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Pain Management; Key Q&A.

My sister and I both have back problems. But her back pain knocks her off her feet, and she stays in bed for a few days. Mine isn't quite so bad. Why is that?

Pain is a highly subjective experience. No two people feel pain the same way, whether they are related or not. Your pain threshold might be greater than your sister's. Or your sister's back pain might be more serious than your pain. Either way, both of you are having pain, and both of you should be treating it. Talk to your health care professional about the best ways to relieve your pain.

What are the best pain relievers to use?

The best medicinal pain reliever to use should be determined based on your symptoms. Acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin are all over-the-counter remedies and should be helpful in managing aches and pains. However, make sure you don't take more than the recommended dose in the suggested time period. Too much medication could cause harmful stomach pain or liver or kidney problems, depending on the medication. Lifestyle changes including exercise and a healthier diet might also serve as indirect pain relievers.

I have horrible headaches that sometimes even prevent me from seeing. Aspirin doesn't seem to help. Is there anything I can do?

Yes. You may suffer from migraines. These headaches are especially painful and require specialized treatment. An accurate diagnosis is key to treating migraines. Discuss your symptoms with a health care professional. Before you go for an appointment, take note of possible headache triggers, such as specific smells, noises, foods or emotional stressors, so that you can discuss these triggers with your health care professional. Remember: try to describe your pain and symptoms in as much detail as possible.

My health care professional has told me to exercise to relieve my pain. But I don't like to exercise. Besides, exercising is sometimes painful. What am I supposed to do?

You don't have to run at a break-neck speed, do high-impact aerobics or power lifting to exercise. Exercise comes in many forms--walking, chasing your children around the house and housework are all considered exercise. After all, toting laundry up and down stairs is work. And if your exercise is painful, you're doing the wrong kind of exercise. First of all, don't overdo it. Pick an activity you like to do and try to do it every day, even if it is walking around your block. Try to do it once a day. Build from there. Also, be sure to consult with your health care professional before beginning any new program.

I'm afraid of taking too many pain relievers and getting hooked on them.

Some prescription drugs can lead to addiction and other health problems if they are overused or not used according to a health care professional's instructions. If you suspect you are addicted to a prescription drug, ask yourself the following questions:

Are there times I can't remember what happened because I was taking drugs?

Does my personality change when I take the drug(s)?

Have I ever changed health care professionals to get a prescription filled?

Do I take the drug to get high?

Do I take the drug even when I have not had any pain?

Talk to a health care professional about getting help if you answered "yes" to any of the above questions.

I've been trying to quit smoking for months now. Smoking seems to make my pain worse. Could this be true?

Yes. Smoking makes pain worse. Studies, especially for low back pain, have consistently shown that patients who smoke have a much poorer prognosis, regardless of the treatment offered, than nonsmokers. Also, there is some evidence from pharmacological studies that smoking interferes with the absorption and blood level of various medications, including analgesics. If you can't quit smoking on your own, ask your health care professional for guidance and for information about different approaches to quitting that might be more successful for you.

References

"Types of pain." Merck. August 2007. http://www.merck.com. Accessed January 2007.

"Migraine." Mayo Clinic. June 2007. http://www.mayoclinic.com. Accessed January 2008.

"Treatment (for pain)." Merck August 2007. http://www.merck.com4. Accessed January 2008.

"Fibromyalgia." The Mayo Clinic. June 2007. http://www.mayoclinic.com. Accessed January 2007.

"What's new at the National Pain Foundation." The National Pain Foundation. 2008. http://www.nationalpainfoundation.org/. Accessed January 2008.

"Tylenol indications and dosage." RxList. http://www.rxlist.com. Accessed January 2008.

"New JCAHO Standards for Pain Management:Carpe Diem!" President's message. The American Pain Society. 2000. http://www.ampainsoc.org. Accessed January 2008.

"Acetaminophen." Drugs.com. January 4, 2008. http://www.drugs.com. Accessed January 2008.

"Ibuprofen." Drugs.com. January 8, 2008. http://www.drugs.com. Accessed January 2008.

"OxyContin Abuse and Diversion and Efforts to Address the Problem." U.S. General Accounting Office: Report to Congressional Requestors. December 2003. http://www.fda.gov.

PAINUCope, a multimedia educational program for people living with pain. c 1998 D. J. Wilkie. A new product under development by eNURSING LLC, Seattle, WA, http://www.enursingllc.com. Accessed June 6, 2004.

"Lumbar Spine Pathology and Atherosclerotic Risk Factors: A 52-Year Prospective Study of 1337 Patients." American Academy of Orthopaedic Surgeons 2001 Annual Meeting. Feb 28-Mar. 4, 2001. Poster Session.http://www.aaos.org. Accessed February 2002.

Woodside JR. "Female smokers have increased postoperative narcotic requirements." J Addict Dis 2000; 19(4):1-10. Department of Family Medicine, East Tennessee State University, Johnson City, TN.

MEDLINEplus Health Information: a service of the National Library of Medicine and the U.S. National Institutes of Health. Accessed June 6, 2004. http://www.nlm.nih.gov

International Center for the Control of Pain in Childen and Adults. The University of Iowa College of Nursing. Accessed June 6, 2004.http://adultpain.nursing.uiowa.edu

"FDA Strengthens Warnings for OxyContin." U.S. Food and Drug Administration FDA Talk Paper. July 25, 2001.http://www.fda.go. Accessed June 6, 2004.

Pain Management Standards for 2001. The Joint Commission on Accreditation of Health care Organizations (JCAHO). Accessed June 6, 2004.http://www.jcaho.org.

"Rheumatoid Arthritis." National Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health. Accessed June 6, 2004.http://www.medem.com.

"Acupunture Information and Resources." National Center for Complimentary and Alternative Medicine, National Institutes of Health. http://nccam.nih.gov. Updated March 2002. Accessed June 6, 2004.

"Managing Cancer Pain." Reviewed April 2002. American Pain Foundation. http://www.painfoundation.org. Accessed June 6, 2004.

"Osteoarthritis." The Arthritis Foundation. http://www.arthritis.org. Accessed June 6, 2004.

Lippe, PM. An apologia in defense of pain medicine. Clin J Pain 1998; 14: 189-190.

Ray, A. Pain Perception. Clin Geriatrics March 2001; 10:3, 38-43.

Ray, A and Zbik, A. Cognitive Therapies and Beyond, in Tollison, CD, ed, Practical Pain Management 3rd ed, Lippincott, Williams & Wilkins, 2002; 189-208.

Sifton, David, ed. The PDR Family Guide to Natural Medicines and Healing Therapies (PDR Family Guides). Medical Economics, 1999.

Watkins, CE. "Medical Hypnosis--Uses, Techniques and Contraindications of Hypnotherapy." Northern County Psychiatric Associates. http://www.baltimorepsych.com. Accessed June 6, 2004.

"Lifecycle and Headache." American Council for Headache Education. http://www.achenet.org. Accessed June 6, 2004.

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Publication:NWHRC Health Center - Pain Management
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Date:Sep 12, 2008
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