Living with Pain

When discussing pain with clinicians, they may use different types of pain scales, questionnaires, or other verbal or numerical assessments to find out the intensity and severity of the pain. For example, they may ask you to rate the intensity of the pain on a scale between 1 and 10.1 It is helpful to be as honest and specific as possible, and not be concerned about over or under exaggerating your pain experience. For example, a helpful fact can be that the pain started at a level 7 in the morning and decreased to a mild level 3 during the day.2

You may also be asked to choose words that describe the pain, such as “stabbing, sharp, achy,” among others.2 Prior to the initial visit with the clinician, it might be helpful to keep a pain diary and jot down key characteristics about the pain.3 If any treatment is recommended, the diary can also be used to track the treatment’s effectiveness, as well as different things that might affect it (for example, food and drink, sleep).3

When describing pain to a doctor, it can be easy to just focus on how it makes you feel, or the feeling of the pain itself.3,4 It’s equally important to describe changes in your function and daily activities, even if you think they are not relevant.2 Pain is a personal experience, but also causes small and large changes in your daily life.3 For example, specific things you can describe are if you are able to drive well, climb the stairs, dress in the morning, pay your bills on time, or do chores.2 This type of information can indicate the extent to which the pain is affecting your function and well-being and can indicate other underlying issues.2 It is important to set long- and short-term goals with your doctor regarding pain assessment and/or treatment types so you are able to resume work, or bring your pain down a certain manageable level.2

Pain and self-medication

Tell your doctor if you are doing or have done anything to self-medicate your pain. Many people can successfully manage their pain with over-the-counter medications and alternative treatments. However, there are also a number of illicit drugs that are used for pain relief, and self-medicating with these can have dangerous consequences.5 Opioids can be sold as street drugs, but these are not the same as pharmaceutically manufactured opioids.5 These drugs are usually manufactured in other countries and brought in illegally.5 They can often look like prescription opioids, such as pressed pills, while others will be sold as powders, sprays, or other forms.5 They are increasingly sold on the internet, and can cause confusion between which pills are pharmaceutically manufactured and which are illicit.5 Fentanyl, which can be prescribed for pain management by a healthcare professional, is also commonly sold as a street drug.6 However, illicit fentanyl can contain lethal doses and/or can be mixed with other illicit drugs such as heroin, methamphetamine, and cocaine.6

Illegally made opioids like fentanyl contribute to almost 70% of fatal overdoses.7 Unless an opioid is prescribed specifically for you by a licensed medical professional, there is no way of being sure about its legitimacy, and therefore should not be taken.

For self-treating pain, over-the-counter pain remedies can be used, such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen and aspirin.8 Heat packs can be used to relax muscles, and ice packs can help with swelling, which minimizes pain.9 Other therapies, such as acupuncture, acupressure, and massage can also help with managing pain.10 A selective diet (such as gluten-free) can be beneficial for certain types of inflammatory pain, while exercise can work to mitigate other pain conditions.11 Physical therapy and occupational therapy are two effective tools for pain management, and therapists can recommend exercises to improve mobility and strength while also providing pain relief.11 Psychologists, social workers, and other therapists can also provide pain management through cognitive behavior therapy (CBT) and other methods.12

For moderate to severe pain, or chronic pain that’s difficult to resolve, is widespread, or does not respond to any non-pharmacologic therapies, it is best to speak to a healthcare professional who can recommend prescription medications, such as opioids.16

Different types of pain require visits to different healthcare settings. Acute pain is pain that can last a few moments to a few months, and may require emergency medical attention, or just one or two office visits. Examples of this include a severe cut or burn, or sudden abdominal pain from a virus.17

Chronic pain is any pain that lasts 3 to 6 months or longer, and may be due to recovery from surgery or another procedure.18,19 Chronic pain can also be a disease itself, such as fibromyalgia, or secondary pain from another disease.18 Chronic pain requires office visits with a primary care doctor or pain specialist, and follow-up visits may be required to assess effectiveness of treatment and/or to reassess pain levels.18

References

  1. Hawker GA, et al. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63(suppl 11):S240-S252.
  2. US Pain Foundation. How to talk about pain so your doctor will listen. January 8, 2020. https://uspainfoundation.org/blog/how-to-talk-about-pain-so-your-doctor-will-listen/
  3. Kaiser Permanente. Learning About a Pain Diary. July 10, 2023. https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.learning-about-a-pain-diary.abk1346
  4. Jensen MP, et al. The words patients use to describe chronic pain: Implications for measuring pain quality. Pain. 2013;154:2722-2728.
  5. Edinoff AN, Martinez Garza D, Vining SP, et al. New synthetic opioids: Clinical considerations and dangers. Pain Ther. 2023;12:399-421.
  6. US Drug Enforcement Administration (DEA). Facts About Fentanyl. https://www.dea.gov/resources/facts-about-fentanyl
  7. Centers for Disease Control and Prevention (CDC). Fentanyl. May 7, 2024. https://www.cdc.gov/overdose-prevention/about/fentanyl.html
  8. Information from your family doctor. Pain relievers: Understanding your options. Am Fam Physician. 2004;69:1199-1200.
  9. Gotter A. Treating pain with Heat and Cold. Updated May 26, 2023. https://www.healthline.com/health/chronic-pain/treating-pain-with-heat-and-cold
  10. Mayo Clinic. Ferral K. Complementary therapies for chronic pain: Acupuncture, massage and more. March 22, 2024. https://mcpress.mayoclinic.org/healthy-aging/complementary-therapies-for-chronic-pain-acupuncture-massage-and-more/
  11. Harvard Medical School. 8 non-invasive pain relief techniques that really work. July 28, 2017. https://www.health.harvard.edu/pain/8-non-invasive-pain-relief-techniques-that-really-work
  12. Subramanian S. How psychologists can help treat chronic pain. The New York Times. November 9, 2021. https://www.nytimes.com/2021/11/09/well/mind/psychologists-chronic-pain-therapy.html
  13. National Center for Complementary and Integrative Health. Chronic pain: What you need to know. Last updated January 1, 2023. https://www.nccih.nih.gov/health/chronic-pain-what-you-need-to-know
  14. Licciardone JC, Schultz MJ, Amen B. Osteopathic manipulation in the management of chronic pain: Current perspectives. J Pain Res. 2020;13:1839-1847.
  15. Castellano-Tejedor C. Non-pharmacological interventions for the management of chronic health conditions and non-communicable diseases. Int J Environ Res Public Health. 2022;19:8536.
  16. International Association for the Study of Pain (IASP). Opioids for pain management. February 2018. https://www.iasp-pain.org/advocacy/iasp-statements/opioids-for-pain-management/
  17. International Association for the Study of Pain (IASP). Acute pain. https://www.iasp-pain.org/resources/topics/acute-pain/
  18. International Association for the Study of Pain (IASP). Definitions of chronic pain syndromes. https://www.iasp-pain.org/advocacy/definitions-of-chronic-pain-syndromes/
  19. Dydyk AM, Conermann T. Chronic Pain. StatPearls. Last update May 6, 2024. https://www.ncbi.nlm.nih.gov/books/NBK553030/

All URLs accessed August 23, 2024.

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