Pain Relief

PAIN: ACUTE VS CHRONIC

While pain can be debilitating, a lot of customers are reluctant to see someone about it and may well be suffering in silence. If someone does come to the pharmacy to purchase pain relief, it is important to assess if their pain is acute or chronic so as to assess if a GP visit should be recommended for an underlying condition.

Acute Pain Causes

Acute pain begins suddenly and is usually sharp in quality. It serves as a warning of disease or a threat to the body. Acute pain might be caused by many events or circumstances, including: • Burns or cuts

• Broken bones

• Dental work

• Labour and childbirth

• Surgery Acute pain can be mild and fleeting, or it might be severe and last for weeks or months. In most cases, acute pain does not last longer than six months, and it disappears when the underlying cause of pain has been treated or has healed. Unrelieved acute pain, however, might lead to chronic pain.

Chronic Pain Causes

People with persistent pain often think of themselves as suffering from a specific ailment, whether it’s arthritis, back pain, migraines, or something else. But anyone who has experienced pain for several months or longer with little relief is suffering from chronic pain. Despite decades of research, chronic pain remains poorly understood and notoriously hard to control. There are various conditions that are thought to cause chronic pain: • Lower back pain • Arthritis, especially osteoarthritis • Headache

• Multiple sclerosis • Fibromyalgia • Shingles • Nerve damage (neuropathy) Treating the underlying condition is, of course, vitally important. But often that does not resolve chronic pain. Increasingly, doctors consider chronic pain a condition of its own, requiring pain treatment that addresses the patient’s physical and psychological health. At a fundamental level, chronic pain is a matter of biology: Errant nerve impulses keep alerting the brain about tissue damage that no longer exists, if it ever did. But complex social and psychological factors are also at play, and they seem to help determine who fares well despite even severe chronic pain -- and whose lives quickly unravel. Negative emotions, including sadness and anxiety, seem to aggravate chronic pain. For example, people who dwell on their discomfort tend to be more disabled by chronic pain than people who try to take their pain in stride.

Pain Treatment

Depending upon its severity, pain can be treated in a number of ways. Symptomatic options for the treatment of pain might include one or more of the following: • Non-steroidal anti-inflammatory drugs (NSAIDs) • Acetaminophen In cases of Chronic Pain:

• Antidepressants. Several drugs approved to treat depression are also prescribed by doctors to help relieve chronic pain. These include tricyclic antidepressants such as amitriptyline, imipramine, clomipramine, desipramine, doxepin, and nortriptyline. The pain-relieving effect of tricyclics appears to be distinct from the mood-boosting effect, so these drugs can be helpful even in chronic pain patients who are not depressed. • Opioids (such as morphine or codeine) • Localized anaesthetic (a shot of a pain killer medicine into the area of the pain) • Nerve blocks (the blocking of a group of nerves with local anaesthetics) • Acupuncture • Electrical stimulation

• Physical therapy • Surgery • Psychotherapy (talk therapy) • Relaxation techniques such as deep breathing • Biofeedback (treatment technique in which people are trained to improve their health by using signals from their own bodies) • Behaviour modification

WWho? Anyone

WWhat are the symptoms? Pain in one or more sites in the body

HHow long has the patient had the symptoms? If the pain lasts longer

than three months it is considered chronic

AAction already taken? The patient may have already used OTC

pain relief

MMedication? Opioids to be used sparingly due to addictive properties