Treating Pain

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What Is Pain?

Two Views of Pain Close Window A. The

big picture. When you bang your finger, the signal starts at the very tips of

nerve cells, then travels to and up the spinal cord, and into a part of the

brain called the thalamus. The thalamus sends the signals out to several parts

of the brain, including those that control touch, emotion, physical reaction,

and memory. B. Up close. Pain signals are carried by two types of nerve

fibers, A-delta and C fibers. The A-delta fiber carries the first, sharp pain.

The C fiber conveys the dull, throbbing pain that follows. The signals travel

through the spinal cord through a dense array of nerve cells known as the dorsal

horn. The dorsal horn sends the signals up to the brain’s thalamus, which then

distributes them to many different parts of the brain.

Treating Pain

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In contrast to a couple of centuries ago, when surgical anesthesia consisted

of a shot of whisky and a bullet to bite down on, pain management today is a

highly refined art. Still, most pain specialists would tell you that, more often

than not, successful treatment is the product of a methodical process of trial

and error. And what works for one person may not work for you. For that reason,

it makes sense to become familiar with all the options and experiment until you

find your own personal pain relief strategy. In some instances pain is easy to

identify and treat: Pain from appendicitis is cured by removing the appendix,

for example. A simple headache may respond to an over-the-counter pain reliever.

When pain becomes chronic, however, doctors rely more on a strategy of combining

several therapies in an effort to disrupt the pain process in as many ways as

possible. A wide range of pain treatments are now available, ranging from simple

aspirin to implantable morphine

pumps and from massage to injection therapies.

Different treatments can work together to augment one another’s effects. For

example, physical treatments such as massage may reduce the amount of pain

medication needed by a person with low back pain. Likewise, painkillers may

allow the person to exercise and strengthen muscles that support the spine.

Because weak muscles cause many cases of low back pain, strengthening back

muscles can alleviate backaches. Indeed, physical activity and exercise can help

to alleviate — and prevent — a number of painful conditions, ranging from stress

headaches to arthritis.

When treating pain, doctors generally prefer to start with the therapies that

have the fewest negative consequences. This often includes aspirin or other mild

pain relievers combined with heat, cold, exercise, and other physical therapies.

Depending on your progress and diagnosis, the doctor may suggest different or

stronger medications — including those developed specifically to treat your

condition and others that may surprise you. (Some of the most effective pain

medications now in use were originally developed to treat heart disease, mood

disorders, and seizures.)

If medication strategies do not provide sufficient relief, the doctor may

recommend injection treatments and other specialized procedures (including

surgery) if these interventions seem warranted. These techniques are performed

by specialists with advance training and some have risks — including the

possibility of making the situation worse — that you should consider carefully.

Alternative therapies have grown increasingly popular for pain relief. Many of

these techniques — including meditation, progressive muscle relaxation,

biofeedback, and guided imagery —focus on the mind/body connection and draw upon

the body’s natural pain-fighting mechanisms. Many people find it helpful to

combine such alternative therapies with more traditional pain relief strategies,

for maximum relief.

This report discusses all of these options in more depth and reviews pain

relief strategies for common conditions such as arthritis, back pain, and

headache, as well as serious diseases such as cancer. Your doctor can also

provide you with valuable information about which therapies might be most

helpful for your condition. Try not to become discouraged if the first

treatments recommended don’t work. In most cases, other options exist. Your

doctor will be able to modify your treatment plan based on your feedback. For

this reason, establishing a good dialogue with your doctor is crucial to the

success of your treatment.

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