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Pain in the neck. Royal pain. Pain and suffering…Pain rarely refers to anything good! Yet, pain is one of the most common human experiences. In fact, about 100 million Americans struggle with chronic pain.
Pain is the body's way of sending a warning to the brain that something is wrong. It's a necessary evil, and it helps keep us safe from harm. Think of what would happen if you didn't feel pain when you touched a hot stove, for example, or a sharp knife. You feel pain when pain signals travel from the nerves along the spinal cord to the brain. Once they get to the brain, these pain signals combine with thoughts, feelings and expectations to shape the way we think and respond to that pain.
Pain can be "acute" or "chronic."
When an injury has healed, but the brain is still responding to signals of pain, pain becomes a medical condition.
Studies show that women are more likely to seek treatment for pain. This is probably because women experience pain more than men. and they also are more likely to speak with their healthcare providers about pain. It isn't always easy to talk about pain. Some people think talking about pain is a sign of weakness.
Some of the most common causes of chronic pain are back pain, leg/foot pain, arm/hand pain, headache, and pain caused by diseases. Most patients who report chronic pain say they have more than one type of pain.
Pain cannot be measured objectively; only the person with the pain can say how much pain she is feeling. A healthcare provider will try to assess the pain by asking the patient where she feels the pain, how long she has felt the pain, if the pain is constant, and how she would rate the pain on a scale of 0 to 10. A patient will also be asked to describe the pain, whether it's sharp or dull, throbbing or shooting, hot or cold.
Tests to diagnose pain may include:
Some patients may have emotional conflicts that make it hard for them to cope with physical pain. If a person has trouble at work, in their marriage, or with other family issues, she may not be able to handle the physical pain the same as someone without other stress in her life.
Finding treatment that works can take time and effort. Often, pain can be managed or treated through a mix of tactics, such as medicine, alternative therapies and lifestyle changes. For some, surgery may be an option. Pain treatment and management are personal, since what works for one person may not work for someone else.
Medicines
There are many types of pain medications, both over-the-counter (OTC) and prescription, to help you manage pain.
Analgesics (pain relievers):
Antidepressants
Antidepressants can help treat pain by changing the levels of neurotransmitters (brain chemicals) and altering the pain messages reaching the brain. When a woman is depressed and also in pain, these medications can both reduce pain and improve mood. The tricyclic antidepressants, such as desipramine (Norpramin) and imipramine (Tofranil), help to restore the body's normal perception of pain and may be a helpful treatment option even when a patient is not depressed. Drugs that stimulate the feel-good brain chemicals serotonin and norepinephrine, such as duloxetine (Cymbalta) and venlafaxine (Effexor XR), can improve both mood and pain.
Anxiolytics
Anxiolytics are used to prevent and treat anxiety. A type of anxiolytic often prescribed is called benzodiazepines; common names for these medicines are Valium, Xanax, Lithium, Ativan, and Klonopin. Some people benefit from anxiolytics for muscle spasms. Women are at increased likelihood for being prescribed Valium or another benzodiazepine with opioids; this combination increases the potential for overdose.
Anti-seizure Medications
Anti-seizure medicines work by causing changes in signals in the brain. They work best for pain caused by nerve damage, such as pain from diabetes, shingles, herniated disk, fibromyalgia, cancer treatment, and other types of nerve pain. Older anti-seizure or anticonvulsant drugs have more side effects than newer drugs. Medicines like gabapentin (Gralise, Neurontin) and pregabalin (Lyrica) can relieve pain caused by damaged nerves.
Muscle Relaxants
Muscle relaxants work through your brain and spinal cord to help relieve pain and decrease muscle spasms.
Combination Drugs
Some medications used for pain combine acetaminophen and an opioid, such as Vicodin (acetaminophen and hydrocodone), Ultracet (acetaminophen and tramadol) or Percocet (oxycodone and acetaminophen). Others may combine acetaminophen with a relaxant (for example, Fioricet, which is a combination of acetaminophen, butalbital and caffeine).
Therapeutic Injections
A number of injections may be used to relieve pain.
Topical Relief
In addition to cold and heat therapy (ice packs and heating pads), there are many pain-relief products that can be applied to the surface of the skin. Some are prescription, while others can be purchased OTC. These products include capsaicin, lidocaine and diclofenac.
Physical and Occupational Therapy
Physical therapy (PT) can help a person increase their activity level by improving strength, flexibility, and endurance. The focus of occupational therapy (OT) is to help a person return to activities needed for daily life, such as those for work, school, self-care, housework, and sleep. Ultrasound, cold laser therapy, and spinal cord stimulators are all tools that may be used during PT and OT.
Psychotherapy
Psychotherapy can offer pain relief by altering how your brain processes pain messages and sensations. Different types of therapy can help a person see and experience their pain in a new way. By changing your thoughts, behaviors and understanding of the pain, you may be able to process the pain differently. Interventions that have shown promise for pain relief include:
Alternative Therapies
Types of alternative or holistic pain management include:
These approaches may be used as alternatives to medications or in conjunction with them.
Lifestyle approaches
Lifestyle changes may be useful in helping to relieve pain, as well as prevent pain.
When to Consider Using a Pain Clinic
You might consider visiting a pain clinic if your pain does not go away after medical treatment.
Pain clinics specialize in the prevention, evaluation, diagnosis and treatment of painful disorders. Treatment may include medication, physical and rehabilitative services, massage and meditation, and counseling for patients and their families.
Just as doctors and nurses differ by specialty, so do pain clinics. Some offer residential programs, where you stay at the facility. Others have outpatient programs.
To treat your pain symptoms, choose a pain center that:
You can find a list of pain specialists who are Diplomates of the American Board of Pain Medicine on the American Board of Pain Medicine web site: abpm.org.
Here are some questions to ask yourself before going to your healthcare provider.
Review the following Questions to Ask so you are ready to talk to your healthcare professional.
No two people feel pain the same way, whether they are related or not. You may be able to handle more pain than your sister. 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 healthcare professional about the best ways to relieve your pain.
The best pain reliever to use should be based on your symptoms. Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin are all over-the-counter drugs that can help manage aches and pains. Lifestyle changes, such as exercise and a healthy diet, may also help relieve pain. Try starting with lifestyle changes that can be done at home and have no or less side effects before moving into medications and therapies that may have more risk.
Yes. You may suffer from migraines. These headaches are especially painful and require specialized treatment. Diagnosis is key to treating migraines. Discuss your symptoms with a health care professional. Before you go for an exam, take note of headache triggers, such as smells, sounds, foods or stressors, so that you can discuss these triggers with your health care professional. Also make note of how often you have headaches and what time of day they occur. Remember: try to describe your pain and symptoms in as much detail as you can.
You don't have to run, do high-impact aerobics or power lift to exercise. Exercise comes in many forms—walking, chasing your children around the house and housework are all types of exercise. After all, toting laundry up and down stairs is work. If your exercise is painful, you're doing the wrong kind of activity. First of all, don't overdo it. It isn't helpful to overdo it one day and then take three days to recover. Do a little bit every day and pay attention to your body – increase how long you exercise or how strenuous the activity is in a thoughtful way. Pick something you like to do and try to do it every day, even if it is walking around your block. Build from there. Be sure to speak with your health care professional before starting any new program.
Some prescription drugs can lead to misuse, overuse and other health problems if you do not follow your health care professional's instructions. If you think you are addicted to a prescription drug, ask yourself these questions:
Talk to a health care professional about getting help if you answered "yes" to any of the above questions.
Yes, smoking makes pain worse. Studies, especially for low back pain, have shown that patients who smoke have a harder time than patients who don't smoke finding relief from pain, no matter which treatment they used. Also, some studies show that smoking may block the absorption of some medications, including analgesics. If you can't quit smoking on your own, ask your health care professional for help and for information about different approaches to quitting that might work for you.
For information and support on Pain Management, please see the recommended organizations, books and Spanish-language resources listed below.
American Academy of Orthopaedic Surgeons (AAOS)
Website: https://www.aaos.org
Address: 6300 North River Road
Rosemont, IL 60018
Phone: 847-823-7186
American Chronic Pain Association
Website: https://www.theacpa.org
Address: P.O. Box 850
Rocklin, CA 95677
Hotline: 1-800-533-3231
Email: acpa@pacbell.net
American Council for Headache Education
Website: https://www.achenet.org
Address: 19 Mantua Rd.
Mt. Royal, NJ 08061
Phone: 1-800-255-2243
Email: acheq@talley.com
American Occupational Therapy Association
Website: https://www.aota.org
Address: 4720 Montgomery Lane
P.O. Box 31220
Bethesda, MD 20824
Hotline: 1-800-377-8555
Phone: 301-652-2682
American Pain Society
Website: https://www.ampainsoc.org
Address: 4700 West Lake Ave.
Glenview, IL 60025
Phone: 847-375-4715
Email: info@ampainsoc.org
American Physical Therapy Association (APTA)
Website: https://www.apta.org
Address: 1111 N. Fairfax Street
Alexandria, VA 22314
Hotline: 1-800-999-APTA (1-800-999-2782)
Phone: 703-684-APTA (703-684-2782)
Association for Behavioral and Cognitive Therapies (ABCT)
Website: https://www.aabt.org
Address: 305 7th Avenue, 16th Floor
New York, NY 10001
Phone: 212-647-1890
Bone and Joint Decade
Website: https://www.usbjd.org/index.cfm
Address: 6300 North River Road
Rosemont, IL 60018
Phone: 847-384-4010
Email: usbjd@usbjd.org
National Headache Foundation
Website: https://www.headaches.org
Address: 820 N. Orleans, Suite 217
Chicago, IL 60610
Hotline: 1-888-NHF-5552 (1-888-643-5552)
Email: info@headaches.org
National Institute of Neurological Disorders and Stroke
Website: https://www.ninds.nih.gov
Address: NIH Neurological Institute
P.O. Box 5801
Bethesda, MD 20824
Hotline: 1-800-352-9424
Phone: 301-496-5751
PainPathways Magazine
Website: https://www.painpathways.org
Address: 145 Kimel Park Drive, Ste 350
Winston-Salem, NC 27103
Phone: 336-765-6181, ext 124
Spondylitis Association of America
Website: https://www.spondylitis.org
Address: P.O. Box 5872
Sherman Oaks, CA 91413
Hotline: 1-800-777-8189
Phone: 818-981-1616
Email: info@spondylitis.org
Texas Back Institute
Website: https://www.texasback.com
Address: 3600 W. 7th Street
Fort Worth, TX 76107
Hotline: 1-800-247-BACK (1-800-247-2225)
Trigeminal Neuralgia Association
Website: https://www.fpa-support.org
Address: 925 Northwest 56th Terrace, Suite C
Gainesville, FL 32605
Hotline: 1-800-923-3608
Phone: 352-331-7009
Email: patientinfo@tna-support.org
Books
Acupuncture: Everything You Ever Wanted to Know, but Were Afraid to Ask
by Gary F. Fleischman and Charles Stein
Basics of Acupuncture
by Gabriel Stux, Brian Berman, Bruce Pomeranz, and P. Kofen
A Life Larger Than Pain
by Erv Hinds
Back Pain Helpbook
by James Moore, RN Kate Lorig, Michael Von Korff, M.P.H. Virginia Gonzalez and Diana Laurent
The Back Pain Sourcebook
by Stephanie Levin-Gervasi and James F., M.D. Zucherman
Break Through Pain: A Step-by-Step Mindfulness Meditation Program for Transforming Chronic and Acute Pain
by Shinzen Young
Mayo Clinic on Chronic Pain
by David Swanson
Pain Cure: The Proven Medical Program that Helps End Your Chronic Pain
by Dharma Singh Khalsa and Cameron Stauth
Pain Free: A Revolutionary Method for Stopping Chronic Pain
by Pete Egoscue and Roger Gittines
The RealAge Makeover: Take Years Off Your Looks and Add Them to Your Life
by Michael F. Roizen
Women and Pain: Why It Hurts and What You Can Do
by Mark Young
Yoga for Pain Relief: Simple Practices to Calm Your Mind & Heal Your Chronic Pain
by Kelly McGonigal and Timothy McCall
Spanish-language resources
Medline Plus: Pain Relievers
Website: https://www.nlm.nih.gov/medlineplus/spanish/painrelievers.html
Address: Customer Service
8600 Rockville Pike
Bethesda, MD 20894
Email: custserv@nlm.nih.gov
HealthyWomen content is for informational purposes only. Please consult your healthcare provider for medical advice, diagnosis or treatment.