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Pain Control Clinic

What is Pain?
  • Pain is an unpleasant feeling or experience both physical and emotional. Pain is what hurts. It is a common symptom that sends patient rushing to the doctor’s clinic or emergency room. Whatever the nature, intolerable pain is often perceived by the patient as a sign of serious disease. 
What are the different types of pain? 
  • Pain maybe acute or chronic. Acute pain is severe and lasts a relatively short time. It is usually a signal that body tissue is being injured in some way, and the pain generally disappears when the injury heals. Chronic or persistent pain may range from mild to severe, and it is present to some degree for long periods of time. It may occur several times a day, even when the proper dose of medicine is given for chronic and persistent pain. 
How is pain measured? 

Pain rating scales are used to help the patient communicate the intensity (severity) of pain and to guide the treatment plan. Commonly used scales include: 

 
1.  Numeric rating scale (NRS): The NRS is the most commonly used rating scale. Patients rate their pain on a 0-to-10 scale, with 0 representing “no pain”, 1-3 mild pain, 4-6 moderate pain, 7-10 severe pain. 

 2.   Wong-Baker FACES Pain Rating Scale: This scale can be used with young children (from 3 years and above). It also works well for many older children and adults as well as those who speak a different language. The scale ranges from 0-10, with 6 facial expressions suggesting various pain intensities. Each face is accompanied by a descriptor, such as “No Hurt” for the facial expression (0).

What are the symptoms of pain? 
  • Words are such as achy, sharp, dull, crampy, dull, electrical, burning, throbbing, or stabbing can help your doctor find the right medicine to treat the pain. 
Why is treating pain important? 
  • Pain should be treated early. Pain can affect activity, sleep and energy levels as well as moods. When pain is not treated properly, you feel:
    • Tired
    • Depressed
    • Angry
    • Worried
    • Lonely
    • Stressed
  •  When pain is managed properly, you can:
    • Enjoy being active
    • Sleep better
    • Enjoy family and friends
    • Prevent depression
    • Improve your appetite
    • Enjoy sexual intimacy 
When should I see a doctor? 
  • If the pain is bothersome to you and you believe it to be significant enough, it’s important to go and see a doctor. These include back pain or neck pain, which develops with associated weakness, loss of sensation or falls.
 Why do some people have higher pain thresholds than others? 
  • There are a number of differences that researchers have looked at as far as pain thresholds; differences may be based on your age, race, or gender. 
Why do I hurt, and is pain a good thing? 
  • Pain is useful in a number of different ways, and why our bodies hurt and why pain is important are for a number of reasons. Pain alerts us to the fact that something is not correct with our bodies; it could be a sign of infection such as abscess in the leg that all of a sudden starts to hurt and causes acute pain. 
How is pain treated?  
  • Pain is treated in many different ways. The treatment chosen for you will depend on your condition, cause of pain, medical and psychological condition. The first step in developing a Pain Control plan is to consult a doctor, who will assess your pain, pain history (medicines taken before, pain management practices) to be able to come up with a pain management plan. 
About cancer pain  
  • The pain you feel may be from the cancer itself and the amount of pain you have may depend on the type of cancer, the stage (extent) of the disease, and your pain threshold (tolerance for pain). Most of the pain comes when a tumor presses on bones, nerves, or body organs. It can also be caused by the treatment or procedures for diagnosing cancer. 
  • On the other hand, you may have pain that has nothing to do with your illness or treatment. Like anyone, you can get headaches, muscle strains, and other aches and pains. 
How is cancer pain treated?  
  • Cancer pain is usually treated with medicine (also called analgesics) and with nondrug treatments such as relaxation techniques, imagery, and others. Medicines are safe when they are used properly. You can buy some effective pain relievers without a prescription. These medicines are called nonprescription or over-the-counter pain relievers. For others, a prescription from the doctor is necessary. 
What are the medicines used to relieve pain?  
  • The type of medicine and the method by which the medicine is given depend on the type and cause of pain. Drugs used to treat pain are the non-opiod analgesics and the opioid analgesics. 
    • NON-OPIOID ANALGESICS- included in this category are aspirin, mefenamic acid, paracetamol, ibuprofen, NSAIDS-these drugs act by counteracting inflammatory mediators present in tissue injury.         
    • OPIOID ANALGESICS- (also known as narcotics): These medicines are used alone or with nonopioids to treat moderate to severe pain. Included in this category are morphine sulfate, fentanyl, oxycodone, methadone, codeine, meperidine. You need prescription for these medicines. 
How is pain medicine given?  
  • Patients with constant or severe pain generally benefit from the round-the-clock dosing. Patients may experience breakthrough pain and are given “rescue medications” or as needed because it is often difficult to treat pain when it is severe. 
  • ROUTE OF ADMINISTRATION - oral, intravenous, subcutaneous, skin patch and epidural.        
  • Pump: Patient-controlled analgesia (PCA) - a device used to deliver pain medicine accurately, efficiently, and safely. It can be given continuously, or as needed or both. When you need pain relief, you can receive a preset dose of pain medicine by pressing a button on a computerized pump that is connected to pressing a button on a computerized pump that is connected to a small tube in your body. The medicine is injected into the vein (intravenously), just under the skin (subcutaneously), or into the spinal area. 
What is breakthrough pain?  
  • Pain unfortunately is unpredictable; it can spike and become severe at times, that we have difficulty predicting. When that pain does break through your underlying pain medication, you oftentimes require short-acting medications to help treat the pain while it is so severe. 
What are the side effects of pain medicine?  
  • Many side effects from pain medicine can be prevented. Some mild side effects that do occur such as nausea and vomiting, itchiness, dizziness, and drowsiness will usually go away after a few days as your body adjusts to the medicine.
 Other pain relief methods:
  •  Some people have pain that is not relieved by medicine or nondrug treatment alone. In these cases, other treatments can be used to relieve pain such as radiation therapy, surgery, and nerve blocks. 
Nondrug treatments for pain  
  • Nondrug treatments are now widely used to help manage cancer pain. There are many techniques that are used alone or along with medicine. These methods include relaxation, massage, hot or cold compress, slow rhythmic breathing, active listening to music, imagery, emotional support and counseling. 
What can pain clinic do for my pain?  
  • A Pain Clinic can bring together doctors from various specialties, which can pool their expertise to come up with an individualized, comprehensive care plan to treat your pain. Treatments at a pain clinic can range anywhere from medications to state-of-the art procedures. A multidisciplinary pain center is typically staffed by neurologist, interventionalist, physical medicine and rehabilitation doctors, psychologists, physical therapist.
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