What a Pain!

by Frederick Jaccarino, MD

Pain is an important part of staying alive, and we all must learn to cope with this unpleasant sensation. Pain is real even if you can’t touch it, weigh it, or objectively measure it. To describe a painful condition we usually compare it to other pains more commonly known and experienced, such as hitting your finger with a hammer or the pain of natural childbirth.

Two moms may have seemingly very similar childbirth experiences; ask one about it and she’ll say “no big deal,” while the second vows “never again!” Neither is wrong about their perception of the pain. Doctors have no test to predict or measure a patient’s level of discomfort, so they rely on the sufferer’s own assessment of how badly it hurts.

As a child painful events are learning experiences. Consider a toddler who touches a hot iron. The painful blister is a far more effective teacher than mom’s repeated warnings. If that same toddler flunks the blister lesson, he will be unlikely to survive to adulthood.

Short term (acute) pain is an alarm; something is awry, and a remedy needed. Doctors tend to be good at relieving acute pain. Ear infections, broken bones, and kidney stones are examples. Remove the stone, set the bone, and the pain will soon be gone. Pains due to infections usually fade when the invading bacteria are killed.

Imagine an ear infection without any pain. You wouldn’t recognize that the bacteria are multiplying and spreading. Minus pain, the infecting bacteria could spread into your skull and brain and eventually overwhelm your body’s defenses. But if pain alerts you to the infection, you will know to fight back, and can call in your ally, the doctor. Acute pains are necessary for the survival of the individual and the success of our species.

The rational response to pain is to identify the cause and to repair the malady. The process can be less uncomfortable if one can use pain relievers while awaiting the cure. Medications for pain relief include anti-inflammatories such as ibuprofen, aspirin, and naproxen. Prednisone and other cortisone relatives are also inflammation fighters. Analgesics such as acetaminophen, narcotics, and anesthetics also treat pain.

Analgesics blunt our perception of pain but do not fix the problem. These medicines may cause serious side effects such as damage to liver, or kidneys, as well as mental dulling and addiction. Nonpharmacologic pain relief by meditation, biofeedback, and other techniques help to divert or deceive the sufferer’s brain so that less pain is felt. Acute pain is not nearly as thorny a problem as is long-lasting, or chronic, pain. Think of the constant pain of joints swollen by arthritis, stiff lower backs, or bones pressured by growing clumps of cancer cells. Painful conditions like these can last for months or years. Soon we will discuss treatment options for chronic pain sufferers. It is estimated that there are 100 million Americans afflicted with chronic pain; surely you know some.

2 thoughts on “What a Pain!

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  2. Pingback: What a Pain! – The Resident — World Pain Foundation

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