Pain Management - Medical specialists

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Pain Management - Further information

Overview of pain therapy

Pain therapy (or algiatry, pain control, pain management, pain medicine) is the medical sector responsible for easing suffering and enhancing the quality of life for those living with persistent pain. While some forms of pain may often resolve rapidly once the underlying injury or pathology (cause of the disease or illness) has healed or run its course, the effective management of longer-term (chronic) pain symptoms may well have to call upon the expertise of an interdisciplinary group of skilled practitioners.

Medical treatments address injury and pathology with the aim of providing a remedy as fast as possible, while alleviating pain and suffering throughout the process. However, once a distressing injury or pathology is no longer responding to treatment strategies, and long-term pain is present even after the injury or pathology has been repaired or healed, and when medical knowledge is unable to specify the cause of pain, medicine must still take steps to ease suffering. Chronic pain is treated by an array of techniques, ranging from pharmacological measures to interventional procedures, physical therapies and psychological approaches.

Frau mit schmerzhafter Verspannung
© detailblick-foto / Fotolia

Who offers pain management?

In addition to specialist pain clinics, the majority of medical institutions of all kinds will offer pain therapy as an important part of their services. Best practice addresses pain via multidisciplinary teams, where most medical fields are represented. Pain management is a growing area of medical focus involving medical practitioners, clinical psychologists, occupational therapists, pharmacists, physiotherapists and other professionals. Other disciplines beyond the mainstream medical world, such as acupuncture, are also gaining greater acceptance for the role they can play in some forms of pain therapy.

What does pain therapy help with?

The best pain therapy will address your pain needs by working with you to develop a pain-therapy strategy tailored to meet your own needs and preferences. Appropriate remedies will be employed to meet these aims, and may include everything from recommended lifestyle changes and over-the-counter medications through to surgery as a treatment of last resort.

When is pain therapy used?

Pain management is used in most medical contexts and aims to select the most appropriate pain-management strategy in each case. Nursing often defines pain as "whatever the experiencing person says it is, existing whenever the experiencing person says it does" – a compassionate response that acknowledges the paramount need to relieve a patient’s distressing symptoms.

Any pain management strategy begins with an exploratory exchange to establish pain symptoms by asking about:

  • intensity (How bad does it feel?)
  • description (What sort of pain do you feel?)
  • duration (When did this pain begin?)
  • possible remedial measures (What, if anything, eases your pain?)

The answers to these questions form the basis of a preliminary pain-management response.

What are the risks of pain management?

Different pain therapies each have their own limitations and drawbacks, but as the following examples illustrate, communication seems to be an overarching problem:

  • Those suffering pain may have not be able to recognise or adequately describe the pain they feel, or its intensity.
  • Healthcare providers and patients may be unable to cooperatively discuss how the pain is responding to pain management strategies.
  • Patients may often persist in taking pain management treatments or remedies that are less effective than required, or which may be causing them additional problems.
  • Some pain treatments can have harmful side effects, especially when overused.

A shared goal of pain management programmes is to identify the level of treatment that eases the pain, and to avoid exceeding that level.

A further dilemma for pain management initiatives is that pain is the body’s natural mechanism for highlighting problems. Thus, pain should naturally subside and disappear as healing reaches its conclusion. If pain management measures remove all pain, this may occasionally mask the need to treat more significant underlying problems.

Are there alternatives to pain therapy?

When used alongside traditional medicine, alternative pain therapies are usually described as complementary medicine. These approaches, which span a range of disciplines and philosophies, include:

  • acupuncture
  • aromatherapy
  • biofeedback
  • chiropractic treatments
  • guided imagery
  • herbal remedies
  • hypnosis
  • massage
  • relaxation
  • yoga

While all of these can often produce results, there is a need for more comparative research to evaluate the full extent of their effectiveness and identify the options that offer maximum benefit for those suffering pain.

Mind-Body Therapy

Mind-body approaches to pain relief aim to harness the mind’s ability to combat pain, control symptoms and promote healing. Significant techniques include relaxation, meditation, biofeedback and hypnosis.

Acupuncture

A traditional technique refined over many centuries, acupuncture is often recommended as a complementary treatment for many pain-related conditions. It is believed that acupuncture relieves pain by inducing the release of endorphins – body chemicals that mimic the effects of morphine. When this process is initiated, the nerves are unable to transmit messages of pain to the brain.

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