Pain affects more Americans than any other condition, including diabetes, heart disease, and cancer combined. As a result, pain management is one of the major challenges of the American medical system. The current opioid addiction crisis is just one outcome of the widespread pain management challenge. But there are many options for effective relief that do not depend on potentially addictive opioids or other medications.
The key to effective, long-term pain management is to understand what pain is and to determine the underlying causes. Healing can begin when patient and therapist clearly understand the cause.
Acute versus chronic pain
The starting point is to assess the type of pain. The first two main categories are acute and chronic pain, the difference being how long the pain lasts.
Acute pain is usually the result of an illness, injury or surgery, and the cause is usually fairly easy to determine. Treatment is typically according to that underlying cause — a broken bone, sprained joint or burn, for example. Pain medication is often the prescribed treatment, but is not necessarily the only option.
Chronic pain lasts a long time: weeks, months or years, and can even persist for a lifetime. Often, it’s harder to see the underlying cause. It could be the result of not treating the cause of acute pain properly, or it could be the sign of an undiagnosed, underlying condition, such as heart disease, diabetes or even cancer.
Breakthrough pain describes a flare-up of pain that overwhelms medication. Sometimes, it’s caused when pain medication wears off; at other times, it can be triggered by something as innocuous as turning around or taking a step. Sometimes it happens spontaneously.
Types of pain
· Somatic pain is caused by irritation on the skin or in the muscles, tendons, ligaments or bone tissues.
· Myofascial pain, a sub-category of somatic pain, is in a muscle a muscle group.
· Visceral pain in the internal organs such as heart, lungs and other organs, is often hard for sufferers to identify exactly where it begins.
· Neuropathic pain is caused by damage to the nerves, spinal cord or brain. For example, symptom such as the feeling of burning or stabbing pain, accompanied by numbness or tingling sensations, can be the result of nerve compression or more severe damage to the spinal cord.
· Radicular pain is a type of neuropathic pain caused by pressure on nerve roots. It causes pain to shoot down the length of the nerve. For example, when nerves in the neck or spine are compressed, such as after a car accident or sports injury, pain shoots down the leg or arm. Consequences
Chronic pain, even if the level is relatively mild, makes the person suffering from it more prone to psychological consequences, including anxiety and depression. This can start a vicious cycle, where anxiety or depression make chronic pain worse, which leads to more anxiety and depression.
· Medication is usually the first option for most medical therapists. These include acetaminophen, aspirin and nonsteroidal anti-inflammatory drugs, or NSAIDs. Some of these, such as ibuprofen, can be bought over the counter, or without a prescription. They can be very effective for acute pain and some chronic pain, but over time can have significant side effects.
Some antidepressants can be effective in chronic pain management, taken over the long term in doses lower than those used for treating depression.
· Opioids are often prescribed for certain types of chronic pain, and have significant side effects, including drowsiness, nausea and addiction.
· Surgery is not a common treatment for pain management — it’s usually a last resort. Some surgery can relieve pressure or correct a compression of nerves that cause nerve damage. However, surgery can have other significant side effects, as well.
Effective treatments of root causes of pain
The cutting edge of pain management and therapy is not surgical nor pharmacological. The goal is to restore patients to their full former lives and abilities without cutting, and minimal downtime.
New pain management techniques like prolotherapy, stem-cell therapy, platelet-rich plasma therapy (PRP) and osteopathic manipulative treatment (OMT) encourage the body’s built-in healing processes to stimulate the regeneration of healthy tissues and free the patient from pain.
Freedom from pain
Identifying the type of pain suffered, listening to the patient and then working together to determine the best treatments is the approach that we at In2It Medical find the most effective over the long term