1. Introduction
2. Question to Ask Yourself
3. Questions to Ask Your Doctor
4. Further Information

 

Introduction

If you live with pain, you are not alone.

Maybe you suffer from acute pain caused by an injury, illness, or recent surgery. Acute pain generally lasts less than six months, and usually disappears when the underlying cause has been treated or has healed.

Or maybe you suffer from chronic pain. At least 34 million Americans suffer from chronic pain caused by arthritis, low back problems, neuralgia, or migraine headache. Some 15 million working Americans have pain on - a chronic basis. Chronic pain lasts for six months or more - and could last forever.

No matter what type of pain you suffer, it's important for you to learn the most effective way to relieve or manage it.

Pain is a complex condition that can affect you in several ways. Besides making your body hurt, pain can "hurt" your overall health and emotional well-being. It can make you feel isolated, anxious, or depressed. Pain can also stop you from doing things you enjoy, affect your ability to work, and keep you from sleeping well or eating right. Pain can even interfere with your relationships with family and friends.

It's important to understand that pain is a medical condition that can - and should be treated. In this way, pain is similar to other medical problems, like infections, high blood pressure, or diabetes. You should expect to be treated for pain much as you expect treatment for these other types of medical conditions.

But unlike other medical conditions, the doctor can't see or detect your pain. This is why it's up to you to tell your doctor you're in pain and to describe your pain as clearly and specifically as possible. And, ultimately, it's up to you to ask for medical help.

Relieving the physical sensation of pain with medication is an important step in managing pain. Several types of pain medications are available that relieve both acute and chronic pain. But medications work differently for different people. Some may not give you the pain relief you need. Some may treat your underlying condition, not your pain. Others have serious side effects you should know about before you agree to take them.

It's also important to understand that medication is only one type of medical treatment for pain and only one aspect of successful pain management. In fact, studies increasingly show that pain management is most effective when it is based on a multidisciplinary approach that addresses the emotional and behavioral consequences of pain, as well as the physical discomfort.

The more you tell your doctor about your pain and how it affects your life, the more he or she will-be able to help you. And the more you learn about pain management, the more control you will have over your pain.

One of the best ways to learn is to ask questions. In the following pages, you'll find important questions you should ask about pain and pain treatment.

The first group of questions is for you. Taking the time to answer these questions before you see your doctor will help you describe your pain effectively when you're in the doctor's office. Better understanding of your pain will help your doctor find the best way to manage it. The second group, of questions is for your doctor. The answers to these questions will help you understand the treatment approach your doctor recommends - and how to get the most out of your therapy.

Keep in mind that pain management is a partnership between you, your doctor, and other professionals who may be involved. But ultimately, it's up to you to take control of your pain management. The best way to take control is to follow your doctor's orders, whether it's taking medicine as prescribed, making changes in your lifestyle, doing a daily exercise routine - or any other directions you're given. Otherwise, therapy may not be successful.

Questions to Ask Yourself

Since your doctor can't see or detect your pain, it's your responsibility to make sure he or she has a clear understanding of how you feel. Be assertive. Tell your doctor as much as you can - even if he or she doesn't ask.

Where is your pain?
Describe all painful areas.

How bad is your pain?
Give the doctor specific information about the pain you feel. Use descriptive words, like throb, ache, burn, or tingle. Is your pain mild, moderate, or severe? Are you constantly in pain, or does it come and go? Does it vary in intensity? What, if anything, triggers your pain (for example, moving a particular way, doing certain tasks, changes in the weather, stressful situations, etc.)? Is your pain bearable, or is it excruciating? Is it excruciating all of the time?

What do you think causes your pain?
Give the doctor as much information as you can about what might have caused your pain. Did you injure yourself? Did your pain begin when you had an illness? Do you have a job or hobby that causes muscle strain or nerve injury through repetitive motion, such as word processing, practicing the piano, or 4 playing tennis?

How long have you been in pain?
Knowing whether you suffer from acute or chronic pain will help your doctor determine the best course of treatment.

How do you relieve your pain?
Describe ways you've learned to make your pain feel better, such as using heat, moving your body a certain way, or taking nonprescription drugs like aspirin, acetaminophen, or ibuprofen.

What pain medications have you taken in the past?
Describe any past experiences with pain medications and how well they worked. Also make sure to mention any side effects you experienced, particularly stomach upset, heartburn, or gastrointestinal distress. The common type of prescription pain medications called non-steroidal anti-inflammatories, or NSAIDs (e.g., ibuprofen, naproxen and nabumetone), can irritate the lining of the stomach and intestines, leading to ulcers, gastrointestinal bleeding, or serious emergency complications in a significant number of people who take them. Some prescription pain medications can cause constipation, nausea, dizziness, headache, drowsiness and vomiting.

Besides pain, what other medical conditions do you have?
Do you take drugs for these conditions? Make sure the doctor is aware of all conditions you have, such as ulcers, high blood pressure, diabetes, kidney problems, or depression. Also make sure the doctor is aware of all medications you take, including those that you buy without a prescription. Some pain medications are dangerous if they are taken with other types of drugs. Others can contribute to conditions like stomach distress or kidney problems.

Do you have any allergies?
Some pain medications can cause allergic reactions. Make sure your doctor knows about any allergies or drug reactions you've experienced.

Do you have any fears or concerns about pain medications?
Many people are reluctant to take pain medications because of concerns about side effects. Others are worried they'll become "hooked" or addicted. Discuss your concerns with your doctor.

Has your pain forced you to make changes in your lifestyle?
Let your doctor know how your pain has affected your emotions and behavior. Has it affected your ability to work or perform routine tasks? Has it made you feel angry or sad? Has it affected your personal relationships?

Questions to Ask Your Doctor

The more you understand about the pain therapy your doctor recommends, the more you will benefit from treatment. Don't hesitate to ask any questions you may have. Remember, your doctor wants to help you.

How well do you understand the pain I feel?
Discuss the answers to the questions you asked yourself with your doctor. The more your doctor understands about your pain, the better he or she will be able to treat you.

Do I need to see a specialist for my pain?
Certain types of pain require the attention of a medical specialist, such as a neurologist, physiatrist or orthopedic surgeon. There are also doctors who specialize in treating pain, and pain clinics that offer comprehensive pain management programs. Finding the right doctor and the right pain management program is critical to the success of your treatment.

Will pain medicine help me?
Several types of pain medications are available to relieve pain, including NSAIDs, tramadol and other centrally acting analgesics. Not all pain medications work effectively in all people. Tell your doctor immediately if you're not getting adequate relief from prescribed medication. Also tell your doctor if the side effects of your therapy are bothersome - or unacceptable. Work with your doctor to find the therapy that's best for you. This may mean adjusting the dose, or switching to a different type of pain medicine. Keep in mind that medication is only one aspect of effective pain management. Ask your doctor if nondrug treatments such as physical therapy, exercise, or relaxation techniques would be helpful in your case.

Do pain medications cause side effects?
Most pain medications cause side effects, some more serious than others. The commonly prescribed NSAID pain relievers irritate the lining in the stomach and intestines, which can cause ulcers or gastrointestinal bleeding. The other types of commonly prescribed pain drugs have different kinds of side effects, including constipation, drowsiness, nausea, vomiting, or dizziness. Sometimes side effects occur when you begin therapy and go away after your body gets used to the medication. Certain types of pain medicine can also cause physical dependence.

Do pain medications cause seizures?
Although uncommon, there is a risk of seizure associated with some centrally acting analgesics. It is important to tell your health care professional if you previously have had a seizure and if you are taking opioid analgesics or medications commonly used to treat depression (e.g., amitriptyline, fluoxetine). Also, taking pain medications above the recommended dosage increases the risk of seizures.

Should I take other medication to manage the side effects of my pain therapy?
While taking medications to relieve the side effects of pain therapy may offer temporary relief, it could also disguise a serious medical problem. Many patients, for example, take antacids or acid blockers to ease stomach distress caused by NSAIDs. But masking gastrointestinal symptoms can lead to critical delays in detection and treatment of emergency complications, such as ulcers.

Will I become addicted to pain medication?
Information indicates that getting "hooked" or addicted to pain medication is rare. It's true that certain pain medications can cause physical dependence, which means the patient may feel flulike or other types of "withdrawal symptoms" when medication is stopped. In most cases, these symptoms can be avoided through gradual withdrawal based on increasingly smaller doses. It's important to understand that physical dependence does not mean abuse or addiction. Certain pain medications can be used inappropriately (abused) to get high or for effects other than pain relief. Addiction is a psychological problem that compels people to abuse pain drugs. Don't let any misunderstandings of the difference between physical dependence, abuse, and addiction prevent you from getting the most effective relief for your pain.

Can I take nonprescription pain relievers in addition to prescription pain drugs?
Sometimes, people have intensified bouts of pain that are not controlled by otherwise effective pain therapy. If this happens, you may be tempted to take nonprescription drugs for added relief. But first ask your doctor or pharmacist if it's safe. Combinations of certain pain relievers could cause serious problems.

How often should I take my pain medication?
Many patients wait until their pain is severe before taking medication. But pain is easier to control when it is mild. Your doctor will probably tell you to take your pain medication. on a regular basis. This may mean taking it the same time every day. Work with your doctor to develop a personal daily plan for your pain control.

Besides taking medicine, what else can I do to manage my pain?
Pain medication is only one aspect, of effective pain management. Your doctor might suggest several types of non-drug treatments in addition to drug therapy. Non-drug treatments include physical therapy, exercise, breathing and relaxation techniques, biofeedback, massage, hot or cold packs, or nerve stimulation through a technique called transcutaneous electrical nerve stimulation, or TENS. Your doctor might also suggest changes in your diet. Ask your doctor to discuss the types of non-drug pain management approaches that can help you.

Pain can make you feel sad, angry, vulnerable, lonely - or a host of other negative emotions. Many people have learned to cope with these emotions through professional counseling or patient support groups. Ask your doctor for help in finding these services.

People respond to pain in different ways. Some people even believe that acknowledging pain is a character weakness. Keep in mind that pain is a medical condition. You should expect to be treated for pain just like you expect treatment for other medical problems. But remember, it's your responsibility to ask your doctor to help you control your pain.

Don't hesitate to ask your doctor for help. And don't hesitate to ask your doctor questions about the pain management approach he or she recommends.

The following organizations can provide more information about pain:

American Chronic Pain Association
PO Box 850
Rocklin, CA 95677
916-632-0922
www.theacpa.org

American Pain Society
4700 W. Lake Avenue
Glenview, IL 60025
847-375-4715
www.ampainsoc.org

Reprinted with permission ©1999
The Back & Body Center