Sharp pain. What is pain? What types of pain are there and how to deal with them? Which is manifested by pain

Everyone has experienced pain at one time or another. Pain can range from mild to severe, appear once, be constant, or come and go intermittently. There are many types of pain, and often pain is the first sign that something is wrong with the body.

Most often, doctors are contacted when there is acute pain or chronic pain.

What is acute pain?

Acute pain begins suddenly and is usually described as sharp. It often serves as a warning about a disease or a possible threat to the body from external factors. Acute pain can be caused by many factors, such as:

• Medical manipulations and surgical intervention (without anesthesia);
• bone fractures;
• Dental treatment;
• Burns and cuts;
• Childbirth in women;

Acute pain can be mild and last literally seconds. But there is also severe acute pain that does not go away for weeks or even months. In most cases, acute pain is treated for no longer than six months. Usually, acute pain disappears when its main cause is eliminated - wounds are treated, injuries heal. But sometimes constant acute pain develops into chronic pain.

What is chronic pain?

Chronic pain is pain that persists for more than three months. It even happens that the wounds that caused the pain have already healed or other provoking factors have been eliminated, but the pain still does not disappear. Pain signals can remain active in the nervous system for weeks, months, or even years. As a result, a person may experience pain-related physical and emotional conditions that interfere with a normal life. The physical consequences of pain are muscle tension, low mobility and physical activity, and decreased appetite. On an emotional level, depression, anger, anxiety, fear of re-injury appear.

Common types of chronic pain are:

• Headache;
• Abdominal pain;
• Back pain and in particular lower back pain;
• Pain in the side;
• Cancer pain;
• Arthritis pain;
• Neurogenic pain arising from nerve damage;
• Psychogenic pain (pain that is not associated with past illnesses, injuries or any internal problems).

Chronic pain can start after an injury or infection, and for other reasons. But for some people, chronic pain is not associated with any injury or damage at all, and it is not always possible to explain why such chronic pain occurs.

2. Doctors who treat pain

Depending on what and how it hurts, and what caused the pain, different specialists can be engaged in the diagnosis and treatment of pain - neurologists, neurosurgeons, orthopedic surgeons, oncologists, therapists and other doctors of specialized specialties who will treat the cause of pain - a disease, one symptom of which is pain.

3. Diagnosis of pain

There are various methods to help determine the cause of the pain. In addition to the general analysis of pain symptoms, special tests and studies can be carried out:

• Computed tomography (CT);
• Magnetic resonance imaging (MRI);
• Discography (examination for the diagnosis of back pain with the introduction of a contrast agent into the spinal disc);
• Myelogram (also performed with the introduction of a contrast agent into the spinal canal to increase the ability of X-ray examination. A myelogram helps to see nerve compression caused by herniated discs or fractures);
• Bone scan to help identify bone disorders due to infection, trauma, or other causes
• Ultrasound of internal organs.

4. Pain management

Depending on the strength of the pain and its causes, the treatment of pain may be different. Of course, self-medication is not worth it, especially if the pain is severe or does not go away for a long time. Symptomatic treatment of pain may include:

• Over-the-counter pain medications, including muscle relaxers, antispasmodics, and some antidepressants;
• Nerve blockade (blocking a group of nerves with an injection of a local anesthetic);
• Alternative pain treatments such as acupuncture, hirudotherapy, apitherapy and others;
• electrical stimulation;
• Physiotherapy;
• Surgical treatment of pain;
• Psychological help.

Some pain medications work better when combined with other pain treatments.

Acute pain indicates a new violation in work, in other words, acute pain requires close attention from the moment it occurs. If the pain is localized in the organs / systems accessible to the patient himself (eyes, teeth), then the patient is able to independently assess the severity of the violation and calculate the need and time for seeking qualified help.

In the case of "internal" pain, everything is not so simple. It should be remembered that pain tends to radiate (spread). If a signal (irritation) occurs in one part of the nerve pathway of pain signal transmission, the entire “nerve” pathway will be involved in generating this pain signal, and discomfort may not always occur in the place where the damaged organ is located. In addition to the classic examples of pain irradiation, such as pain on the surface of the skin in case of damage to internal organs and facial pain, the phenomenon of repercussion may occur - the formation of pain sensations in areas that are remote from the damaged organ. For example, with pain in the heart, pain occurs under the scapula, on the inner surface of the left forearm.

If the stomach is damaged, pain is felt in the thoracic spine, if the intestines (upper sections) are damaged, pain sensations can be localized in the lumbar spine. Pain from an inflamed appendix and an irritated pancreas is extremely difficult to differentiate according to symptoms in the acute period, it is especially important in this case to be aware of the fact that pain from an inflamed appendix will refer to morphological pains requiring surgical intervention, and acute pain from an inflamed pancreas has basically functional in nature and requires conservative long-term therapeutic treatment. These few examples are an indicator of the complexity of the system of occurrence and awareness of pain, the causes of which can only be understood by a trained specialist.

The presence of any kind of pain brings discomfort, it is especially difficult to experience sudden acute pain.

In the chest cavity, the state of acute pain most often indicates the presence of damage to the heart muscle (heart attacks and pre-infarction conditions), it should be remembered that damage to lung tissues never causes pain. Pain in case of damage to the respiratory organs may indicate the ingress of foreign bodies into them, spasm of the smooth muscles of the bronchi, pain in the intercostal muscles, pain from damage to the bones of the ribs, but never acute pain in the chest will indicate the presence of tuberculosis and similar diseases leading to lung tissue changes.

Attacks of acute pain

In the case when attacks of acute pain are constantly repeated, it should be understood that the problem for the body is not resolved and the methods used so far have not worked. The paroxysmal pain is a valuable diagnostic material, the patient, if possible, should record the onset of attacks, their strength, frequency, duration.

Acute pain during pregnancy

The female body may experience acute pain during pregnancy due to physiological changes in the body. Growing weight can provoke pain in the joints, the appearance of stretch marks as damage to muscle fibers and ligamentous tissue is the cause of "pregnancy itch", engorgement of the mammary glands can cause chest pain, a change in the position of internal organs often causes pain in the stomach and intestines, headache as well is the result of hormonal stress. The appearance of any acute pain in the pelvic area and muscle spasm in the pelvic organs causes immediate hospitalization of the pregnant woman to determine the causes of acute pain and assess the threats to the fetus.

Types of acute pain

Consider the types of pain in more detail. The very concept of acute pain is usually understood as subjective experiences associated with true or imaginary tissue damage. Based on this formulation, pain is divided into phantom pain (sensations of pain that occur in missing organs or limbs), mental pain (moral suffering, psychogenic disorders), pathological acute pain (arising as a result of damage to the central and peripheral nervous systems without disturbing the structure or work organs/systems) and physical pain (the signal comes in case of malfunction of organs/systems or if they are damaged).

Depending on the localization of pain, acute pains are skin, muscle, joint, pain of internal organs (cavitary pain), dental, eye, headache, etc.

Acute pain and chronic pain are distinguished by the patient himself in terms of the level of pain sensations; according to the description, acute pain can be stabbing, cutting, pulling, twisting, paroxysmal or constant, etc.

Pain can occur both with prolonged irritation of any receptors (nerve endings), and with irritation of specific "pain receptors". The latter are divided into mechanical, thermal and chemical. There are two types of receptors - C and Aδ-fiber. C-receptors are responsible for the conduction of slow pains, for example, pain from poisoning, from massive radiation injuries, Aδ-fiber receptors are responsible for the conduction of instantaneous pain signals.

Acute headache

Headaches, especially acute pain, may indicate a spasm of the smooth muscles of the vessels that feed the brain, or a developing pathological process of inflammation of various etiologies, in which the meninges are affected, or pain with an unclear etiology (cause). Meningitis is also among the causes of acute headaches, the diagnosis of acute headaches is especially important, since the level of increasing damage can be irreversible and lead the patient to disability. The degree of impairment that may remain after the end of treatment depends on the timing of seeking help from the onset of the disease. It should be remembered that the medulla itself does not have specific receptors for generating a pain signal, and disorders that occur during strokes do not have a period when the body signals a developing disorder with acute pain. In any case, acute headache requires examination by specialized specialists and self-medication is unacceptable.

Sharp pain in shoulder blade

By itself, acute pain in the scapula has no explanation, since the scapula is a bone. But with pain in the heart, pain occurs under the scapula, on the inner surface of the left forearm. Special common pathways of innervation of the heart, individual areas of skin and muscles on the back, which have common roots in the spinal cord of the spine, provide the patient with pain in the heart of sensations that he will call the doctor as "acute pain in the shoulder blade." There is a possibility of such pain with osteochondrosis, mechanical damage and significant physical exertion, however, always violations of the heart should be first in line to exclude the causes of these pains.

Sharp pain in the tooth

When the enamel is damaged, acute pain in the tooth occurs. This type of pain appears with an injury that can be instantaneous (chip, tooth extraction), or developed gradually due to the caries process. Enamel is devoid of nerve endings, therefore, acute pain in the tooth indicates irritation of the exposed nerve endings located under the enamel in the pulp. The process of irritation of the nerve endings cannot stop on its own, acute pain in the tooth disappears only with the help of a dentist or after the complete destruction of the tooth itself, however, with natural destruction, an extensive inflammatory process may develop that will affect the periosteum, probably the jaw bone. To prevent such complications and save teeth, you should visit the dentist regularly, even in cases where a person does not experience any toothache. Another cause of acute toothache from contact with food, air, water may be the development of the process of inflammation of the gums (periodontitis), the development of which leads to the exposure of the root neck of the tooth.

Acute ear pain

Often the patient is taken by surprise by acute pain in the ear. Against the background of relative health, an acute pain syndrome suddenly develops. The reason for this may be a foreign body, more often an insect that crawls into the ear of a sleeping person. If this situation is excluded, then acute pain in the ear is a consequence of otitis media. Otitis develops when pathogenic flora enters a closed, warm, moist nutrient medium - into the human ear. Reproduction of microflora occurs when immunity is weakened, for example, from hypothermia, from climate change.

Acute sore throat

Also, with hypothermia, acute pain in the throat can occur. This signal also indicates the reproduction of pathogenic flora, which is present on the mucous membranes and requires close attention. To facilitate the treatment process, it is recommended to provide a diagnosis, for example, to pass a bakposev with the determination of sensitivity to antibiotics of the sown microflora. If acute pain in the throat is not the result of mechanical damage (from swallowing sharp objects), then the fight against this pain should be carried out under the close attention of otolaryngologists. Inept self-treatment can lead to complications in the form of a purulent process in the tonsils, swelling of the throat.

Acute pain in the abdomen

In the abdominal cavity, the cause of pain can be the presence of an inflamed appendicitis, ruptures of various cysts, intestinal obstruction - this is just a small list of problems that lead to treatment in a state of "acute abdominal pain" and require urgent help. There is a mass of nerve endings in the peritoneum, which makes it difficult to resolve the issue of differential diagnosis. Subjective sensations and complaints may exceed the danger of the condition, but when taking painkillers, acute abdominal pain can be masked for several hours, making it difficult to assess the severity of the patient, which can lead to the loss of precious time for prompt assistance.

Acute pain in the intestines

Acute pain in the stomach

Many people suffer from severe stomach pain. The causes of this condition can be a chronic increase in the acidity of the stomach, intake / absence of food, food poisoning, complications of the ulcer process, neoplasms, etc. If the patient has previously experienced similar conditions and knows what causes acute pain in the stomach, then the diagnosis of a sudden condition is facilitated. With spontaneously occurring pain, the presence of an ulcerative lesion of the mucosa in a state of exacerbation with a complication in the form of perforation of the stomach, its vessels, and bleeding that has appeared is more often suspected. It is also possible to develop gastralgia (acute pain in the stomach) with nervous strain, significant physical exertion.

Sharp pain in the lower abdomen

Sometimes acute pain in the lower abdomen can spontaneously occur. In this case, attention should be paid to gender anatomical differences. In women, acute pain in the lower abdomen can be most likely due to various inflammatory processes in the reproductive organs, spasmodic contractions of the muscles of the uterus. In men, acute pain in the lower abdomen often indicates a violation of the intestines. For both sexes, the likelihood of developing inflammation of appendicitis, the development of peritonitis as a complication of damage to the integrity of the intestine should be excluded as quickly as possible.

Sharp pain in the groin

Patients experience acute pain in the groin, which may indicate the presence of an inguinal hernia. Hernias in the groin can be with infringement of the hernial contents, and the so-called "reset", non-incarcerated hernias, in which the help of a surgeon is also necessary, but surgical intervention can be avoided. Sometimes acute pain in the groin comes from the inflamed nearest inguinal lymph node, the cause of inflammation of which should be sought in the defeat of nearby organs. Extremely rarely, acute pain in the groin is the result of disorders in the spine.

Sharp pain in the side

Most often, with complaints of pain in the peritoneum, acute pain in the side is released. It is there that the kidneys are located, which are capable of giving severe pain both with pyelonephritis (inflammation) and with the expulsion of sand and stones. Sometimes acute pain in the side indicates a violation of the spine, intestines, gives pain in the side and disruption of the pancreas, gallbladder, liver, spleen.

Sharp pain in right side

In patients, acute pain in the right side occurs most often in violation of the liver, gallbladder or kidney. It is extremely rare for intestinal loops to become the culprit for such local pain. In case of malfunction of the kidney, its inflammation leads to acute paroxysmal pains, which are sharply aggravated by blows with the edge of the palm on the back in the projection of the diseased organ. Any doctor can conduct such an express examination. Violation of the liver is often accompanied by its increase. In this case, acute pain in the right side sharply increases with palpation (palpation) of the edge of the liver protruding from the right hypochondrium (in a healthy state, the liver does not protrude beyond the border of the ribs). Problems in the functioning of the gallbladder cause acute attacks of pain with vomiting and radiating pain to the back. Also, pain in the right side should be listened to in case of suspicion of inflammation of appendicitis. In any case, acute pain in the right side requires examination and an accurate diagnosis before taking painkillers.

Sharp pain in left side

Necessarily acute pain in the left side should alert the patient. On the left are the pancreas, spleen and kidney. The pancreas itself, in case of inflammation, can give pain, felt as a sharp pain in the left side, but it is located deep in the body and closer to the center of the imaginary axis of the spine. A sharp stabbing pain is generated by the spleen and kidney. The spleen becomes inflamed extremely rarely, its spasm and pain syndrome are caused by physical exertion and nervous experiences, this feature is physiological and the pain goes away on its own. For accurate diagnosis, rupture (mechanical damage) of the spleen should be excluded.

Sharp pain in the groin

Sometimes acute pain in the hypochondrium is difficult to diagnose due to the large involvement of nearby organs. Most often, this pain is generated either by an inflamed enlarged liver with a gallbladder on the right, or an inflamed tail of the pancreas on the left, or kidneys (symmetrically or one), or disturbances in the work of the stomach (pain in front in the projection of the solar plexus).

Acute kidney pain

By itself, acute pain in the kidneys is easily recognized and is not confused with anything. The kidneys hurt with pyelonephritis (inflammation) in the acute period. Violations in this case arise as a result of the development of pathogenic microflora. Also, acute pain in the kidneys appears during the evacuation (expulsion) of stones and sand as a result of mechanical irritation. Sometimes acute pain in the kidneys appears against the background of an infectious disease as a result of the increased work of this organ during the removal of decay products.

Acute chest pain

In the chest cavity, the state of acute pain most often indicates the presence of damage to the heart muscle (heart attacks and pre-infarction conditions), it should be remembered that damage to lung tissues never causes pain. Acute pain in the chest and pain in case of damage to the respiratory organs may indicate the ingress of foreign bodies into them, spasm of the smooth muscles of the bronchi, pain in the intercostal muscles, pain from damage to the bones of the ribs, but never acute pain in the chest will indicate the presence of tuberculosis and the like. diseases that lead to changes in the lung tissue.

Sharp pain in the heart

If the patient claims that he has acute pain in the heart, then a heart attack or ischemic disorders in the functioning of the heart muscle should be assumed, the condition may arise as a result of a nervous shock experienced or unreasonably heavy physical exertion.

Acute joint pain

In a patient, acute joint pain is a syndrome in a wide variety of systemic diseases. More often, the joints most distant from the heart (the joints of the fingers) are first involved in the painful process, over time, the process affects the joints of the wrists and ankles. For a person, acute pain in the joints signals an inflammatory process in the joint bag, degenerative processes of changes in cartilage tissue, changes in hormonal levels. Diagnosis of pain in the joints is most often a long and painstaking process.

Sharp shoulder pain

There is an acute pain in the shoulder with joint inflammation, cartilage changes, as a result of an immune attack of one's own body. Often, acute shoulder pain is associated with injuries and prolonged physical exertion. Pain often leads to limited movement of the joint.

Acute back pain

Increasingly, a modern person has acute back pain. Pain is associated with the peculiarity of upright walking, which only a person has. Due to the vertical position of the body, the back experiences overload and requires a careful and attentive attitude.

Acute pain in the spine

Such sensations as acute pain in the spine are familiar to many. This pain is a consequence of damage to the nerve roots emerging from the spinal canal of the spine. Sudden acute pain in the spine indicates a sharp irritation of the nerve fiber from compression during damage (flattening, displacement) of the vertebral discs, which, in turn, damage the nerve. It happens that acute pain in the spine is caused by trauma, fracture or cracks in the vertebrae.

Acute lower back pain

With prolonged loads and static tension of the back muscles, acute pain in the lower back appears. This is due to a malnutrition of nerve fibers due to prolonged muscle tension, with a change in the intervertebral discs due to an unphysiological working posture. If acute pain in the lower back arose as a result of lifting weights and a sharp turn of the body, then we should talk about an injury.

Sharp pain in the leg

With lower back pain, there is often a sharp pain in the leg. This is due to the fact that if the nerve endings at the lumbar level are damaged, the underlying organ innervated by this process will also suffer. It happens that acute pain in the leg is caused by inflammation of the sciatic nerve. The pain syndrome in this case is difficult to stop and treatment with rehabilitation takes a long time.

Acute knee pain

A disorder such as acute pain in the knee is most often the result of destruction of the ligaments or part of the knee joint. Most often, acute pain cider is caused by a tear or destruction of the meniscus, parts of which "wedge" the knee joint, scratching the cartilaginous surface. These scratches and the fragments of the meniscus themselves gradually cause an aseptic inflammatory process, acute pain in the knee from this process haunts the patient for a long time. Help is usually immediate.

Acute neck pain

Very often, acute pain in the neck occurs suddenly with an unsuccessful sharp turn of the head to the side. This type of pain is post-traumatic from subluxation of the cervical vertebrae. Only a surgeon can help in this case. It happens that acute pain in the neck occurs as a result of prolonged fixation of the head in one position and is inherently muscular. In this case, help is limited to massage, rest and self-control in the future.

Where to go with acute pain?

The current level of development of medicine unequivocally answers the question of where to go with acute pain. With a pronounced pain syndrome, only a specialist can determine the presence of a danger to life, the degree of damage to organs / systems and the method of helping the patient.

If the state of acute pain is diagnosed by the patient as a signal from the internal organs and at the same time the patient becomes pale, he is cold, his pulse quickens a little, his pressure drops - with all these signs, you must immediately lie down and call an ambulance. The described signs may indicate the onset of internal bleeding, and in such a state it is highly undesirable to go anywhere or even walk. In case of acute pain in the heart, it is necessary to call an ambulance and clarify whether the arrival of a cardiological team is possible. The cardiologist will be able to coordinate the actions of doctors and the patient to achieve the best result in the treatment of heart attacks and pre-infarction conditions with the least consequences. If the patient has stopped (eliminated) the state of acute pain on his own, the next step in helping himself should be to contact a specialized specialist. With an exacerbation of inflammation in the maxillary sinuses, only the ENT will help get rid of the headaches that have arisen in connection with sinusitis. A neuropathologist will help to understand the causes of pain behind the sternum - whether they are the result of violations of the heart or whether these pains indicate problems in the spine. Pain in the intestines can indicate a threat to life or be functional - only the surgeon will answer the question of how dangerous the state of acute pain is for the patient. Many conditions of violations of the functioning of the organs of the epigastric region require systematic lifelong maintenance treatment, which is individually selected and prescribed by a gastroenterologist. Deviation from the recommendations of a gastroenterologist and a violation of the diet will immediately affect the acute pain in the pancreas of the liver, gallbladder, stomach.

In the event that the patient does not seek help to identify the causes of acute pain, does not respond to body signals about damage, a coma may develop (damages reach such a degree that the body loses the ability to function). A person in a coma cannot indicate the location of the pain, and doctors spend precious time trying to find out the causes of the depressed consciousness. In absolutely all cases, acute pain, like chronic pain, requires a careful attitude, the most accurate diagnosis and qualified assistance.

How to relieve acute pain?

Many are concerned about the removal of acute pain. Pain itself does not pose a threat, it is only a signal, but the state in which a person experiences pain leads to exhaustion of the patient. Often, acute pain relief is carried out immediately after assessing the severity of the condition. It is not recommended to carry out the removal of acute pain earlier, since for many diagnoses it is the nature of acute pain that is fundamental.

Today, the question of how to relieve acute pain is not worth it. Pharmacies have a very large selection of painkillers, as well as a sufficient selection of drugs that are used only in a hospital setting. You can also choose non-traditional methods of anesthesia.

How to relieve acute headache?

A very well-established set of traditional medicines - ibuprofen, aspirin, tempalgin, paracetamol - will help relieve an acute headache. For children from 12 years of age and adults, the initial dose of ibuprofen will be 200 mg in 3-4 doses per day. If absolutely necessary, it is permissible to increase the initial dose to 400 mg, also 3 times a day. The maximum doses are, single - 1200, daily - 2400 mg. At least 6 hours should elapse between doses. The mechanism of action of ibuprofen mainly consists in interrupting the transmission of the pain signal.

There are frequent cases when a spasm of the neck muscles, which impede the outflow of venous blood, is responsible for the headache. The simplest rubbing of the neck and tilting the head back will help relieve muscle tension, which, in turn, will no longer impede the passage of blood through the veins.

Of the non-traditional methods of dealing with headaches, one can recommend local hot douches, warm baths as a relaxant, cold compresses on the side that causes maximum pain. Cold compresses are contraindicated in facial neuralgia. Good results in the fight against headache showed feverfew maiden. If a fresh herb is available for treatment, then the dosage of consumption is one to two leaves per day. Encapsulated feverfew is used in a dosage of up to 300 mg per day, and in the form of tinctures - up to 40 drops per day. To relieve headaches associated with overwork, it is recommended to use rosemary in the form of tea, which is brewed immediately before use (1 teaspoon of rosemary per cup of boiling water, leave for 10 minutes).

How to relieve acute toothache?

Only strong analgesics, such as solpadeine, panadol-extra, ibuprofen, naproxin, will help relieve acute toothache - these drugs do not affect blood clotting, which is extremely important when providing dental care. For the fastest possible effect, it is possible to use Dentol ointment, but the duration of the drug does not exceed 20 minutes. Of the non-traditional methods of first aid for toothache, one should especially note those that help with gum disease - rinsing with a decoction of sage, saturated saline, mixtures of mint with oak bark, chamomile with calendula.

It is also practiced to wrap a diseased tooth with gruel from garlic, baked onions. Another technique for relieving toothache can be rubbing the auricle from the side of the diseased tooth. The method of soaring legs has proven itself well: legs should be soared, as with a cold, then put on warm socks and lie under the covers. All of the above methods do not lead to a cure and are methods of first aid.

Sore throat relief

With sore throat in the case of the development of an inflammatory process, the main goal of treatment is the complex treatment of the body and disinfection of the mucous surface in case of a bacterial or viral infection, stopping the action of direct irritants (for example, smoke). At the same time, it is possible to reduce pain, regardless of the further specified diagnosis. You should talk as little as possible, drink more warm liquid (not hot!), The liquid should not contain acids, including fruit ones, so as not to cause excessive irritation of the mucous membrane, rinsing with salted water, any antiseptic tinctures (rinsing with eucalyptus tincture, rinsing with echinacea tincture, rinsing with dissolved furacilin tablets). All sorts of modern lozenges with antiseptics have proven themselves well, as well as their predecessor - Septifril streptomycin sucking tablets. All kinds of sprays are convenient to use (Happy Lore, Angistop, Ingalipt, etc.).

How to relieve acute pain in the ear?

If there is a sharp pain in the ear (the appearance of otitis), you should make sure that there is no foreign body in the ear. If an insect has crawled into the ear, then it is washed with a significant amount of warm vegetable oil. Due to the fact that the insect causes unbearable pain, it should be killed. To do this, oil is poured into the ear of a lying person and the insect dies in this liquid. If, after turning over, the leaking oil did not carry the insect along with it and it remained in the ear, attempts to wash it can be made several more times, but you should not get carried away, any liquid in the ear can provoke otitis media. Without any complications, at any point of medical care, a specialist will be able to wash the insect out of the ear canal. If the pain in the ear is caused by otitis media (inflammation), then acute pain can be relieved using otinum, otipax, sofradex, garazon. In no case should you warm your ear! The "grandmother's" method of instillation with a solution of boric acid, which is an antiseptic, has proven itself well. Also, at the same time, you should drip your nose (!) with any vasoconstrictor drug with an action similar to galazolin, which will reduce swelling of the mucous membrane and improve the outflow of any accumulated fluid in the middle ear through the Eustachian tube and thereby relieve acute pain. To clarify the scheme of further treatment, it is necessary to diagnose the causes of otitis media.

Relieve acute joint pain

For acute pain in the joints of the arms, legs, pain in the spine, analgesics have proven themselves well (baralgin, analgin, spazgan, etc.), analgin solution 50% - 2.0 ml in combination with a solution of diphenhydramine 1% - 1.0 ml in the form intramuscular injections at night for 5 to 10 days, blockade (chopping) with lidocaine 2% - 2.0 ml, non-narcotic analgesics (ketanov, stadol, zoldiar) of a complex mechanism of action, 1 tablet 2-3 times a day. Dexalgin, voltaren, ketanov will help. In case of suspicion of compression of the nerve endings due to injury (subluxation), the cut should start taking decongestants (mannitol, aescinat). In the case when injections are not available, a good therapeutic effect can be obtained from Diclak-gel, Finalgel and their analogues.

Of the tablet preparations for the relief of pain, all types of available analgesics are suitable. If there are no suitable ones in the home first aid kit, you can use drugs recommended for relieving flu symptoms (they include anti-inflammatory, analgesic and decongestant components) for first aid.

How to relieve pain in the heart?

With pain in the heart, it is necessary to accurately realize the degree of responsibility to one's health for the lost time in myocardial infarction. If, nevertheless, access to a cardiologist is limited, then help with pain behind the sternum can be obtained from validol (vasodilating, “weak” relaxant), however, for serious heart problems, this drug is ineffective, it is necessary to take nitroglycerin, which has a pronounced vascular effect, acts quickly, but, due to its active action, it is not always well tolerated (may cause dry mouth, dizziness). To alleviate the condition with unexplained causes of pain in the heart with nitroglycerin, take 1 tab. aspirin, which is desirable to chew (taking just one aspirin tablet, even in the presence of myocardial infarction, significantly reduces the number of deaths from thrombosis on the first day). Cardiomagnyl is also recommended - a drug to improve blood circulation, prevent thrombosis, prevent a recurrent heart attack, take 1 tab. per day To alleviate the condition with arrhythmia, coronary heart disease, heart attacks, drugs are taken that reduce the need for oxygen in the heart muscle, slowing the heart rate - anaprilin, atenolol, metoprolol. It is permissible to take analgesics (pentalgin, sedalgin). Some methods of traditional medicine can alleviate the patient's condition with pain in the heart area, these are herbal tinctures with a relaxing effect: hawthorn, lemon balm (mint), valerian. A mustard plaster on the chest in the projection of the heart also helps. However, with incessant pain sensations, it is categorically contraindicated to move a lot, try to come to the doctor on your own. Definitely need to call an ambulance at home.

How to relieve acute pain in the side?

If the patient is taken by surprise by a sharp pain in the right or left side, the presence of renal colic should be assumed. Renal colic appears as an irritation reaction in the kidney or ureter from stones and sand. The only way to help should be aimed at increasing the rate of expulsion of the stone and facilitating this process. Starting painkillers with an unspecified diagnosis can be deadly! Warming and analgesic procedures in the case of inflamed appendicitis instantly lead to peritonitis. If the cause of the pain is established as renal colic, it is recommended to take all possible analgesics (promedol, omnopon, baralgin). Be sure to take antispasmodics (papaverine, platifillin, no-shpu) and warm relaxing baths are recommended. The removal of renal colic is carried out in a hospital, the patient is administered drugs according to the scheme with mixtures that include both analgesics and antispasmodics, it is recommended to put a heating pad on one side. Supervision of specialists will help prevent complications and provide emergency care in case of massive bleeding.

How to relieve acute pain in the intestines?

Pain in the intestines can be caused by overstretching of the walls due to delayed emptying or the appearance of gases. To eliminate these causes, you should take a laxative. Laxatives can be chemical derivatives or obtained from natural plant materials (buckthorn bark, senna leaf, laxative pharmacy collection in the form of tea). In the case of dysbacteriosis, the pathogenic microflora should first be eliminated with antibiotics (an antibiotic will be prescribed only after the analysis of bakposev with the determination of sensitivity to antibiotics), followed by colonization of the intestines with beneficial microflora (acidum and bifidum bacteria). If the pain in the intestines cannot be self-diagnosed, then it should not be eliminated on its own.

How to relieve acute pain in the stomach?

Stomach pain can be caused by gastritis with high or low acidity. Express diagnostics consists in determining the time of onset of pain: before eating, “hungry” pains appear, as a rule, with increased acidity and in this case are eliminated by drugs that depress the secretory function of the stomach, enveloping and soothing solutions (platifillin, metacin, vinylin, de-nol) If pains appear after eating and the patient does not remember the state of heartburn, then in this case fractional nutrition is indicated or, depending on the lack of enzymes and gastric juice, it is recommended to take enzymes and solutions that replace the defect. If the pain is cutting, unbearable, you should assume the presence of an ulcer and consult a gastroenterologist. Ulcers of the stomach and duodenum are dangerous for bleeding. For effective relief of pain in case of increased acidity, a decoction of flax seeds is indicated (the seeds are brewed and infused for about an hour to obtain a thick mucous sediment, which is filtered from the seeds and drunk as pain occurs as an enveloping and sedative agent). You can use infusions of herbs, consisting of one part of comfrey, calendula, calamus root, St.

Pain in the stomach may indicate not only the presence of an ulcer, but also polyposis (polyps of the stomach), conditions of acute poisoning, problems in the pancreas or gallbladder. The relief of acute pain in the latter cases comes down to taking antispasmodics to relax the smooth muscles of the ducts of the glands and taking any analgesics. Help with acute pain in the right hypochondrium also comes down to taking analgesics and antispasmodics. From analgesics, analgin, paracetamol, tramal buprenorphine are used, from antispasmodics - baralgin, no-shpu, papazol, drotaverine.

The state of sharp pain in the groin, lower abdomen may indicate intestinal obstruction, inflammation of the appendix, strangulation of the hernia - in these cases, the help of a surgeon is needed, before the arrival of doctors, you should in no case warm the intestines. To alleviate the condition, you can take any analgesics, to weaken the contraction of the intestine, you can use antispasmodics. If cutting pains are associated with urination, then the onset of cystitis should be assumed and the main help will be to eliminate the causes of inflammation. Painkillers will not be included in the treatment regimen for cystitis, since pain in cystitis rarely reaches such strength that it requires correction, but with individual pain intolerance, any analgesics can be used (analgin, rapidol, tempalgin).

It is necessary to determine the types of pain in order to prescribe an adequate treatment for the syndrome. The nature of the pain allows you to identify a possible pathology. Localization of pain allows you to determine the location of the pathological lesion. Potential causes of pain are the direction in which the main measures for the treatment of the disease are carried out.

We offer you a material that describes the main types of pain.

Pain is a psychophysiological reaction of the body that occurs with strong irritation of sensitive nerve endings embedded in organs and tissues. This is the oldest defensive reaction in evolutionary terms. It signals trouble and causes the body's response, aimed at eliminating the cause of pain. Pain is one of the earliest symptoms of some diseases.

There is the following localization of pain in patients:

• Somatic superficial (in case of damage to the skin);
• Somatic deep (with damage to the musculoskeletal system);
• Visceral (with damage to internal organs).

If the localization of pain does not coincide with the site of injury, the following are distinguished:

• Projected pain (for example, when the spinal roots are compressed, the pain is projected into the areas of the body innervated by them - it “shoots” in the arm, leg, etc.);
• Reflected pain (occurs due to damage to internal organs and is localized in distant superficial areas of the body).

By damage to the structures of the nervous system:

Pain that occurs when the peripheral nerves are damaged is called neuropathic, and when the structures of the central nervous system are damaged, they are called central.

The nature of the pain

When making a diagnosis and choosing a method of treatment, it is necessary to determine the nature of the pain.

acute pain is a new, recent pain that is inextricably linked to the injury that caused it, and is usually a symptom of some disease. It disappears when the damage is repaired.

chronic pain often acquires the status of an independent disease, continues for a long period of time even after the elimination of the cause that caused acute pain. The most acceptable period for assessing pain as chronic is its duration of more than 3 months.

Types of pain

Types of pain that the pharmacist most often encounters in his practice:

Headache(migraine, beam or cluster headaches, chronic paroxysmal hemicrania and muscle tension headaches; secondary or symptomatic - a consequence of a traumatic brain injury, vascular pathology of the brain, tumors, etc.);

• Pain associated with inflammation of the elements of the musculoskeletal system (articular pain, discogenic radiculitis, myofascial pain, myalgia);
• Abdominal pain (abdominal pain);
• Pain in trauma, dislocations);
• Pain in skin lesions (abrasions, burns);
• Toothache and pain after dental interventions;
• Pain with angina pectoris;
• menstrual pain;
• Pain in cancer patients.

Causes of pain

Before deciding which pain relievers will help and recommending an over-the-counter remedy, the pharmacist should ask the following questions:

How long does the pain bother and what is its nature (pain for more than 7 days indicates the need for medical intervention)?

What is the likely cause of the pain (eg, exercise-related muscle and joint pain can be managed with over-the-counter analgesics)?

Can the patient clearly localize and describe the pain (if the pain is difficult to localize, it is more likely to be reflected in diseases of the internal organs, which requires a medical consultation)?

Identifying possible causes of pain is sometimes not easy.

Has the patient been examined for joint diseases?

With pain in the joint: are there swelling, local increase in temperature, increased pain when touched? If so, it may be infectious arthritis or a rheumatic disease. The use of analgesics in these cases may delay the correct diagnosis.

Has the patient previously taken any prescription or over-the-counter drugs? This should be known to account for potential drug interactions, treatment complications, and allergic reactions.

If the patient's condition is not severe and the pain is not a symptom of a more serious illness, over-the-counter drugs should be recommended. However, the pharmacist/pharmacist should advise you to see a doctor when pain lasts more than 7 days or symptoms recur after a few days of temporary improvement.

Prescribing painkillers

The sequence of actions of the doctor when prescribing painkillers:

1. The doctor carefully interviews and carefully examines the patient. Finds out the effectiveness and duration of previously taken drugs, the presence of concomitant diseases and drug complications. The doctor must determine the leading peripheral component of pain (tendon-muscular, neurogenic, etc.), find out the presence of psychosocial and emotional-stress precursors of chronic pain syndrome. An analysis of the data obtained will allow you to choose the main, patient-specific drug group (non-steroidal anti-inflammatory drugs (NSAIDs), sodium or calcium channel blockers, monoamine reuptake inhibitors, etc.) and draw up a treatment regimen.

2. In prescribing painkillers, the doctor usually adheres to a rational sequence of prescribing painkillers, which means the following:

• It is possible to use several drugs that support analgesia;
• Use of an adequate period of time to evaluate the effectiveness of the drug (perhaps several weeks);
• The use of a combination of drugs;
• warning of their side effects.

3. Only a doctor can recommend the rational use of drugs as a component of complex pain therapy, i.e. prescribe additional sessions of physiotherapy, blockade with local anesthetics, and possibly recommend the use of neurosurgical methods.

Warning: chronic pain! A very serious medical problem is chronic pain - an independent syndrome that develops with progressive diseases and persistent dysfunction of organs and systems, in which etiotropic therapy is not effective enough or impossible.

acute pain

Acute pain plays a protective role and contributes to the maintenance of life. It signals damage, which helps the body protect itself from further injury. Acute pain optimizes behavior by promoting wound healing (eg, laying down or immobilizing the injured limb). Thus, it has a protective value for the body. Special care is required for acute pain.

chronic pain

Chronic pain (more than 6 months), in contrast to acute pain, is devoid of a signaling and protective function and does not contribute to optimizing the patient's behavior aimed at healing the injury. Chronic pain becomes an independent painful condition, as it leads to mental exhaustion and social maladaptation. The patient may experience irritability, weakness, a narrowing of the circle of interests and a decrease in social activity. Treatment of chronic pain requires a preliminary examination of the patient and finding out the causes of this syndrome.

The significance of chronic pain is determined not only by the severe suffering of patients who experience this painful symptom for a long time, which inevitably leads to physical and social maladaptation. But - at present, this is no longer in doubt - chronic pain is an independent factor that significantly worsens life prognosis.

Note to supervisor

Therapy of chronic pain is an extremely difficult test for the doctor. Physician-patient interactions must include many factors: pain relief, stress reduction, resumption of normal activity, return to professional status. Often the treatment of chronic pain requires the participation of several specialists, but for the result to be successful, it is necessary that the patient also has a stake in the success.

Counseling a visitor with chronic pain

Usually visitors with chronic pain are frequent visitors to the pharmacy. Unfortunately, counseling such visitors presents some difficulties, since a long-term pain syndrome turns healthy and strong people into neurasthenics, distrustful, suspicious and very dependent on the doctor. Although a visitor with chronic pain usually purchases drugs by prescription, the participation of a pharmacist certainly has a positive effect on the correctness of taking medications. To do this, the patient and the pharmacist must establish friendly contact, i.e. the latter must have good communication skills, even despite the negative changes in the former's character caused by chronic pain.

Irritability with pain

An effective visitor-pharmacist relationship is possible if the latter is able to be a source of understandable information. It must be understood that the patient may experience irritability with pain, which depletes his mental and adaptive forces.

The pharmacist must remove barriers in communication with the patient related to his educational, socio-economic and cultural level, interests and habits. In addition, the patient must be sure of the strict confidentiality of all information discussed with the pharmacist.

The pharmacist should first determine the patient's level of awareness. In the course of communication, it is necessary to use easy-to-understand words and avoid complex medical terms.

Effective communication occurs when the recipient of the information hears and understands what is being communicated to him. This can be achieved through active listening. irritability with pain can be stopped with mild sedatives.

Do not forget that pain exhausts the patient not only physically, but also mentally. A patient with chronic pain is focused only on his own body, so you should not independently initiate a conflict with him. Remember that according to the Code of Ethics, "the main duty of the pharmacist is to look after the welfare of each patient and put his interests above his own interests."

Pain. What is this feeling - everyone knows. Despite the fact that it is very unpleasant, its function is useful. After all, severe pain is a signal of the body, which is aimed at drawing a person's attention to problems in the body. If the relationship with him is in order, then you can easily distinguish the pain that arose after exercise from the one that appeared after a very spicy meal.

Most often it is divided into two types: primary and secondary. Other names are epicritical and protopathic.

primary pain

Primary is pain that is caused directly by some kind of damage. It can be a sharp pain after a needle prick. This type is very sharp and strong, but after the impact of the damaging object stops, the primary pain immediately disappears.

It often happens that the pain after the disappearance of the traumatic effect does not disappear, but acquires the status of a chronic disease. Sometimes it can persist for so long that even doctors are unable to determine the reason why it arose in the first place.

secondary pain

Secondary pain is already pulling. At the same time, it is very difficult to indicate the place in which it is localized. In such a situation, it is customary to talk about a pain syndrome that requires treatment.

Why does pain occur?

So, a person has secondary pain. What is this syndrome? What are its reasons? After tissue damage occurs, pain receptors send an appropriate signal to the central nervous system, that is, the brain and spinal cord. This process is associated with electrical impulses and the release of special substances that are responsible for the transmission of nerve signals between neurons. Since the human nervous system is a rather complex system with many connections, in the management of sensations associated with pain, there are often failures in which neurons send pain impulses even when there are no stimuli.

Localization of pain

According to localization, the syndrome is divided into two forms: local and projection. If the failure happened somewhere on the periphery of the human nervous system, then the pain syndrome almost exactly coincides with the damaged area. This includes pain after visiting the dentist.

If a failure occurred in the central nervous system, then a projection form appears. This includes phantom, wandering pains.

Depth of pain

According to this characteristic, visceral and somatic are divided.

Visceral pain refers to sensations from the internal organs.

Somatic pain sensations are perceived as joint, muscle and skin pain.

There are symptoms that need to be addressed urgently.

Very severe, sharp pain in the head that has not been observed before

In this case, you must urgently consult a doctor. It can be both pain from a cold, and a brain hemorrhage, which is already much more serious. If there is no certainty about the reason that caused such a feeling, then you need to undergo a medical examination or call an ambulance. Treating acute pain before the cause is identified is not the best option. The main symptom is that the sensation passes before the injury heals. Correct diagnosis is very important.

Pain in the throat, chest, jaw, arm, shoulder, or abdomen

If there is chest pain, this may be a bad sign of pneumonia or a heart attack. But you need to know that with heart disease, there is usually some discomfort, not pain. What is discomfort in such diseases? Some complain of tightness in the chest, as if someone is sitting on top.

Discomfort that is associated with heart disease can be felt in the upper chest, as well as in the jaw or throat, left arm or shoulder, and in the abdomen. All this can be accompanied by nausea. So, if a person constantly experiences something like this and knows that he is at risk, you need to urgently check. After all, very often people miss time because they misinterpret the symptoms of pain. Doctors say that the discomfort that occurs from time to time should also be taken seriously. It may be associated with physical stress, emotional distress, or excitement. If this is experienced after gardening, and then passes during rest, then this is most likely angina pectoris, the attacks of which most often occur in hot or cold weather. Discomfort and pain in women with cardiovascular diseases are implicit. They can masquerade as symptoms of diseases of the gastrointestinal tract, which include discomfort in the abdomen, bloating. After menopause, the risk of these diseases increases dramatically. Therefore, you need to be attentive to your health.

Pain in the lower back or between the shoulder blades

Some doctors say it's a sign of arthritis. But there are other options to keep in mind. It could be a gastrointestinal disease or a heart attack. In a particular case, aching pain in these places may be a symptom. In people who are at risk for diseases associated with the heart and blood vessels, the integrity of organs may be impaired. These people include those with excessively high blood pressure, circulation problems, as well as smokers and diabetics.

Severe abdominal pain

These include inflammation of the appendix, problems with the pancreas and gallbladder, as well as stomach ulcers and other disorders that cause abdominal pain. You need to see a doctor.

Pain in the calf muscles

Thrombosis is a very serious disease. It feels intense pain. What is thrombosis? This is when a blood clot occurs in the veins, causing discomfort. A large number of people are affected by this disease. Its danger lies in the fact that part of such a clot comes off, which leads to death. Risk factors are advanced age, cancer, low mobility after prolonged bed rest, obesity, pregnancy. Sometimes there is no pain, but only swelling. In any case, it is better to seek help immediately.

Heat in the legs

This problem is familiar to many patients with diabetes. It was through her that this dangerous disease was revealed. Some people don't know they have diabetes. So the heat in the legs is one of the first signs. There is a tingling sensation or which may indicate damaged nerves.

Scattered pains, as well as combined

A variety of physical, painful symptoms often occur in depressive states. Patients may complain of soreness in the limbs or abdomen, diffuse pain in the head, and sometimes both. Due to the fact that discomfort may be chronic and not felt strongly, patients and their families may simply ignore such symptoms. And the stronger the depressive disorder, the more difficult it is for a person to describe the sensations. Pain after psychological trauma is often difficult to explain. This can be confusing for doctors. That is why it is necessary to identify other symptoms before making a diagnosis of depression. If you lose interest in life, you can’t think and work with high efficiency, and there are quarrels with people, you need to get the help of a doctor. When something hurts, you do not need to endure silently. After all, depression is not just a deterioration in the state and quality of life. It needs to be treated very actively before it has time to cause serious changes.

All of the above types of pain are dangerous, as they can be symptoms of serious diseases. Therefore, at the slightest sign, you should immediately seek help from doctors. After all, the essence of pain lies in the fact that a person understands that something is wrong in the body. In addition to unpleasant sensations and significant changes in the human body, pain can lead to sad consequences, the worst of which is death.

Pain is a signal that something is wrong with the body. This signal must be taken seriously and find out the true cause of the pain.

The feeling of pain occurs when sensitive nerve endings are irritated, a huge number of which are located in the skin and other parts of the body. These pain receptors recognize many different stimuli, such as heat, pressure, or stretching; the reaction they cause may also be different. Each person perceives pain in their own way, and psychological factors exacerbate this perception. In general, pain is an alarm signal that the body is in danger, overworked, or sick.

If you're in pain

• Pain is an alarm signal from our body. Take this signal seriously and try to eliminate the cause that caused the pain.
• Pain medications can help reduce the appearance of pain, but will not address its cause.
• Since pain that is not treated can become chronic, it must be treated.
• If the pain doesn't go away, see a doctor. A doctor should also be examined if you cannot determine the exact localization of severe pain, or if you have other complaints besides pain.
• Pain medications can have various side effects, especially if used for a long time. Talk to your doctor or physical therapist about the safe use of these medications.
• Women who are pregnant or breastfeeding should not take pain medication. Many of them can cause severe disorders in children. They can be taken in small doses by infants and young children (contact your doctor or pharmacist for more information).

Definition, transmission and perception of pain

To better understand what pain is, let's look at how our body perceives the pain signal and how this information is transmitted further and processed.

Nerve cells receive and transmit signals. Each nerve cell has a part with which it perceives the signal and transmits it further. Short branches of the nerve cell are called dendrites, they receive stimuli. When the free end of the nerve is irritated, an electrical signal is generated, which is transmitted further through the nerve cell to the axon. An axon is a long process of a nerve, often covered with a myelin sheath. The myelin sheath speeds up the transmission of the electrical signal. The axon operates on the principle of a one-way road, and along it the signal travels only in one direction - to the signal-transmitting end. At the end of the nerve there are synapses that provide signal transmission to other nerve and muscle cells.

At the synapse, an electrical signal stimulates the release and release of substances in the synaptic cleft called neurotransmitters. Neurotransmitters get on the receptors of a nearby nerve cell and cause the opening of ion channels. Ion channels are small openings through which certain particles can move. Charged atoms, or so-called ions, enter the cell through these channels. They have an electrical charge, which causes the formation of a corresponding electrical potential and electrical signal transmission.

When the signal reaches the spinal cord, it is transmitted further to the brain. The signal first travels to a region of the brain known as the thalamus, and from there to sensitive areas of the cerebral cortex. Here the signal is converted into a feeling of pain. The type and intensity of the signal determines whether it will be perceived as pain, a simple touch, or not at all. A signal in the spinal cord can trigger a reflex. In this case, the signal is passed on to nerve cells called motor neurons, which cause the muscles to contract. This allows us to respond to pain even before we have analyzed what it is.

For example, when we touch a hot surface with our hand, we pull it away before we realize that the surface is hot.

The brain continuously receives a huge amount of information from all the sensors in the body. Most of this information is screened out and does not reach consciousness. Only in this way can you concentrate on things that are important in each specific situation.

If you wear shoes for a certain time and do not concentrate on sensations, then you gradually stop noticing them. But if the shoes are uncomfortable and cause pain, it becomes difficult to pay attention to something else.

Types of pain

The pain can be of different intensity and cause different sensations - from tingling to burning and throbbing. If the patient is able to determine the source of pain and describe its type, it is much easier to establish its cause.

Types of pain depending on location:

Somatic pains come from the skin, muscles, joints, bones and connective tissues.
The source of visceral pain is the internal organs, for example, their stretching, spasms or inflammation.
Neuropathic pain occurs when nerve cells are over-irritated or damaged.

Acute and chronic pain

Acute pain lasts for a limited period of time and can pass quickly, so it is easier to bear even if it is more intense
Chronic pain can either be long lasting (back pain, pain caused by a tumor) or recur frequently (migraine, angina pectoris). Chronic pain is difficult to bear

Psychological pain

Not all types of pain arise due to irritation of pain receptors. Pain can also be a manifestation of psychological disorders. Such pain is not imaginary, it is caused by a real signal of pain.

Pain memory

In the absence of adequate treatment, the pain signal continues to flow and can cause irreversible changes in the nerve fibers. The nerves become too sensitive, and even the slightest touch or change in temperature gives rise to a feeling of pain. Thus, easily treatable acute pain can become intolerable chronic pain.

Pain is closely related to the individual's pain perception threshold. Each person reacts to pain differently. The pain threshold is also affected by the specific situation, for example, fear exacerbates the perception of pain, and concentration on some other object softens it.

Pain intensity

The intensity of pain cannot be measured, because each of us has a different threshold for perceiving pain. Therefore, various questionnaires are used to assess the intensity of pain.

The easiest way to measure pain is with a visual analog scale. The patient is asked to describe the intensity of pain by selecting the appropriate number of points from 0 to 10, where 0 is “no pain” and 10 is “unbearable pain”. This scale is often supplemented by a more detailed description of the level of pain or a pictogram. For young children, along with this scale, use a diagram with various expressions of a child's face that convey shades of pain.

Describing pain intensity with words

0 No pain 2 Mild pain 4 Moderate pain 6 Moderate pain 8 Severe pain 10 Unbearable pain

Wong-Baker Face Scale

Pain Tolerance Scale

0 No pain 2 Pain can be ignored 4 Interferes with activities 6 Interferes with concentration 8 Interferes with basic needs 10 Requires bed rest

Other questionnaires included questions about the localization of pain and an accurate description of sensations. An accurate description of the pain is helpful in making a diagnosis. In some situations and cases of diseases, a more detailed analysis is necessary. Several types of standard questionnaires are available to help determine the severity of the disease and its impact on quality of life. Patients are asked if they are able to manage daily activities such as getting dressed, bathing, etc.

Modern methods can monitor the activity of various parts of the brain and determine the level of activity of nerve cells, but there is no method that can be used to determine how badly a patient feels because of the pain they feel.

Pain and inflammation

Pain and inflammation are often closely related and can form a vicious circle: inflammation exacerbates pain, and pain stimulates the production of inflammatory mediators.

To understand how pain and inflammation are related to each other, consider the following example. Touching a sharp object, such as a needle or a knife, causes an instinctive reaction of the body: the hand withdraws from the object even before we have subjected the situation to conscious analysis. Right after that, we feel a sharp pain. The reaction of the body depends on the severity of the damage. The heartbeat quickens, and the body is mobilized to act in a dangerous situation. The initial pain subsides within minutes or hours. The next day, changes are visible at the site of the wound: it is reddened and sometimes hot. The feeling of pain also changed: acute pain was replaced by diffuse. In addition, even a light touch on intact, reddened skin near the wound can be painful.

The reason for these changes is the beginning of the inflammatory process. Pain resulting from injury stimulates nearby tissues, where inflammatory mediators are formed, which in turn cause small blood vessels to dilate. More blood enters the tissues, which explains their redness and a feeling of heat. Inflammatory mediators also increase the sensitivity of nerve cells, so even a soft touch, which under normal conditions would not cause discomfort, is painful at the site of injury.

Pain provokes inflammation, and inflammation increases the intensity of pain, so pain treatment and inflammation treatment are often two sides of the same coin.

Pain treatment

Pain can be the result of various factors and manifests itself with different intensity, so there is no one optimal way to treat all cases of pain, moreover, the response to treatment is individual for each patient. Because of this, treatment must be specific. The main goal is to eliminate the cause of the pain.

Pain Remedies:

Weak and medium action

Paracetamol
NSAIDs (Diclofenac, Ibuprofen, Naproxen)
Metamiazole

Strong

Tramadol
Light opioids
Strong opioids
Up

Medical therapy for pain

Depending on the intensity of pain or its localization, different medicines or groups of medicines are used. To relieve acute pain, paracetamol-containing preparations are often used first of all. Paracetamol does not have a pronounced anti-inflammatory effect, it spares the stomach, but can cause serious disturbances in the activity of the liver. Patients with liver problems should consult their doctor before taking these medicines.

Drinking alcohol at the same time as paracetamol can be very dangerous and even fatal.

The group of non-steroidal anti-inflammatory drugs (NSAIDs) includes many different drugs. The most commonly used medicines contain diclofenac, ibuprofen or naproxen. All NSAIDs reduce pain and inflammation. NSAIDs can damage the stomach or intestines and even cause bleeding. Patients suffering from stomach ulcers should consult their doctor before using these medicines.

Acetylsalicylate (Aspirin®) is a special member of the NSAID group, as it reduces blood clotting. To reduce blood clotting, it is given in small doses to patients who have had a heart attack or stroke, or to patients at high risk of cardiovascular complications. The side effect of this medication, which can also cause stomach problems, is the desired effect in this case. In therapy, acetylsalicylic acid is often replaced by other NSAIDs that have a lower risk of gastrointestinal side effects.

Metamiazole is a strong NSAID that is given to patients with severe pain. But it can cause blood problems, such as a decrease in the number of white and red blood cells. Because of this additional risk, the physician must evaluate the benefit of therapy against the risks of using this medication. Metamiazole can only be used when it has been prescribed to the patient.

Tramadol is a very mild opioid that rarely causes breathing problems. But it also has most of the side effects of opioids, such as being sedating or causing dizziness and nausea. Patients taking medications containing tramadol should not drive or operate machinery. Just like all opioids, tramadol can cause addiction and tolerance (a decrease in the desired effect over time). Tramadol is used in cases where other NSAIDs have not been sufficiently effective, and it can only be used as directed by a doctor.

All mild and strong opioids have similar side effects, they cause dependence and tolerance. Opioids impair the function of transmitting a nerve signal from one nerve cell to another, but at the same time disrupt the transmission of other signals between nerve cells. Opioids are associated with life-threatening side effects, such as respiratory depression and decreased gastrointestinal activity. Opioids are highly controlled substances that are used only in special cases, for example, to relieve postoperative or tumor-induced pain. Antiepileptic drugs and vitamin B are more effective in treating neuropathic pain than classic pain medications.

Attention!

A medicine that works wonders for your neighbor will not necessarily help you. It may even be dangerous because you have other risk factors. Talk to your doctor or pharmacist if you decide to change the way you manage your pain.

The simultaneous use of several medicines may increase the risk of side effects. Do not change your therapy yourself and do not take medicines that you have at home or that you have purchased without first consulting your doctor or pharmacist.

Non-drug pain management

Non-drug treatments can be used alone or in combination with medications. Just as in the case of drug therapy, each patient reacts to different methods in his own way. The doctor may recommend various types of therapy, but only the patient himself can evaluate their effect. To understand which method is most effective, it is worth trying a few tricks.

Physiotherapy helps in treating the cause of the pain by exercising muscles and improving range of motion. Physiotherapy (massage, warming, cooling) helps to relax, so it is recommended to reduce painful symptoms.

Electrotherapy is based on the peculiarity of the transmission of a nerve signal as an electrical one. Targeted electrical stimulation helps balance the pain signaling system.

Techniques such as hypnosis, biofeedback and relaxation change the perception of pain in patients with chronic pain and help improve quality of life.

The effectiveness of any treatment, with or without medication, can best be judged by the patient himself. Everyone has individual needs and desires, which should be discussed with your doctor. It will be wise to try another type of treatment if the current one does not bring the desired relief. The list of therapies listed here is far from complete. Your healthcare provider may suggest other alternatives.

How can unwanted side effects be avoided?

Each drug that has any effect can cause side effects. The doctor carefully evaluates the benefits and possible risks of therapy in order to minimize unwanted side effects.

When choosing a particular medicine for the treatment of a patient, the doctor thinks not only about the maximum effectiveness, but also about possible side effects. The doctor should always evaluate the ratio of the desired effect and risks. The risk of adverse events is not equally high in all patients, but depends on the disease, age, gender, other medications taken and other risk factors.

Various forms of medication are available: injections, tablets, suppositories or topical preparations such as gels, patches or sticks. This allows the therapy to be tailored to individual needs.

To reduce individual side effects, you can take additional medications at the same time. With prolonged use of NSAIDs, therapy is supplemented with gastroprotectors - the so-called proton pump inhibitors. These medications reduce the risk of gastrointestinal bleeding that can result from long-term use of NSAIDs.

You can help your doctor choose the right medicine for you by telling him about other medicines you are taking, even though they were not prescribed for you. The doctor must be informed about all the risk factors and your desires in order to prescribe the best treatment for you.