Pain Management
Medical Author: Standiford Helm II, MD
Medical Editor: William C. Shiel, Jr., MD, FACP,
FACR
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Pain...Oh, What a Pain!
Medical Author: William C.
Shiel, Jr., MD, FACP, FACR
 Pain is an unpleasant sensation
in animals that is caused by actual or perceived injury to body
tissues and produces physical and emotional reactions. Presumably,
pain sensation has evolved to protect our bodies from harm by
causing us to perform certain actions and avoid others. Pain might
be called a protector, a predictor, or simply a hassle. In this
article, I will discuss some basic concepts of pain.
We all experience pain to greater or lesser degrees at
various points of our lives. It is said that pain is the most common reason
patients seek medical attention. But, each of us perceives a given pain stimulus in our own unique
manner. The intensity of the response to a pain stimulus is largely subjective,
meaning the severity of the pain can most accurately be defined by the person
with the pain, rather than by other observers.
Our individual pain perception can vary at different
times, even in response to the identical stimulus. For example, an athlete
during competition may not be able to feel the tissue injury of a cut or a
bruise until the competition has finished. We may feel more or less pain
depending on our mood, sleep pattern,
hunger, or activity.
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Introduction to pain management
Pain management can be simple or complex,
depending on the cause of the pain. An example of pain that is typically less complex would
be nerve root irritation
from a herniated disc with pain radiating down the leg. This condition
can often be alleviated with an epidural steroid injection and
physical therapy. Sometimes, however, the pain does not go away. This can
require a wide variety of skills and techniques to treat the pain. These skills
and techniques include:
All of these skills and services are necessary because pain can involve many
aspects of a person's daily life.
How is pain treatment guided?
The treatment of pain is guided by the history of the pain, its intensity,
duration, aggravating and relieving conditions, and structures involved in
causing the pain. In order for a structure to cause pain, it must have a
nerve supply, be susceptible to injury, and stimulation of the structure should
cause pain. The concept behind most interventional procedures for
treating pain is that there is a specific structure in the body with nerves of
sensation that is
generating the pain. Pain management has a role in identifying the precise
source of the problem and isolating the optimal treatment.
Fluoroscopy is an X-ray
guided viewing method. Fluoroscopy is often used to
assist the doctor in precisely locating the injection so that the medication
reaches the appropriate spot and only the appropriate spot.
Next: What are the basic types of pain? »
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- Cortisone Injection - Read about cortisone injection treatment for inflammation, allergic reaction, sciatica and arthritis. Learn about side effects and complications of a cortisone shot.
- Headache - Learn about the different types of headaches, migraine, tension, cluster, menstrual, and spinal headaches; and their causes, symptoms, diagnosis and treatment.
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Pain Management
Neuropathic Pain »
Introduction
Neuropathic pain is a complex, chronic pain state that usually is
accompanied by tissue injury. With neuropathic pain, the nerve fibers
themselves may be damaged, dysfunctional or injured. These damaged nerve fibers
send incorrect signals to other pain centers. The impact of nerve fiber injury
includes a change in nerve function both at the site of injury and areas around
the injury.
One example of neuropathic pain is called phantom limb syndrome. This occurs
when an arm or a leg has been removed because of illness or injury, but the
brain still gets pain messages from the nerves that originally carried impulses
from the missing limb. These nerves now misfire and cause pain.
What causes neuropathic pain?
Neuropathic pain often seems to have no obvious cause; but, some common causes of neuropathic pain include:
- Alcoholism
- Amputation
- Back, leg, and hi...
Read the Neuropathic Pain article »
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