Let me state for the record that I am totally against pain. But, I can't agree with the overuse, misuse, and inappropriate use of pain medications. It is important to understand that pain is not all b...

Let me state for the record that I am totally against pain. But, I can't agree with the overuse, misuse, and inappropriate use of pain medications. It is important to understand that pain is not all bad for it serves a useful purpose like the smoke alarm in your home. It's actually a good idea to be alerted to the fact that a situation is brewing before the house burns to the ground although I will admit that the constant shrieking does become tiresome in a hurry. By all means turn off the alarm, but please don't neglect to fight the fire - the consequences can be devastating. Pain is no more and no less than the body's warning system that a physical or chemical stimuli has stressed your body beyond its ability to compensate.

The CDC (Centers for Disease Control and Prevention) states that, "Although many types of prescription drugs are abused, there is currently a growing, deadly epidemic of prescription painkiller abuse. Nearly three out of four prescription drug overdoses are caused by prescription painkillers梐lso called opioid pain relievers. The unprecedented rise in overdose deaths in the US parallels a 300% increase since 1999 in the sale of these strong painkillers. These drugs were involved in 14,800 overdose deaths in 2008, more than cocaine and heroin combined. The misuse and abuse of prescription painkillers was responsible for more than 475,000 emergency department visits in 2009, a number that nearly doubled in just five years."

Different Causes Require Different Treatments

It seems absurd to have to state the obvious which is that the appropriate treatment of pain is dependent upon identifying the cause of the pain, and yet most patients and many of their doctors seem to miss this vital point. As an example, let us suppose that a patient presents with severe leg pain made worse when walking. Shall we prescribe pain medication and advise the patient not to do so much walking or should we perhaps try to determine the cause of the pain via examination and history, and only then determine an appropriate course of treatment?

Let's say that the examination reveals a puncture wound on the bottom of the foot and the history indicates an incident whereby the patient stepped upon a rusty nail. This is starting to sound like tetanus - a bacterial infection. Maybe the examination reveals teeth marks and the patient reports having been bitten by a fox. This sounds like rabies - a viral infection. Does it make sense that the treatment for a bacterial infection and a viral infection would be different although the leg pain is the same? Is a painkiller really the answer?

Or, the examination reveals swelling and the patient reports falling from a tree. This sounds like a fracture. Maybe the examination reveals no injury at all, but the patient reports a history of back pain. This sounds like a pinched sciatic nerve. Does it make sense that the treatment for a fracture and a pinched nerve would be different although the leg pain is the same? Is a painkiller really the answer?

A Further Distinction Must Be Made

Bacterial infections and viral infections are chemical in nature and the appropriate treatment is chemical in nature, and this is delivered either by pill or by injection. I can't imagine how a physical treatment such as an ice pack or a foot massage could be considered appropriate treatment for tetanus or rabies whether these temporarily make the leg feel better or not. Alternately, fractures and pinched nerves are physical in nature and the appropriate treatment is physical in nature, and in this case I would suggest that a surgeon physically set the bone and a chiropractor physically manipulate the spine. I can't imagine how a chemical treatment such as a painkiller could be considered appropriate treatment for broken bones or pinched nerves whether the drug temporarily makes it feel better or not. Does it make sense that chemical problems require chemical solutions, and that physical problems require physical solutions?

Like smoke, pain is not the problem - it's a sign that you have a problem, and turning off the alarm is not the answer. Cover it up and learn to live with it at your own peril. However, if you put out the fire, you might discover that the smoke will soon go away by itself.