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Rehabilitative Pain Management


What is rehabilitative pain management?

Rehabilitative pain management consists of treatments and therapies to treat pain while you recover from an injury or illness. It may also include learning to do activities differently to avoid injury.

What are the types of pain?

  • Acute pain: This pain comes on suddenly and lasts a short time. The pain usually goes away as your body heals, but may become chronic if left untreated.
  • Chronic pain: This describes pain that 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 pain diagnosed?

A pain diary may help to find the cause of your pain. The diary can help you track pain cycles. You may also need any of the following to check how much pain you have or to find its cause:

  • Physical examination: Your healthcare provider will examine you and look for painful areas. He may touch or press different places on your body. He may ask you questions about your pain.
  • Pain scales: These may help measure how much pain you feel. There are many pain scales that include numbers or faces. Your healthcare provider may ask you to rate the pain on a scale of 0 to 10.
    Pain Scale

Why is pain control important?

If pain is not treated, it can decrease your appetite, sleeping, and energy. It can also affect your mood and your relationships. You may feel that your pain will never go away. This can cause a cycle of suffering, sleeplessness, and sadness.

How is pain treated?

  • NSAIDs: These medicines decrease swelling and pain. You can buy NSAIDs without a doctor's order. Ask your healthcare provider which medicine is right for you, and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.
  • Narcotic analgesics: These are used for moderate to severe pain.
  • Muscle relaxers help decrease pain and muscle spasms.
  • Steroids: These decrease inflammation that causes pain.

How can pain medicine be given?

  • Topical: This is given as a cream or gel to spread on your skin.
  • Transdermal: This is given as a patch for your skin. This medicine is released slowly to give pain relief for as long as 72 hours.
  • By mouth: Pain medicine may be given as a pill, liquid to swallow, or a lozenge to suck on.
  • Intranasal: This is sprayed into your nose.
  • Rectal: Pain medicine may be given as suppository to put into your rectum.
  • Shot: These may be given into an IV, a muscle, or under your skin.
  • Patient-controlled analgesia (PCA): This is button you can push to release medicine into the catheter.
  • Epidural: This is when medicine is given through a catheter (tube) that is placed into the areas around your spinal cord.
  • Nerve block: This is given as a shot and put close to the nerves where you have pain. It may be used to decrease short-term pain.

How do I take pain medicine safely?

  • Time it correctly: Take your pain medicine 30 minutes before exercise or physical therapy. This helps decrease pain to help meet the goals of your rehabilitation treatments.
  • Take your pain medicine as directed: Too much medicine may make it difficult to breathe. 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 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 of constipation.
  • Do not suddenly stop taking narcotic pain medicine: If you have been taking narcotics 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.

How can I manage my symptoms?

  • Heat: Heat helps decrease pain and muscle spasms. Apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed.
  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on the area for 15 to 20 minutes every hour or as directed.
  • Physical therapy: A physical therapist can teach you exercises to help improve movement and strength, and to decrease pain. An occupational therapist can teach you skills to help with your daily activities.
  • Taping: This may be used to support muscles and keep parts of your body in the correct position. Taping should only be done for short times and by experienced healthcare providers.
  • Arch supports and orthotics: These are devices that are put in your shoes to help you stand, walk, or run correctly.
  • Knee sleeves and braces: These help decrease pain by giving your knees extra support.
  • Assistive devices: You may need a splint, cane, crutches, or a walker to help you move and to decrease pain. They help you to remove pressure from the injury and provide extra support.
  • Ultrasound: This sound wave applied to muscles to decrease pain. Topical medicines may be added to help decrease pain and decrease inflammation.
  • Transcutaneous electrical stimulations (TENS): This is a portable, pocket-sized, battery-powered device that attaches to your skin. It uses mild, safe electrical signals to help control pain.
  • Spinal cord stimulation (SCS): An electrode (a metal wire) is placed near your spinal cord during surgery. SCS also uses mild, safe electrical signals to help control pain.
  • Surgery: Surgery may include cutting nerves or repairing joints that are the cause of your pain.

When should I contact my healthcare provider?

  • 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 that is not helped with treatment.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • Blood soaks through your bandage.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You suddenly feel lightheaded and short of breath.
  • You have chest pain when you take a deep breath or cough. You may cough up blood.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers 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.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.