Pain Management
Basic Information

Pain Management

Table of Contents

Introduction: The Universal Disorder

You know it at once. It may be the fiery sensation of a burn moments after your finger touches the stove. Or it's a dull ache above your brow after a day of stress and tension. Or you may recognize it as a sharp pierce in your back after you lift something heavy.

It is pain. In its most benign form, it warns us that something isn't quite right, that we should take medicine or see a doctor. At its worst, however, pain robs us of our productivity, our well-being, and, for many of us suffering from extended illness, our very lives. Pain is a complex perception that differs enormously among indi...

Fast Facts: Learn! Fast!

What are acute and chronic pain?

  • The International Association for the Study of Pain defines pain as: An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.
  • It is useful to distinguish between two basic types of pain, acute and chronic, and they differ greatly.
  • Acute pain, for the most part, results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly, for example, after trauma or surgery, and may be accompanied by anxiety or emotional distress. The cause of acute pain can usually be diagnosed and treated, and the pain is self-limiting, that is, it is confined to a given period of time and severity. In some rare instances, it can become chronic.
  • Chronic pain is widely believed to represent disease itself. It can be made much worse by environmental and psychological factors. Chronic pain persists over a longer period of time than acute pain and is resistant to most medical treatments. It can, and often does, cause severe problems for patients.
  • Hundreds of pain syndromes or disorders make up the spectrum of pain.

For more information

What causes pain?

  • We may experience pain as a prick, tingle, sting, burn, or ache.
  • Receptors on the skin trigger a series of events, beginning with an electrical impulse that travels from the skin to the spinal cord.
  • The spinal cord acts as a sort of relay center where the pain signal can be blocked, enhanced, or otherwise modified before it is relayed to the brain.
  • The most common destination in the brain for pain signals is the thalamus and from there to the cortex, the headquarters for complex thoughts.
  • Pain is a complicated process that involves an intricate interplay between a number of important chemicals found naturally in the brain and spinal cord. In general, these chemicals, called neurotransmitters, transmit nerve impulses from one cell to another.
  • The body's chemicals act in the transmission of pain messages by stimulating neurotransmitter receptors found on the surface of cells; each receptor has a corresponding neurotransmitter.
  • Another type of receptor that responds to painful stimuli is called a nociceptor. Nociceptors are thin nerve fibers in the skin, muscle, and other body tissues, that, when stimulated, carry pain signals to the spinal cord and brain.
  • The body's natural painkillers may yet prove to be the most promising pain relievers, pointing to one of the most important new avenues in drug development.

For more information

How is pain diagnosed?

  • There is no way to tell how much pain a person has.
  • No test can measure the intensity of pain, no imaging device can show pain, and no instrument can locate pain precisely.
  • Sometimes, as in the case of headaches, physicians find that the best aid to diagnosis is the patient's own description of the type, duration, and location of pain.
  • Defining pain as sharp or dull, constant or intermittent, burning or aching may give the best clues to the cause of pain.
  • These descriptions are part of what is called the pain history, taken by the physician during the preliminary examination of a patient with pain.
  • Physicians, however, do have a number of technologies they use to find the cause of pain. Primarily these include:
    • Electrodiagnostic procedures include electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies.
    • Imaging, especially magnetic resonance imaging or MRI, provides physicians with pictures of the body's structures and tissues.
    • X-rays produce pictures of the body's structures, such as bones and joints.
    • A neurological examination in which the physician tests movement, reflexes, sensation, balance, and coordination.

For more information

How is pain treated?

  • The goal of pain management is to improve function, enabling individuals to work, attend school, or participate in other day-to-day activities.
  • Patients and their physicians have a number of options for the treatment of pain; some are more effective than others.
  • Sometimes, relaxation and the use of imagery as a distraction provide relief. These methods can be powerful and effective, according to those who advocate their use.
  • Whatever the treatment regime, it is important to remember that pain is treatable.
  • Click here for a list of common treatment methods.

For more information

Latest News
Chronic Pain Conditions Cost $32K Per Patient Annually
Why More Painkiller Addicts Are Using Heroin, Too
Brain Chemistry May Change to Cope With Pain
Prescription Naproxen as Good as Narcotic Painkillers for Low Back Pain: Study
Early Physical Therapy Not a Cure-All for Low Back Pain: Study
Prescription Painkiller Abuse Rate Down, But Many Are Addicted: Study
Americans Concerned About Prescription Painkiller Addiction
Medical Marijuana Seems Safe for Chronic Pain Patients, Study Finds
Booster Massage Dose May Be Helpful in Chronic Neck Pain
Spirituality Can Aid Active Coping in Inter-Disciplinary Pain Rehab
Back Pain Patients Seek Pain Relief First, Mobility Second
Low-Dose Aspirin, Other Painkillers May Lower Colon Cancer Risk
Steroid Injections Probably Won't Help Your Lower Back Pain
Acetaminophen Falsely Elevates CGM Glucose Values
25 Million U.S. Adults Struggle With Daily Pain
Classification Details Pain Prevalence Among U.S. Adults
Florida Laws May Help Lower Abuse of Prescription Painkillers
FDA Approves OxyContin for Children As Young As 11
Yeast's New Use: Making Narcotic Painkillers
U.K. Study: Alcohol Use Tied to Less Disability in Chronic Pain
U.S. Medical Groups Join to Fight Prescription Painkiller Abuse
Many Don't Tell Docs About Using Alternative Therapies for Pain
Better Sleep May Mean Less Chronic Pain
Antidepressant, Painkiller Combo May Raise Risk of Brain Bleed
Experts Urge Caution With Popular Painkillers After FDA Warning
FDA Strengthens Heart Attack, Stroke Warning for Popular Painkillers
Painkiller Overdoses Often Involve 'Pharmacy Shopping'
Who's Most Likely to Get Addicted to Their Narcotic Painkiller?
Health Tip: Log Symptoms in a Headache Diary
Many Doctors Underestimate Risks of Prescription Painkillers: Survey
Evidence Supports Medical Pot for Some Conditions, Not Others
Labels on Edible Medical Marijuana Products Often Misleading: Study
Many Migraine Sufferers Given Narcotic Painkillers, Barbiturates
DMARDs May Be Underused for Low Back Pain
Omega-3s May Be Useful Adjunct to Opioids in Pain Therapy
Health Tip: Sleeping With Chronic Pain
More Babies Born to Mothers Addicted to Pain Meds
Medical Pot-Painkiller Combo Isn't Always Recipe for Abuse
It May Soon Be Possible to Easily 'Brew' Narcotics
ERs See Spike in Narcotic Painkiller Abuse Cases
Insomniacs May Be More Sensitive to Pain
New Moms' Codeine Use Down Since Health Warnings
Texting Cuts Patients' Need for Pain Meds During Surgery
ER Doctors Cautious When Prescribing Narcotic Painkillers: Study
'Tamper-Proof' Narcotic Painkiller May Be Curbing Abuse: Study
Could Taking Acetaminophen Dull Your Happiness?
Narcotic Painkillers in Pregnancy Common, Harmful to Baby: Study
Mindfulness Program Beneficial for Chronic Pain
Physical Therapy Equals Surgery for Certain Lower Back Pain, Study Says
One-Quarter of Narcotic Painkillers Misused, Study Shows
Questions and Answers
Book Reviews
Basic InformationMore InformationLatest NewsQuestions and AnswersLinksBook Reviews
Related Topics

Depression: Major Depression & Unipolar Varieties
Medical Disorders
Mental Disorders