Pain and pain management – adults - Better Health Channel

Managing pain that cannot be easily relieved SkiptomaincontentPainandpainmanagementHomePainandpainmanagementPainandpainmanagement–adultsActionsforthispageListen Print SummaryReadthefullfactsheetManagementstrategiesforpainincludepainmedicines,physicaltherapiesandcomplementarytherapies(suchasacupunctureandmassage).Studiessuggestthataperson'squalityoflifeisinfluencedbytheiroutlookandbythewaytheycopeemotionallywithpain.Seekadviceonnewcopingstrategiesandskills.Apsychologistcanhelpyoucopewithpain.OnthispageTypesofpainPainmanagementstrategiesCausesofpainHowpainaffectsthebodyManagingpainwithoutmedicinesPainmedicinesHowpainmedicinesworkChoosingtherightpainmedicineManagingyourmedicineseffectivelySideeffectsofpainmedicinesPrecautionswhentakingpainmedicinesManagingpainthatcannotbeeasilyrelievedWheretogethelpPain isaverycommoncondition.Theoccurrenceofpainrisesaspeoplegetolder,andwomenaremorelikelytoexperiencepainthanmen. TypesofpainThereare2maintypesofpain: Acutepain–anormalresponsetoaninjuryormedicalcondition.Itstartssuddenlyandisusuallyshort-lived.Chronicpain–continuesbeyondthetimeexpectedforhealing.Itgenerallylastsforlongerthan3months.Painmaybeanythingfromadullachetoasharpstabandcanrangefrommildtoextreme.Youmayfeelpaininonepartofyourbodyoritmaybewidespread.PainmanagementstrategiesStudiessuggestthataperson’semotionalwellbeing canimpacttheexperienceofpain.Understandingthecauseandlearningeffectivewaystocopewithyourpaincanimproveyourqualityoflife.Keypainmanagementstrategiesinclude:painmedicinesphysicaltherapies(suchasheatorcoldpacks,massage,hydrotherapyandexercise)psychologicaltherapies(suchascognitivebehaviouraltherapy,relaxationtechniquesandmeditation) mindandbodytechniques(suchasacupuncture)communitysupportgroups. CausesofpainThemostcommoncausesofpaininadultsinclude:injurymedicalconditions(suchascancer,arthritis andbackproblems)surgery. HowpainaffectsthebodyPainisacomplexprotectivemechanism.Itisanessentialpartofevolutionthatprotectsthebodyfromdangerandharm. Thebodyhaspainreceptorsthatareattachedto2maintypesofnervesthatdetectdanger.Onenervetyperelaysmessagesquickly,causingasharp,suddenpain.Theotherrelaysmessagesslowly,causingadull,throbbingpain. Someareasofthebodyhavemorepainreceptorsthanothers.Forexample,theskinhaslotsofreceptorssoitiseasytotelltheexactlocationandtypeofpain.Therearefarfewerreceptorsinthegut,soitishardertopinpointthepreciselocationofastomachache.Ifpainreceptorsintheskinareactivatedbytouchingsomethingdangerous(forexamplesomethinghotorsharp),thesenervessendalertstothespinalcordandthentopartofthebraincalledthethalamus. Sometimesthespinalcordsendsanimmediatesignalbacktothemusclestomakethemcontract.Thismovestheaffectedbodypartawayfromthesourceofdangerorharm.Thisisareflexreactionthatpreventsfurtherdamageoccurring.Ithappensbeforeyoufeelpain.Oncethe‘alert!’messagereachesthethalamus,itsortstheinformationthenerveshavesent,takingintoaccountyourpreviousexperience,beliefs,expectations,cultureandsocialnorms.Thisexplainswhypeoplehaveverydifferentresponsestopain.Thethalamusthensendstheinformationontootherpartsofthebrainthatarelinkedtophysicalresponse,thoughtandemotion.Thisiswhenyoumayfeelthesensationofpain,think‘Thathurt!Whatwasit?’,andfeelannoyed.Thethalamusalsocontributestomoodandarousal,whichhelpstoexplainwhyyourinterpretationofpainpartlydependsonyourstateofmind. ManagingpainwithoutmedicinesManynon-medicinetreatmentsareavailabletohelpyoumanageyourpain.Acombinationoftreatmentsandtherapiesisoftenmoreeffectivethanjustone.Somenon-medicineoptionsinclude: Heatorcold–useicepacksimmediatelyafteraninjurytoreduceswelling.Heatpacksarebetterforrelievingchronicmuscleorjointinjuries.Physicaltherapies–suchaswalking,stretching,strengtheningoraerobicexercisesmayhelpreducepain,keepyoumobileandimproveyourmood.Youmayneedtoincreaseyourexerciseveryslowlytoavoidover-doingit.Massage–thisisanotherphysicaltherapy;itisbettersuitedtosofttissueinjuriesandshouldbeavoidedifthepainisinthejoints.Thereissomeevidencethatsuggestsmassagemayhelpmanagepain,butitisnotrecommendedasalong-termtherapy.Relaxationandstressmanagementtechniques–includingmeditationandyoga.Cognitivebehaviourtherapy(CBT)–thisformofpsychologicaltherapycanhelpyoulearntochangehowyouthinkand,inturn,howyoufeelandbehaveaboutpain.Thisisavaluablestrategyforlearningtoself-managechronicpain.Acupuncture–acomponentoftraditionalChinesemedicine.Acupunctureinvolvesinsertingthinneedlesintospecificpointsontheskin.Itaimstorestorebalancewithinthebodyandencourageittohealbyreleasingnaturalpain-relievingcompounds(endorphins).Somepeoplefindthatacupuncturereducestheseverityoftheirpainandenablesthemtomaintainfunction.However,studiesontheeffectivenessofacupunctureinmanagingpainisinconclusive. Transcutaneouselectricalnervestimulation(TENS)therapy–lowvoltageelectricalcurrentspassthroughtheskinviaelectrodes,promptingapain-relievingresponsefromthebody.ThereisnotenoughpublishedevidencetosupporttheuseofTENSforthetreatmentofsomechronicpainconditions.However,somepeoplewithchronicpainthatareunresponsivetoothertreatmentsmayexperienceabenefit. Yourdoctororotherhealthcareprofessionalcanguideyouthroughthebesttreatmentsforyou. PainmedicinesManypeoplewilluseapainmedicine(analgesic)atsometimeintheirlives. Themaintypesofpainmedicinesare: Paracetamol–oftenrecommendedasthefirstmedicinetorelieveshort-termpain.Aspirin–forshort-termreliefoffeverandmild-to-moderatepain(suchasperiodpainorheadache). Non-steroidalanti-inflammatorydrugs(NSAIDs),suchasibuprofen–thesemedicinesrelievepainandreduceinflammation(rednessandswelling).Opioidmedicines,suchascodeine,morphineandoxycodone–thesemedicinesarereservedforsevereorcancerpain.Localanaesthetics(drops,sprays,creamsorinjections)–usedwhennervescanbeeasilyreached. Someantidepressantsandanti-epilepsymedicines–usedforaspecifictypeofpain,callednervepain. HowpainmedicinesworkPainmedicinesworkinvariousways.AspirinandotherNSAIDsarepainmedicinesthathelptoreduceinflammationandfever.Theydothisbystoppingchemicalscalledprostaglandins.Prostaglandinscauseinflammation,swellingandmakenerveendingssensitive,whichcanleadtopain. Prostaglandinsalsohelpprotectthestomachfromstomachacid,whichiswhythesemedicinescancauseirritationandbleedinginsomepeople.Opioidmedicinesworkinadifferentway.Theychangepainmessagesinthebrain,whichiswhythesemedicinescanbeaddictive.ChoosingtherightpainmedicineTherightchoiceofmedicineforyouwilldependon: thelocation,intensity,durationandtypeofpainanyactivitiesthateasethepainormakeitworsetheimpactyourpainhasonyourlifestyle,suchashowitaffectsyourappetiteorqualityofsleepyourothermedicalconditions othermedicinesyoutake.Discussthesewithyourdoctororotherhealthprofessional,sothatyouchoosethesafestandmosteffectivepainreliefoption. ManagingyourmedicineseffectivelyAlwaysfollowinstructionsfortakingyourmedicinessafelyandeffectively.Bydoingso:yourpainismorelikelytobewellmanagedyouarelesslikelytoneedlargerdosesofmedicineyoucanreduceyourriskofsideeffects.Medicinesforchronicpainarebesttakenregularly.Talktoyourdoctororpharmacistifyourmedicinesarenotworkingorarecausingproblems,suchassideeffects.Thesearemorelikelytooccurifyouaretakingpainmedicinesforalongtime.Itisimportanttouseavarietyofstrategiestohelpreducepain.Donotrelyonmedicinesalone.Peoplecanlowerthelevelsofpaintheyfeelby:stayingactivepacingtheirdailyactivitysoastoavoidpainflares(thisinvolvesfindingthebalancebetweenunder-andover-doingit)avoidingpaintriggersusingcopingstrategies.SideeffectsofpainmedicinesSomeofthesideeffectsofcommonpainmedicinesinclude: Paracetamol–sideeffectsarerarewhentakenattherecommendeddoseandforashorttime.Paracetamolcancauseskinrashandliverdamageifusedinlargedosesforalongtime.Aspirin–themostcommonsideeffectsarenausea,vomiting,indigestionandstomachulcer.Somepeoplemayexperiencemoreserioussideeffectssuchasanasthmaattack,tinnitus(ringingintheears),kidneydamageandbleeding.Non-steroidalanti-inflammatorydrugs(NSAIDs)–cancauseheadache,nausea,stomachupset,heartburn,skinrash,tiredness,dizziness,ringingintheearsandraisedbloodpressure.Theycanalsomakeheartfailureorkidneyfailure worse,andincreasetheriskofheartattack,angina,stroke andbleeding.NSAIDsshouldalwaysbeusedcautiouslyandfortheshortesttimepossible. Opioidpainmedicinessuchasmorphine,oxycodoneandcodeine–commonlycausedrowsiness,confusion,falls,nausea,vomitingandconstipation.Theycanalsoreducephysicalcoordinationandbalance.Importantly,thesemedicinescanleadtodependenceandslowdownbreathing,resultinginaccidentalfataloverdose. YoucanfindamorecompletelistofsideeffectsinaConsumerMedicineInformationleaflet.Talktoyourdoctororpharmacistbeforetakinganypainmedicinetoensureitissafeforyou. PrecautionswhentakingpainmedicinesTreatover-the-counterpainmedicineswithcaution,justlikeanyothermedicines.It’salwaysgoodtodiscussanymedicineswithyourdoctororpharmacist.Generalsuggestionsinclude: Don’tself-medicatewithpainmedicinesduringpregnancy –somecanreachthefetusthroughtheplacentaandpotentiallycauseharm.Takecareifyouareelderlyorcaringforanolderperson.Olderpeoplehaveanincreasedriskofsideeffects.Forexample,takingaspirinregularlyforchronicpain(suchasarthritis)cancauseadangerousbleedingstomachulcer.Whenbuyingover-the-counterpainmedicines,speakwithapharmacistaboutanyprescriptionandcomplementarymedicinesyouaretakingsotheycanhelpyouchooseapainmedicinethatissafeforyou. Don’ttakemorethanoneover-the-countermedicineatatimewithoutconsultingyourdoctororpharmacist.Itiseasierthanyouthinktounintentionallytakeanoverdose.Forexample,many‘coldandflu’medicinescontainparacetamol,soitisimportantnottotakeanyotherparacetamol-containingmedicineatthesametime.Seeyourdoctororhealthcareprofessionalforpropertreatmentforsportinjuries.Don’tusepainmedicinesto‘toughitout’. Consultyourdoctororpharmacistbeforeusinganyover-the-countermedicineifyouhaveachronic(ongoing)physicalcondition,suchasheartdisease ordiabetes.ManagingpainthatcannotbeeasilyrelievedSometimespainwillpersistandcannotbeeasilyrelieved.It’snaturaltofeelworried,sadorfearfulwhenyouareinpain.Herearesomesuggestionsforhowtohandlepersistentpain: Focusonimprovingyourday-to-dayfunction,ratherthancompletelystoppingthepain.Acceptthatyourpainmaynotgoawayandthatflare-upsmayoccur.Talkyourselfthroughthesetimes.Findoutasmuchasyoucanaboutyourconditionsothatyoudon'tfretorworryunnecessarilyaboutthepain. Enlistthesupportoffamilyandfriends.Letthemknowwhatsupportyouneed;findwaystostayintouch. Takestepstopreventoreasedepression byanymeansthatworkforyou,includingtalkingtofriendsorprofessionals.Don’tincreaseyourpainmedicineswithouttalkingtoyourdoctororpharmacistfirst.Increasingyourdosemaynothelpyourpainandmightcauseyouharm.Improveyourphysicalfitness,eathealthyfoodsandmakesureyougetalltherestyouneed.Trynottoallowthepaintostopyoulivingyourlifethewayyouwantto.Trygentlyreintroducingactivitiesthatyouusedtoenjoy.Youmayneedtocutbackonsomeactivitiesifpainflare-upsoccur,butincreaseslowlyagainasyoudidbefore.Concentrateonfindingfunandrewardingactivitiesthatdon'tmakeyourpainworse.Seekadviceonnewcopingstrategiesandskillsfromahealthcareprofessionalsuchasapsychologist. WheretogethelpYourGP(doctor)PharmacistNURSE-ON-CALLTel.1300606024–forexperthealthinformationandadvice(24hours,7days)MedicinesLineTel.1300MEDICINE(1300633424)–forinformationonprescription,over-the-counterandcomplementarymedicinesAdverseMedicineEventsLineTel.1300134237PhysiotherapistOccupationaltherapistCounsellorPsychologistOpioidharminAustraliaandcomparisonsbetweenAustraliaandCanada,2018,AustralianInstituteofHealthandWelfare,AustralianGovernment.Pain:whatisgoingon?,NPSMedicineWise.Chronicpain,NPSMedicineWise.Lowbackpain,NPSMedicineWise.Nervepainexplained,NPSMedicineWise.Painandhowyousenseit,myDr.Overviewofpain,2020,MSDmanual–Consumerversion.Painfulfacts,PainAustralia.Localanaesthetic,2017,QueenslandGovernment. Thispagehasbeenproducedinconsultationwithandapproved by: Thispagehasbeenproducedinconsultationwithandapproved by: GivefeedbackaboutthispageWasthispagehelpful?YesNoViewallpainandpainmanagementMoreinformationRelatedinformationAnklesprains Anklesprainisacommonsportsinjuriescausedbyoverstretchingandtearingthesupportingligaments. Ankylosingspondylitis Ankylosingspondylitis(AS)isatypeofinflammatoryarthritisthattargetsthejointsofthespine. Arthritis-juvenile Onechildinevery1,000inAustraliaisdiagnosedwithjuvenilearthritis.Itisoneofthemostcommonchronicconditionstoaffectchildren. Arthritisanddiet Nospecialdietor'miraclefood'cancurearthritis,butsomeconditionsmaybehelpedbyavoidingorincludingcertainfoods. Arthritisandexercise Exercisecanreducesomeofthesymptomsofarthritis,andimprovejointmobilityandstrength. FromotherwebsitesChronicPainAssociationofAustralia.NPSMedicinewise.PainAustralia. Thispagehasbeenproducedinconsultationwithandapproved by: ContentdisclaimerContentonthiswebsiteisprovidedforinformationpurposesonly.Informationaboutatherapy,service,productortreatmentdoesnotinanywayendorseorsupportsuchtherapy,service,productortreatmentandisnotintendedtoreplaceadvicefromyourdoctororotherregisteredhealthprofessional.Theinformationandmaterialscontainedonthiswebsitearenotintendedtoconstituteacomprehensiveguideconcerningallaspectsofthetherapy,productortreatmentdescribedonthewebsite.Allusersareurgedtoalwaysseekadvicefromaregisteredhealthcareprofessionalfordiagnosisandanswerstotheirmedicalquestionsandtoascertainwhethertheparticulartherapy,service,productortreatmentdescribedonthewebsiteissuitableintheircircumstances.TheStateofVictoriaandtheDepartmentofHealth shallnotbearanyliabilityforreliancebyanyuseronthematerialscontainedonthiswebsite. Reviewedon:17-07-2021