Patient Education

Persistent pain can affect every aspect of daily life. The relationship between the patient and the health care provider is an essential component of effective pain management. To develop and maintain a good relationship, it is important for the patient to feel comfortable enough to ask questions and important for the health care provider to answer questions and address concerns thoroughly.

Primary care physicians often are the first to treat patients who experience pain. These doctors (e.g., family practitioners, internists, pediatricians) play an important role in pain management. Pain doctors (also called pain management specialists) usually coordinate patient care as part of a pain management team. Good communication with each member of the health care team can help ensure that the patient’s needs are met.

Pain Management

Pain management specialists use a number of techniques to diagnose and treat pain disorders. Pain evaluations often include taking a personal and family medical history, assessing the patient’s lifestyle (e.g., activity level), reviewing prior tests (e.g., blood tests, imaging tests, electrodiagnostic studies), and performing a physical examination.

Treatment for pain varies, depending on the cause. Some treatments are designed to reduce pain, and some are designed to help patients manage pain. Methods used to relieve pain include the following:

  • Implantable devices (e.g., stimulators)
  • Injections (e.g., corticosteroids)
  • Medications
  • Nerve blocks
  • Physical therapy (also occupational therapy and recreational therapy)
  • Surgery (e.g., joint replacement, spinal surgery, peripheral nerve surgery)
  • Trigger point injections

General Information to Share

It is important to provide the following information to your pain management team before you begin treatment:

How long have you been experiencing pain?

  • Did the pain come on suddenly or develop gradually? What were you doing when you first experienced the pain?
  • Describe the location of the pain. Does it occur in one place, or radiate from one part of the body to another, or does it occur throughout the body?
  • Describe the intensity of the pain. Is it mild, moderate, or severe?
  • Describe the sensation of the pain. (e.g., stinging, burning)
  • Is the pain constant, or does it fluctuate? Does anything improve the pain? Worsen the pain?
  • Does your occupation require physical exertion or mental stress? If so, how much?
  • How does the pain affect your daily life? Does it interfere with activities, sleep, or appetite?
  • Besides pain control, what are your goals during and following treatment (e.g., to continue hobbies)?

Basic Questions to Ask

Answers to the following questions may be helpful before beginning pain treatment:

  • What is my diagnosis?
  • Are additional tests or procedures required to confirm my diagnosis?
  • What medications are available to control my pain? What are the side effects?
  • What other treatment options are available? How do these treatment options differ?
  • What treatment do you recommend? What percentage of patients responds to this treatment?
  • What are the benefits and risks of this treatment?
  • What is the goal of the recommended treatment (e.g., pain relief, increased mobility, increased function, improvement in daily living)?

Key Terms in Pain Management

Pain Management

Pain management is the systematic study of clinical and basic science and its application for the reduction of pain and suffering. This discipline emphasizes an interdisciplinary approach to treatment, blending tools, techniques and principles taken from a variety of the healing arts to create a holistic paradigm for the reduction of pain and suffering.

Acute Pain

Acute pain, for the most part, results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly, for example, after trauma or surgery, and may be accompanied by anxiety or emotional distress. The cause of acute pain can usually be diagnosed and treated, and the pain is self-limiting, that is, it is confined to a given period of time and severity. In some rare instances, it can become chronic.

Chronic Pain

Chronic pain is widely believed to represent disease itself. It can be made much worse by environmental and psychological factors. Chronic pain persists over a longer period of time than acute pain and is resistant to most medical treatments. It can—and often does—cause severe problems for patients. A person may have two or more co-existing chronic pain conditions.

Addiction

Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

Physical Dependence

Physical dependence is a state of adaptation that is manifested by a drug class-specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood levels of the drug, and/or administration of an antagonist.

Tolerance

Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time.