Pain may be thought of as a signal from some part of the body to the brain that there is an “insult” or “injury” to a tissue or body structure. The physiologic mechanisms of pain are fascinating to study, but miserable to experience. Very few people enjoy the experience of pain and most go to extremes to rid themselves of it. However, it can be very challenging – and sometimes impossible – to fully rid the body of pain. In many circumstances, the best that can be expected is to “manage” the pain to a level that allows us to regain some or even all function. Hence the term Pain Management.
Pain is either acute – meaning an immediate response to the insult/injury, or chronic which means the pain has persisted for at least three months.
Acute pain management is usually attempted with short-term pain relievers, also known as analgesics. Most common among them is a class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). Analgesics in this class include such brand names as Advil and Motrin. Other pain relievers in this class include Naproxen and aspirin. Tylenol, which is the brand name for acetaminophen, is a different type of pain reliever, with a different type of effect. All of these are available over-the-counter (OTC) at drug stores and markets. All of these are effective in some people, sometimes; none are effective in everyone, all the time.
Prescription medications may include NSAIDs such as Diclofenac and Toradol. Some prescription drugs are steroidal anti-inflammatories which are usually reserved for chronic pain that cannot be controlled any other way, such as some forms of arthritis.
Opioid drugs, which have been used way too commonly, are narcotics that function by interfering with the brain’s pain centers. These drugs, which include morphine, oxycodone, oxycontin, and brand names such as Percocet, Vicodin, and Norco, may be addictive and interfere with normal cognition. These drugs have been studied in acute pain patients, but not chronic pain patients (because to study them in chronic pain patients would require volunteers with documented severe pain to go for months or years without any pain medications to see the effect – this is how drug studies are conducted. Obviously, no one volunteers for such studies).
Other forms of pain medication include homeopathic remedies, alcohol, and cannabis (marijuana). In Arizona, people suffering from severe and chronic (debilitating) pain may qualify for use of medical marijuana. One of the ingredients in some strains is CBD (cannabidiol), which is a highly effective pain reliever in some people. CBD does NOT cause a “high” and does not impair thinking. However, it is considered to be unlawful by the federal government, and people who use it may not be able to purchase a firearm from a licensed dealer, cannot have a commercial driver’s license, and may be charged with a crime. CBD is also derived from the hemp plant, and is not regulated in this form.
Besides medication, there are many other ways to help manage pain, depending on the source. These may include surgery, physical manipulation by specially-trained physicians, acupuncture performed by trained and licensed professionals, massage, electrostimulation by a TENS unit, Cold LASER, and other procedures.