Managing and Controlling Pain
Why is Pain Management Important?
Pain interferes with recovery from surgery or trauma, sleep, activity, appetite, concentration, work, and relationships. Pain that is not relieved to a comfortable level may lead a person to sleep less, eat less, walk less, have increased nervousness and irritability and experience depression. Unrelieved pain may lead to decreased interest in activities and you may take a longer time to leave the hospital or return to work after surgery or trauma. Pain management can prevent and break the cycle of pain. Achieving a comfort goal in which a person may feel pain but the pain is not bothersome improves one's quality of life and ability to function.
What Causes Pain?
In most cases, pain is caused by damage to nerves or tissue. Damage may occur from burns, arthritis, tumor, blockage in blood vessels or intestines, pressure, infections, inflammation, diabetes, medication treatments (chemotherapy) or surgery. Nerves then carry a pain signal along nerve fibers with in the spine to the brain. Most pain management measures interfere with these signals to decrease or stop the pain message.
What Interferes with Pain Management?
Many factors interfere with pain management efforts.
- Some people believe that pain cannot be controlled. However, greater than 90% of people experiencing pain can be successfully treated with pain relieving medicines.
- Some people also believe that pain medicine, if taken too early, will network later on when the pain level may be more severe. This is not true. Your doctor can adjust the medication to meet the need for pain relief.
- Others sometimes think that taking pain medication is a sign of weakness. Using pain medicine to relieve pain is not a sign of weakness.
- Sometimes people may believe that if they report pain, they will be thought of as being a bad patient or that they may be bothering health care providers. It is important to tell your health care providers about your pain. Informing your health care team about your pain, its effects, or any unmanageable treatment side effects improves the overall success of your pain management plan.
- Some people are concerned about medication interactions or side effects: constipation, dizziness, nausea, drowsiness or decreased breathing. Side effects can also be managed or treated and therefore should not prevent successful pain management. Constipation is an expected effect. It is very important to be sure to prevent and treat constipation. The other side effects usually decrease over time. As with any medication, always inform your health care team of all medications you take. Avoid the use of alcohol and other over-the-counter medications until you discuss them with your doctor.
- Addiction is a very common fear among people requiring pain medication. Addiction is a RARE occurrence, especially with short-term medication usage. If it occurs, a person can be effectively treated for addiction.
- Sometimes people think that they should not take pain medication until the pain is unbearable. Remember - if pain medication is not taken early enough and in the appropriate amounts, a person usually cannot perform activities as well. Greater levels of pain generally require greater amounts of medicine and more time to reduce the pain. Therefore, it is often better to treat pain when it is moderate, rather than waiting until it is severe.
How Do I Communicate about my Pain?
Do not assume that your doctor or nurse know that you have pain, how much pain you have, or how much pain medication you need to achieve a reduced and acceptable level of pain. Every person is unique.
Most often your health care team needs to know how much pain you have and how it has changed since the last time it was evaluated. A Pain Scale is a way for you to help the health care team understand your pain and how it changes with treatment. Generally, a "0 to 10" scale is used with "0" being no pain and "10" being the worst imaginable. (1-3 = mild pain, 4-6 = moderate pain, 7-9 = severe pain) Remember, this is not about how much pain you tolerate. It is simply about how much pain you have. There are no 'right or wrong' answers. Your numbers only compare to your numbers and how your pain changes to more or less from time to time. Sometimes, other pain scales can be used.
Call your doctor or nurse if your pain gets worse, is unchanged or the medicine is not providing you with an acceptable level of pain relief. Use the pain scale as one measure in reporting pain as well as other helpful information describing the pain: burning, aching, shooting, pounding, on-off, constant, deep, sharp, dull. Also report what worsens or lessens the pain. Information about activities that are limited due to pain is important. Always report any new pain or changes in your usual pain.
Remember that your family is an important part of your well-being. Talk to your doctor or nurse about what to expect at home and encourage your family members to ask questions.
Key Points to Remember About Pain Management
- Pain can be controlled
- Take an active part in your pain management
- Understand how pain occurs as a mind-body connection and its impact on life.
- Learn which of the many pain management methods are most likely to work for you.
- Report pain, effects of pain, effects of pain management, and any successes of failures.
