Acute Pain Treatment FREE

John L. Zeller, MD, PhD, Writer; Alison E. Burke, MA, Illustrator; Richard M. Glass, MD, Editor

JAMA. 2008;299(1):128. doi:10.1001/jama.299.1.128.

1. one of the three categories of pain established by the International Association for the Study of Pain,   denoting pain that is causedby occurrences such as traumatic injury, surgical procedures, or medical disorders; clinical symptoms often include increased heartrate, blood pressure, and respiratory rate, shallow  respiration, agitation or restlessness, facial grimaces, or splinting.

2. a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as an un -pleasant sensory and emotionalexperience arising from actual or potential tissue damage or described in  terms of such damage, with sudden or slow onset of anyintensity from mild to severe with an anticipated or predictable end and a duration of less than 6 months.

bearing-down pain pain accompanying uterine contractions during the second stage of labor.

cancer pain one of the three categories of pain established by the International Association for the Study of Pain, denoting painassociated with malignancies and perceived by the individual patient; there are various scales ranking it from 0 to 10 according to level ofseverity.

Pain is an unpleasant sensory and emotional experience usually arising from actual or potential tissue damage. Acute pain can be a difficult medical problem to diagnose and treat. It may be caused by many events or circumstances. Symptoms can last hours, days, or weeks and are commonly associated with tissue injury, inflammation, a surgical procedure, childbirth, or a brief disease process. Other types of pain may be classified as chronic (pain of long duration), neuropathic (pain resulting from damage to nerves),psychogenic (pain not due to visible signs of disease or injury), or cancer-related (effects of a malignant disease on the body). The January 2, 2008, issue of JAMA includes an article that identifies trends in the prescription of medicines to treat acute pain in US emergency departments.

DIAGNOSING THE CAUSE OF PAIN

Your doctor will ask you about your symptoms and the history of your illness, injury, or surgery. You may be asked to fill out a questionnaire to assess the intensity and location of your pain. The Wong-Baker FACES Pain Rating Scale (below) may help young patients rate pain intensity.

Ongoing depression, anxiety, and substance abuse need to be identified. Additional diagnostic tests may include

• Blood tests
• Imaging studies (x-ray, CT, MRI, nuclear scans, ultrasound)
• Dye-injection studies such as a diskogram to identify painful disks in the spine or myelogram to identify areas of spinal nerve compression
• Electromyography and nerve conduction studies to identify nerve abnormalities

TREATMENT OF PAIN

Diagnosing and treating the cause of pain is an essential aspect of treatment. Initial treatment may include some of the following:

• Resting the affected part of the body
• Application of heat or ice
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen; or acetaminophen
• Physical therapy
• Exercise
• Bioelectric therapy (using local electrical stimulation to moderate pain)
• Stress reduction
• Opioid (narcotic) medications (such as codeine or morphine)
• Muscle relaxant medications

A secondary tier of treatments may include

• Antidepressant medications
• Anticonvulsants
• Nerve blocks (use of local anesthetics to block nerve activity)
• Trigger point injections to treat muscle spasms
• Steroid injections to reduce tissue inflammation
• Acupuncture