likely to occur if you are taking pain medicines for a long time. It is important to use a variety of strategies to help reduce pain. Do not rely on medicines alone.
People can lower the levels of pain they feel by:
- Staying active
- Pacing their daily activity so as to avoid pain flares (this involves finding the balance between under- and over-doing it)
- Avoiding pain triggers
- Using coping strategies.
Side Effects Of Pain Medicines
Some of the side effects of common pain medicines include:
- Paracetamol – side effects are rare when taken at the recommended dose and for a short time. Paracetamol can cause skin rash and liver damage if used in large doses for a long time.
- Aspirin – the most common side effects are nausea, vomiting, indigestion, and stomach ulcer. Some people may experience more serious side effects such as an asthma attack, tinnitus (ringing in the ears), kidney damage, and bleeding.
- Non-steroidal anti-inflammatory drugs (NSAIDs) – can cause headache, nausea, stomach upset, heartburn, skin rash, tiredness, dizziness, ringing in the ears, and raised blood pressure. They can also make heart failure or kidney failure worse, and increase the risk of heart attack, angina, stroke, and bleeding. NSAIDs should always be used cautiously and for the shortest time possible.
- Opioid pain medicines such as morphine, oxycodone, and codeine – commonly cause drowsiness, confusion, falls, nausea, vomiting, and constipation. They can also reduce physical coordination and balance. Importantly, these medicines can lead to dependence and slow down breathing, resulting in an accidental fatal overdose.
You can find a more complete list of side effects in a Consumer Medicine Information leaflet. Talk to your doctor or pharmacist before taking any pain medicine to ensure it is safe for you.
Precautions when taking pain medicines
Treat over-the-counter pain medicines with caution, just like any other medicines. It’s always good to discuss any medicines with your doctor or pharmacist.
General suggestions include:
- Don’t self-medicate with pain medicines during pregnancy – some can reach the fetus through the placenta and potentially cause harm.
- Take care if you are elderly or caring for an older person. Older people have an increased risk of side effects. For example, taking aspirin regularly for chronic pain (such as arthritis) can cause a dangerous bleeding stomach ulcer.
- When buying over-the-counter pain medicines, speak with a pharmacist about any prescription and complementary medicines you are taking so they can help you choose a pain medicine that is safe for you.
- Don’t take more than one over-the-counter medicine at a time without consulting your doctor or pharmacist. It is easier than you think to unintentionally take an overdose. For example, many ‘cold and flu medicines contain paracetamol, so it is important not to take any other paracetamol-containing medicine at the same time.