pain management - Colorado Pain Care

Pain is such a commonplace experience that almost everyone is familiar with time-honored remedies like icing, rest or aspirin. What is not as well known is why these pain management treatments are effective. Understanding the science behind each treatment option may provide some insights into when a specific remedy should be used.

The Fundamentals of Acute and Chronic Pain

For most people, pain is simply just pain. To medical experts, however, pain is a complex physiological phenomenon. It is much more than an impulse created by a peripheral nerve in response to bodily damage and instantly transmitted to the brain. Pain involves multiple neural paths, gates and brain processing centers including emotions and memory.

There are some stark differences between acute and chronic pain. Acute pain occurs in response to some damage to the body, and this kind of pain usually stops when that damage has been treated. Chronic pain, however, continues on long after it should have stopped.   Chronic pain also has a lasting effect on the brain; it will eventually deteriorate brain mass, allowing regions that facilitate anxiety and fear to predominate.

Although a lot is known about how pain occurs, many pain conditions remain a mystery to scientists.  For example, the condition known as fibromyalgia is still poorly understood despite the fact that millions of people suffer from it. In many cases, pain specialists rely on clinical results rather than scientific understanding to determine the best pain management treatment.

Understanding Some Common Pain Treatments

You may better understand why physicians recommend the following pain management treatments if you know how they affect pain.

  • Icing—almost everyone recognizes that putting ice on an injured area of the body numbs the pain, but you may be unfamiliar with the exact mechanism. Applying cold slows the flow of blood to the area and reduces swelling. Inflammation following an injury is the body’s way of rushing oxygen and other nutrients to the injured tissue to expedite healing, but this pressure also produces additional pain signals. Cold slows not only the inflammation process but also slows neural transmission rates, alleviating some pain symptoms.
  • Heat—the opposite of icing is also beneficial for many pain conditions.  In general, heat promotes blood circulation, allowing more oxygen and nutrients to reach damaged tissue.  It also produces immediate effects like relaxing tense muscles and loosening stiff joints. Another effect of heat that is often overlooked is how it boosts the emotional state which can blunt the potency of pain symptoms.
  • Exercise—most doctors recommend that you remain active, even if you are healing from an injury or suffering from chronic pain. Exercise helps you in a number of ways. First of all, it prevents muscles from atrophying and joints from losing mobility; both of these conditions can produce additional damage to your body later on.  Secondly, increased flexibility and muscle mass helps you maintain your health and lowers the risk of additional injury. Thirdly, physical exertion promotes restful sleep, a critical activity for healing and pain mitigation. Finally, exercise boosts production of endorphins, a natural pain killer that also elevates mood; depression and anxiety, key pain aggravators, are reduced by exercise.
  • Aspirin—aspirin has been a common pain management treatment for centuries and remains one of the most commonly used today. Aspirin is actually an anti-inflammatory which reduces swelling following an injury.  It accomplishes this by preventing cyclooxygenases—inflammation-causing compounds produced after an injury—from operating.   Cyclooxygenases also act on nerve endings to fire off pain signals, and aspirin diminishes this action.
  • Massage therapy—more people are turning to massage therapy as a way to relieve pain. Massage works at a number of levels to neutralize pain. Initially it is an effective way to relax painfully contracted muscles; muscle contraction is a common response to painful stimuli and over time, this can produce additional pain symptoms. Manual manipulation of muscles also produces endorphins, natural pain killers that also elevate mood.   This elevation in mood helps dull pain as well. Finally, relaxing muscles also promotes circulation, allowing damaged tissue to heal more quickly.
  • Nerve blocks—for people with a pinched nerve or other severe pain condition, a nerve block may be the right pain management treatment. This minimally invasive procedure uses an x-ray guided needle to inject an anesthetic or corticosteroid into a nerve bundle to alleviate pain. An anesthetic will, of course, prevent the nerve from firing off pain signals. A steroid injection will lower inflammation in the area, relieving pressure on the nerve.
  • Radiofrequency ablation—during this minimally invasive procedure, the doctor will apply a mild current to a nerve to destroy it. The science behind this procedure is simple; a high frequency electrical current will produce a small area of heat that is enough to “burn” a single nerve or nerve cluster. By destroying the nerve that is misfiring, you essentially eliminate the pain, at least, until a new nerve is regrown.
  • Electrotherapy—electrotherapy operates on a simple concept: pain signals are electrical currents within nerves. If pain is merely electrical transmissions, then other electrical phenomena should disrupt them. That is how TENS, spinal stimulators and topical electrotherapy devices operate.
  • Psychotherapy—it is well understood that psychology plays an important role in making many kinds of pain—especially chronic pain—more intense. Stress, depression and hopelessness act on pain signals and make them feel much more powerful.  That is why psychotherapy is an important aspect of pain management.  If counseling, behavior modification or psychoactive medications can limit emotional problems, then pain symptoms also improve.
  • Dietary changes—it is critically important to maintain a nutritious diet in order to minimize pain symptoms. Not only will a healthy diet help your body operate at peak efficiency, accelerating the healing process, but a well-managed diet will regulate caloric intake. Obesity is a key aggravator of pain symptoms especially for conditions like lower back pain or joint pain.  Some studies have also found that excess body fat can make you more sensitive to pain.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information.

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