Pain Medicine and Management

Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. It may come and go, or it may be constant treatment depends on the cause and type of pain. There are drug treatments, including pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.

Pain relievers are medicines that reduce or relieve headaches, sore muscles, arthritis, or other aches and pains. There are many different pain medicines, and each one has advantages and risks. Some types of pain respond better to certain medicines than others. Each person may also have a slightly different response to a pain reliever.

To a certain extent, medical practitioners have always been specialized. Specialization was common among Roman physicians. The particular system of modern medical specialties evolved gradually during the 19th century. The particular subdivision of the practice of medicine into various specialties varies from country to country and is somewhat arbitrary. Pain management specialists are most commonly found in the following disciplines: Physiatry (also called Physical medicine and rehabilitation), Anesthesiology, Interventional radiology, Physical therapy. Specialists in psychology, psychiatry, behavioral science, and other areas may also play an important role in a comprehensive pain management program.

Headache is our most common form of pain and a major reason cited for days missed at work or school as well as visits to the doctor.  The International Classification of Headache Disorders, published by the International Headache Society, is used to classify more than 150 types of primary and secondary headache disorders. Primary headaches occur independently and are not caused by another medical condition. 

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  Primary headaches


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  Cluster headaches


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  Tension headaches


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  Secondary headaches.

Migraines are severe, recurring, and painful headaches. They can be preceded or accompanied by sensory warning signs and other symptoms. The extreme pain that migraines cause can last for hours or even days. According to the American Migraine Association, they affect 36 million Americans, or approximately 12 percent of the population. Migraines can follow an aura of sensory disturbances followed by a severe headache that often appears on one side of the head. They tend to affect people aged 15 to 55 years.

The various neuropathic pains can be difficult to treat. However, with careful diagnosis and often a combination of methods of treatments, there is an excellent chance of improving the pain and return of function. Medications are a mainstay of treatment of neuropathic pain.

Most pain information is filtered out by the central nervous system, usually at the level of the spinal cord. Many medications to treat neuropathic pain operate on this filtering process. The types of medications used for neuropathic pain include antidepressants, which influence the amount of serotonin or norepinephrine, and anti-seizure medications, which act on various neurotransmitters, such as GABA and glycine. One of the most powerful tools in treating neuropathic pain is the spinal cord stimulator, which delivers tiny amounts of electrical energy directly onto the spine. Stimulation works by interrupting inappropriate pain information being sent up to the brain. It also creates a tingling in the pain extremity, which masks pain.

While acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself, chronic pain is different. Chronic pain persists. Pain signals keep firing in the nervous system for weeks, months, even years. There may have been an initial mishap sprained back, serious infection, or there may be an on-going cause of pain arthritis, cancer, ear infection, but some people suffer chronic pain in the absence of any past injury or evidence of body damage.

A person may have two or more co-existing chronic pain conditions.  Such conditions can include chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, temporomandibular joint dysfunction, vulvodynia. It is not known whether these disorders share a common cause.