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  • What is Pain?

    Pain is a sensation triggered by the nervous system, usually as a response to an injury or illness. The pain sensation is unpleasant; it hurts and causes discomfort, and perhaps even agony.

    Pain can be experienced in a variety of ways; from short and sharp, to dull and constant. Pain can serve a purpose - acting as a useful mechanism from which to diagnose health problems. Without pain, illnesses may go undetected, or injuries unnoticed. 

    Words that are commonly used to describe pain’s varying sensations include; stinging, burning, throbbing, shooting and aching.

  • What is Acute Pain?

    Acute pain is usually directly related to soft tissue damage, such as a cut or a strain. It is typically sharp in quality and acts as a warning of disease or injury to the body.
     
    As the injured tissue heals, the associated pain should gradually resolve. Acute pain can occur under a wide range of circumstances including:
     
    • Cuts and bruises
    • Burns
    • Broken bones
    • Surgery
    • Labour and childbirth
     
    Acute pain can be mild and brief, or alternatively, it can be severe and last for weeks. For example, the acute pain experienced from a shallow scratch will be mild and brief compared to the acute pain suffered from a broken bone, which will likely be more severe and long-term. In most cases, acute pain will not last beyond six months.
  • What is Chronic Pain?

    Chronic pain describes the type of pain that persists long after the instigating injury or illness has healed.

    In a lot of cases, chronic pain will have originated from a past trauma or infection. However, some sufferers experience chronic pain in the absence of previous physical injury or illness. Common examples of chronic pain include:

    • Headache
    • Back pain
    • Arthritis pain
    • Cancer pain
    • Neurogenic pain (pain that is caused by nerve damage)
    • Psychogenic pain (pain that isn’t related to previous injury or illness)

    Chronic pain can cause a number of unpleasant physical effects including; tense muscles, lethargy, reduced mobility, and changes in appetite. Also, it can impact on a sufferer’s quality of life, which will likely result in a number of emotional effects too. These can include; depression, anxiety, and anger.

  • What are the most common types of Pain?

    The most commonly suffered types of pain include: 
     
    • Back pain – usually nothing too serious. Most cases of back pain are caused by twisting or bending awkwardly, overstretching, hunching, or lifting heavy objects. Other cases of back pain can be the result of a more serious medical condition, such as arthritis, a slipped disc or sciatica.
    • Primary headaches – this type of headache is usually caused by dysfunction of the pain- sensitive structures in the head. Examples of primary headaches include; migraine, tension headache, and cluster headache.
    • Secondary headaches – these are typically a symptom of another ailment, which stimulates the pain-sensitive nerves in the head. A hangover is a good example of a secondary headache.
    • Muscle pain – can also be referred to as myalgia. This common source of pain will likely be caused by stress, tension or overexertion. Some cases of myalgia can be caused by certain medical conditions, including; fibromyalgia, hypokalemia, thyroid problems, and bacterial or viral infections.
    • Joint pain – this type of pain occurs when the joints in the body become damaged, either through illness or injury. A variety of conditions can cause joint pain, including; osteoarthritis, rheumatoid arthritis, gout and bursitis.
    • Period pain – is caused by contractions in the womb that occur during menstruation. During this point of a woman’s monthly cycle, the uterus contracts in order to encourage the wombs lining to shed. These contractions can compress the blood vessels in the womb, which temporarily cuts off their blood supply. Without blood, the womb can become deprived of oxygen, which triggers a chemical release that is interpreted by the brain as pain.
    • Dental pain – is typically the result of inflammation of the tooth’s inner layer. This layer is referred to as the dental pulp, and it contains sensitive nerves and blood vessels. Tooth decay, receding gums, broken fillings, a cracked tooth, and a periapical abscess can all cause inflammation of the dental pulp. Other oral inflictions that can lead to dental pain include; swollen gums, sinusitis, mouth ulcers, and periodontal abscesses.
  • What are the different forms of Pain?

    Pain can be categorised into different groups. The details of each different class of pain is outlined below:
     
    • Neuropathic pain (neuralgia) – is a type of pain that originates from within the nervous system. Neuropathic pain is usually the result of a problem with the signals being sent from the nerves to the brain. This type of pain can be caused by nerve damage, degeneration, or inflammation. It can also be caused by pressure on the nerve, or a nerve infection.
    • Somatic pain – can sometimes be referred to as musculoskeletal pain. The nerves that trigger somatic pain are called nociceptors. They are found in the skin and deep tissues of the body and are sensitive to temperature, vibrations, and swellings in the skin, joints and muscles. A strained muscle or a cut on the skin are both examples of somatic pain.
    • Visceral pain – this type of pain is felt in the internal organs and the main body cavities. Visceral pain is much harder to localise than somatic pain, with the sensation itself resembling a deep ache or a cramp.
    • Sympathetic pain – like neuropathic pain, sympathetic pain occurs when a nerve becomes damaged or unstable. This results in abnormal signals being sent from the nerve, which the brain then interprets as pain. Sympathetic pain occurs in the sympathetic nervous system.
    • Referred pain – this type of pain is experienced at a different site from the original injury. For example, someone who has undergone shoulder surgery may feel referred pain in the arm.
     
  • What are Analgesics?

    Analgesics are medicines that are designed to relieve the symptoms of pain.
     
    Analgesics can be grouped into three main categories:
     
    • Simple analgesics – such as Paracetamol
    • NSAIDs - which include; Ibuprofen, Aspirin, Naproxen
    • Opioid analgesics – which include Morphine, Pethidine, Oxycodone, Tramadol
  • What is Paracetamol?

    Paracetamol is classed as a simple analgesic. It relieves the symptoms of pain and reduces fever.

    Paracetamol is used to treat many ailments where the pain is mild to moderate. It can effectively relieve the symptoms of; headache, muscle ache, toothache, backache, mild arthritis and cold and fevers. However, paracetamol is ineffective at reducing any underlying swelling and inflammation.

  • What are NSAIDs?

    NSAID stands for Non Steroidal Anti-Inflammatory Drug.
     
    They work by inhibiting the production of prostaglandins, which is a substance produced by the body when it becomes injured. Prostaglandins amplify the pain signals being sent to the brain, as well as causing the affected tissue to swell. By inhibiting their production, NSAIDs will relieve the swelling and dull the associated pain.
     
    Some NSAIDs can be bought over-the-counter, whilst others are only available on prescription. They are an effective treatment for mild to moderate pain and can be used to combat; muscle aches, strains & sprains, headaches, fever and joint inflammation. Examples of NSAIDs include:
     
    • Ibuprofen
    • Aspirin
    • Naproxen
    • Diclofenac
    • Ketoprofen
    • Celecoxib
    • Piroxicam
    • Sulindac
  • Can everybody take NSAIDs?

    NSAIDs aren’t always suitable for everyone. It is advised to speak to your doctor or pharmacist before taking NSAIDs should any of the following apply:
     
    • You are pregnant or trying to conceive
    • You are breastfeeding
    • You have asthma
    • You are over 65 years old
    • You are buying for a child under the age of 16 years
    • You have had an allergic reaction to NSAIDs in the past
    • You suffer from a stomach ulcer
       
    • You are taking other medication, which could potentially interact
       
    • You suffer any problems with your heart, blood pressure, liver, kidneys or bowels
    In these cases, it may not always be necessary to avoid NSAIDs, however, they should only be taken on the advice from a qualified healthcare professional.
     
  • What is Codeine?

    Codeine is a mild opioid analgesic. It isn’t very effective when used on its own. Codeine works much better when combined with another painkiller in a single pill, such as paracetamol.
     
    Codeine can be bought over-the-counter in this combined fashion. For example, Co-Codamol 8/500MG contains 8MG of codeine and 500MG of paracetamol. Other over-the-counter preparations that contain codeine include:
     
    • Solpadeine Plus
    • Solpadeine Max
    • Migraleve
    • Syndol
    • Nurofen Plus
     
    Codeine can cause dependency and should therefore only be taken with due care and attention. Codeine products should only ever be used in the short-term, and only at the lowest effective dose for the shortest required time. If you are finding the recommended dose ineffective, you should contact your doctor or other healthcare professional for advice.
  • What is Morphine?

    Morphine is a strong opioid analgesic, which is the strongest group of painkillers available.
     
    Morphine is only available on prescription and is used to treat severe pain, such as broken bones or cancer pain. If prescribed Morphine, your dose and responses will be closely monitored, to ensure you are taking the lowest effective dose that produces the least amount of side-effects. The main side effects associated with morphine include:
     
    • Nausea
    • Drowsiness
    • Dizziness
    • Constipation
    • Dependency
    Other strong opioid analgesics, which are similar to morphine include: Oxycodone, Fentanyl and Buprenorphine. These medicines are only available on prescription.
  • Why have I been prescribed antidepressants for Pain relief?

    Certain medicines that are used to treat depression can also be effective at treating certain types of pain. Specifically, pain caused by damaged or sensitive nerves, such as shingles or sciatica. You don’t have to be depressed for these treatments to work. An example of an antidepressant commonly used for pain relief is Amitriptyline.

    Other medicines can share a similar dual purpose, in the same way antidepressants do. For example, Gabapentin is an antiepileptic medicine, which is also an effective treatment for pain relief.

    Both antidepressants and antiepileptic treatments are only available with a valid prescription from your doctor.

  • When should I see a Doctor about my Pain?

    It is advised to go and speak to your doctor should your pain last longer than is reasonably expected.
     
    This time frame will vary depending on the type of illness or injury that initially caused the pain. If you are suffering from any form of unexplained pain, where the cause is unknown, then it is recommended you speak to your doctor.
  • What is the best Painkiller for me?

    Your choice of pain relief will depend on the type of pain you have. If the pain is mild to moderate with associated inflammation, for example; mild back pain or headaches, then Paracetamol or NSAIDs will be a suitable choice. If however, the pain is being caused by damaged or sensitive nerves, then Amitriptyline or Gabapentin would be a better choice.

    If the pain is severe and isn’t effectively being managed by over-the-counter medicines, then stronger doses or alternative options, such as opioid analgesics, are available with a valid prescription from your doctor.

  • Can I take Paracetamol and Ibuprofen together?

    It is safe to take paracetamol and ibuprofen together if required. The doses can either be taken simultaneously or spaced apart, depending on the level of distress.
     
    It is recommended to take Ibuprofen with, or just after food. Children under sixteen should not take paracetamol and ibuprofen at the same time. However, the doses can be staggered should it be necessary.
  • Can I use Pain relief medication if I am pregnant?

    If you’re pregnant, Paracetamol is generally safe to take. It has been routinely used during all stages of pregnancy. As with most medicines, it is advised to take the lowest effective dose for the shortest
    possible time.
     
    Alternative pain relief may be possible should paracetamol prove ineffective. However, in these cases, it is recommended to speak to your doctor, midwife, or pharmacist prior to choosing an alternative, as certain treatments can carry potential risks to the unborn baby. Where possible, it is best to try and avoid taking any medicine whilst pregnant, especially during the first three months. Minor ailments, such as colds and aches often don’t require medicinal intervention
    .
  • I can't swallow tablets, are there any alternative forms of treatment?

    Pain relief medication is available in a multitude of forms. If you struggle to swallow tablets then there are several alternatives to choose from, including:
     
    • Capsules
    • Caplets
    • Soluble tablets
    • Buccal tablets (dissolves on the tongue)
    • Liquids/suspensions
    • Powder sachets
    • Topical gels
    • Suppositories
    • Patches
  • What else besides medication might help me?

    Whether it’s because medicinal treatments are ineffective or simply too expensive, there are a number of people who look to alternative treatments to help manage their pain.
     
    Transcutaneous Electrical Nerve Stimulation (TENS)– this pain-relieving method uses mild electrical currents, delivered to the site of the pain through small adhesive electrodes. This electrical stimulation is designed to interrupt the pain signals being sent to the brain, whilst relaxing the surrounding muscles. It is generally accepted that TENS treatment requires more conclusive research to determine whether it is a reliable method of pain relief.
     
    There is also a range of complementary and alternative medicines that some people may find useful, most of which are available without a prescription. It is important to note that alternative and complementary medicines are not currently considered a conventional practice, which means there isn’t always conclusive evidence to support its effectiveness. Alternative and complementary treatments include:
     
    • Acupuncture
    • Aromatherapy
    • Biofeedback
    • Hypnotherapy
    • Massage
    • Homeopathy
    • Relaxation therapy
    • Tai Chi
    • Chiropractic
     
    It is always recommended to speak to a healthcare professional before starting any alternative pain management regime.
  • Are there any ways I can prevent Pain?

    Sadly, both acute and chronic pain can’t always be prevented. The obvious advice would be to try and avoid dangerous situations where the risk of injury or illness is high. Also, staying in good physical and mental health will reduce the odds of suffering a potentially painful illness or injury.

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