Dealing with Pain

Pain is the body’s way of telling us something is wrong.  It tells us to move away from a hot stove, limit activity after an injury, or see a doctor if the discomfort becomes worse. Pain can become a concern if it continues for a long time and begins to interfere with sleeping, eating, and enjoying life in general.  Pain cannot be measured like weight or blood pressure.  Each person feels pain differently.

Reporting Pain

It is important when you go to the doctor to report on many things about your pain.

  1. Where does it hurt? Is there more than one place? Does the pain move around?
  2. How long have you had pain?  Is it always there?  Does it come and go? How bad is the pain (0=no pain, 10=worst possible pain)
  3. What makes your pain worse? Position, movement or activity or the time of day?
  4. What makes the pain better? If medication, what kind, how much and how often? Does position, rest, heat/cold, friends, television, relaxation, music help?
  5. How does the pain affect your life? Does it affect activity, eating, sleeping, mood?  Do you have side effects from the pain medication you take such as nausea, sleeping, constipation?
  6. How does the pain feel to you? Is it dull, sharp, throbbing, aching, stabbing, burning, gnawing, cramping, tight, squeezing, shooting?

Pain Treatment

There are many ways to treat pain.  If you have mild to moderate pain, acetaminophen (Tylenol®) and/or non steroidal anti-inflammatory drugs (NSAIDS) may bring relief. NSAIDS may upset your stomach so be sure to check with your doctor before taking them. Ibuprofen (Motrin®, Advil®), Naproxen (Naprosyn®, Aleve®) are examples of NSAIDS.  If these medications do not control your pain your doctor may suggest opioids such as Hydrocodone, Codeine, Methadone, Fentanyl, Oxycodone, Hydromorphone (Dilaudid®) or Morphine.  Remember that Percocet, Vicodin and Tylenol #3 all contain acetaminophen so you should not combine them with more acetaminophen (Tylenol®). If your doctor believes that you have nerve pain there are other medications he may prescribe that help sooth the damaged nerves.  These medications have been used for other reasons, but are especially helpful in controlling nerve pain.  These drugs are Amitriptyline (Elavil®), Nortriptyline (Pamelor®, Aventyl®) and Desipramine.

Based on your pain and condition, you and your health-care provider will decide which medication you need, how you should take it, how much you should take and how often.

Other suggestions to manage pain are heat packs, gentle massage, relaxation techniques, distraction, laughter/humor, music, reading, prayer, visitors or just finding a comfortable position.

Pain Medication and Addiction

Patients and families are always concerned when pain medication is prescribed.  Many are worried about addiction.  Simply using an opioid pain medication will not result in addiction.  About 3-18 % of patients using opioids for pain management will develop a problem with drug addiction.  These patients often have had previous addiction problems.  When you use pain medication over a long period of time, you may eventually need a higher dose or a different pain medication to get the same result. This response is called tolerance and has nothing to do with addiction.  Over time a patient may become dependent on the medications.  Dependence means that you will experience “withdrawal symptoms” if you stop taking medications suddenly.  This happens because your body has gotten used to the medications.  Withdrawal symptoms include nausea, diarrhea, sweating, anxiety and irritability.  If you need to stop a medication you should follow a doctor’s advice and slow down gradually.  It is important to remember that withdrawal has nothing to do with addiction.