Pain Management

Medical Author: Standiford Helm II, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

• Introduction to pain management
• How is pain treatment guided?
• What are the basic types of pain?
  • Nociceptive pain
  • Neuropathic pain
• What are other causes of pain

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. Read more about pain and pain management » Top Searched Pain Management Terms: chronic pain management, acute pain, cancer pain management, pain management techniques, pain control, pain medicine, pain treatment

Introduction to pain management

Pain management can be simple or complex, according to its cause. 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:

• Interventional procedures
• Medication management
• Physical therapy or chiropractic therapy
• Psychological counseling and support
• Acupuncture and other alternative therapies; and
• Referral to other medical specialists

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?

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.

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