UNDERSTAND the problem
In 1931, the French medical missionary Dr. Albert Schweitzer wrote,
“Pain is a more terrible lord of mankind than even death itself.” Today,
pain has become the universal disorder, a serious and costly public
health issue, and a challenge for family, friends, and healthcare
providers who must give support to the individual suffering from the
physical as well as the emotional consequences of pain.
The Two Faces of Pain: Acute and Chronic
What is pain? The International Association for the Study of Pain defines
it 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
(e.g., 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 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. A person may have two or more
co-existing chronic pain conditions. Such conditions can include chronic
fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel
disease, interstitial cystitis, temporomandibular joint dysfunction, and
vulvodynia. It is not known whether these disorders share a common
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. In addition to a patient’s report of
his or her pain, certain tests can give some insight into the cause of
pain. Electrodiagnostic procedures can help physicians tell precisely
which muscles or nerves are affected by weakness or pain. Imaging
(e.g., x-ray, MRI) and neurological examination can provide valuable
information as well.
Patient Education Handout
A service for patients
WHAT are the treatment options
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 regimen, it is important to
remember that pain is treatable. The following treatments are among
the most common.
Acupuncture dates back 2,500 years and involves the application of
needles to precise points on the body. It is part of a general category
of healing called traditional Chinese medicine. Acupuncture remains
controversial but is quite popular and may one day prove to be useful
for a variety of conditions.
Analgesics are a class of drugs that includes most painkillers, such as
aspirin, acetaminophen, and ibuprofen. The word analgesic is derived
from ancient Greek and means to reduce or stop pain. Nonprescription or…