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WHAT YOU NEED TO KNOW:
What is pain management?
Pain management includes medicines and therapies to treat pain from a surgery, injury, or illness. Pain can cause changes in your physical and emotional health, such as depression and sleep problems. Pain management may help you rest, heal, and return to your daily activities. Pain management can also help increase your appetite, sleep, and energy, and improve your mood and relationships.
What are the types of pain?
- Acute pain starts suddenly and lasts a short time. The pain usually goes away as your body heals, but may become chronic if it is not treated.
- Chronic pain lasts a long time or grows worse. It may last for months or years due to a chronic condition. It may be pain that remains after you have recovered from an injury or illness.
How is the cause of pain diagnosed?
Your healthcare provider will examine you and look for painful areas. He or she may touch or press different places on your body and ask about your pain. He or she may ask you to describe your pain. Tell your healthcare provider if your pain is sharp, dull, or achy. Tell him or her if you have constant pain or if it comes and goes. You may also need any of the following to check how much pain you have or to find its cause:
- A pain diary may help to find the cause of your pain. The diary can help you track pain cycles. Include when the pain started, how long it lasted, and how strong it was. Also include anything that made the pain worse or better.
- Pain scales may help measure how much pain you feel. Pain scales may include numbers or faces. Your healthcare provider may ask you to rate the pain on a scale from 0 to 10.
- An x-ray, CT, or MRI may be used to find the cause of your pain. You may be given contrast liquid to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
- Stimulation tests may help find nerves or muscles affected by pain.
How may pain be managed without medicine?
- Massage therapy helps relieve tight muscles. This may help you relax and decrease pain.
- Ultrasound can help decrease pain. Ultrasound is a procedure that uses sound waves to create heat applied to muscles.
- Acupuncture helps reduce pain and other symptoms. Thin needles are used to balance energy channels in the body.
- Biofeedback helps your body respond differently to pain. You will learn what your breathing and heart rate are when you are relaxed. That will help you get your breathing and heart rate to those levels when you are in pain.
- Electrical stimulation may be used to control pain. Transcutaneous electrical stimulations (TENS) is a portable device that attaches to your skin. It uses mild, safe electrical signals to help control pain. Spinal cord stimulation (SCS) is a procedure that uses a metal wire placed near your spinal cord to help control pain. SCS also uses mild, safe electrical signals. The SCS is placed during surgery.
- Surgery and other procedures may help relieve pain. Examples include radio waves, thermal (heat), or laser therapy. Surgery may also include cutting nerves or repairing joints that are the cause of your chronic pain. Surgery may be done if no other therapy works.
Which over-the-counter medicines may be used for pain?
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask if NSAIDs are safe for you. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
- Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
- A pain cream, gel, or patch may be applied to your skin on painful areas.
Which prescription medicines may be used for pain?
- Several kinds of prescription pain medicines are available. An example is opioid, or narcotic, pain medicine. Prescription pain medicines may be used for short-term (acute) pain. These medicines may not be given for long-term (chronic) pain control. Ask your healthcare provider how to take your specific prescription pain medicine safely. Also, some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage.
- Muscle relaxers help decrease pain and muscle spasms.
- Steroids decrease inflammation that causes pain.
- Anesthetic medicines may be injected in or around a nerve to block pain signals from the nerves.
- Anxiety medicine decreases anxiety. High levels of anxiety make pain harder to manage.
- Antidepressants may be used to help decrease or prevent the symptoms of depression or anxiety. They are also used to treat nerve pain.
- Anticonvulsants are usually used to control seizures. They may also be used to decrease chronic pain.
What do I need to know about prescription pain medicine safety?
- Do not suddenly stop taking prescription pain medicine. If you have been taking prescription pain medicine for longer than 2 weeks, a sudden stop may cause dangerous side effects. Ask your healthcare provider for more information before you stop taking your medicine.
- Take your medicine as directed. Take only the amount prescribed or recommended by your healthcare provider. Too much medicine may cause breathing problems or other health issues. If you use a pain patch, be sure to remove the old patch before you place a new one.
- Do not drink alcohol while you use prescription medicines. Alcohol with prescription medicines can make you sleepy and slow your breathing rate. You may stop breathing completely.
- Do not drive or operate heavy machinery after you take prescription pain medicine. Prescription pain medicine can make you drowsy and make it hard to concentrate. You may injure yourself or others if you drive or operate heavy machinery while taking your medicine.
- Time your medicine correctly. Take your pain medicine 30 minutes before exercise or physical therapy. This helps decrease pain to help meet your treatment goals. You may need to take medicine before you go to bed. This may help you sleep and not be woken by pain.
- Watch for side effects. Some foods, alcohol, and other medicines may cause side effects when you take pain medicine. Ask your healthcare provider how to prevent these problems.
- Prevent constipation. This is a common side effect of prescription pain medicine. Eat foods high in fiber, such as raw fruit, vegetables, beans, and whole-grain bread and cereal. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you. Exercise and activity may also help decrease the risk for constipation.
- Follow instructions for what to do with medicine you do not use. Your healthcare provider will give you instructions for how to dispose of pain medicine safely. This helps make sure no one else takes the medicine.
What can I do to manage my pain?
The following may be helpful if you have mild pain or pain between medicine doses:
- Apply heat or ice as directed. Heat also relieves muscle spasms. Ice may help prevent tissue damage. Your healthcare provider may recommend only heat or ice, or you may be told to alternate. For heat, use a heat pack, heating pad, or a warm washcloth. The temperature should not be hot enough to burn your skin. Apply heat for 20 to 30 minutes every 2 hours for as many days as directed. For ice, use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you place it on your skin. Apply ice for 15 to 20 minutes every hour or as directed.
- Elevate the painful area above the level of your heart if possible. This will help decrease swelling and pain. Prop your painful area on pillows or blankets to keep it elevated comfortably.
- Apply compression with an elastic bandage or abdominal binder as directed. An elastic bandage may be used after surgery on your joint, such as your knee. An abdominal binder may be used for surgeries in your abdomen.
- Use devices to help you move and decrease pain. Devices can help remove pressure from the injury and provide extra support. Assistive devices include a splint, cane, crutches, or a walker. Knee sleeves and braces help decrease pain by giving your knees extra support. Arch supports and orthotics are devices that are put in your shoes to help you stand, walk, or run correctly.
- Aromatherapy uses scents to relax, relieve stress, and decrease pain. Oils, extracts, or fragrances from flowers, herbs, and trees may be used. They may be inhaled or used during massages, facials, body wraps, and baths.
- Meditation teaches you how to focus inside yourself. The goal of meditation is to help you feel more calm and peaceful.
- Guided imagery teaches you to imagine a picture in your mind. You learn to focus on the picture instead of your pain. It may help you learn how to change the way your body senses and responds to pain.
- Music may help increase energy levels and improve your mood. It may help reduce pain by triggering your body to release endorphins. These are natural body chemicals that decrease pain. Music may be used with any of the other techniques, such as relaxation and distraction.
- Self-hypnosis is a way to direct your attention to something other than your pain. For example, you might repeat a positive statement about ignoring the pain or seeing the pain in a positive way.
What else can I do to manage pain?
- Keep a pain diary. A pain diary may help track pain cycles so you know when and how your pain starts and ends. Include anything that makes your pain worse or better. Bring the pain diary to follow-up visits with your healthcare provider.
- Talk to your healthcare provider about your daily activities. Some activities can cause pain to become worse or make pain management less effective. Your provider can help you find ways to reduce pain. For example, you may need to change when you take your pain medicine so it is more effective during activities.
- Sleep in a comfortable position. Use pillows to support painful areas.
- Go to rehabilitation as directed. Rehabilitation may include physical and occupational therapy. A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. An occupational therapist teaches you skills to help with your daily activities.
- Exercise to help relieve pain and increase your energy. Talk to your healthcare provider about how much exercise to get each day and which exercises are best for you.
When should I call my doctor or pain specialist?
- You continue to have breakthrough pain (pain between times of taking your medicine).
- The medicine you are taking makes you sleepier than usual or confused.
- You have pain even after you take your pain medicine.
- You have a new pain or the pain seems different than before.
- You have constipation from prescription pain medicine that is not helped with treatment.
- You have questions or concerns about your condition or care.
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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