About 'Pain Medicine'
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Q: What is ‘Pain Medicine’?
A: ‘Pain medicine’ refers to the medical specialty that involves assessing, diagnosing, and treating pain. Pain physicians use a variety of techniques to manage pain, including medicines, physical therapy in the form of exercise, interventions (commonly referred to as injection). Diet advice and psychological counselling are also provided.
Q: What types of pain is treated by a ‘pain physician’?
A: Virtually, all types of longstanding pain (chronic pain) or acute exacerbation of a chronic type of pain is treated by a pain specialist. Example: Back pain, Neck pain, face pain, Cancer pain, joint pain etc.
Q: What are some common pain medications used for pain management?
A: Some common medications used for immediate pain control include paracetamol, diclofenac, tizanidine, tolperisone etc. This list is long but should not be consumed without a doctor’s advice.
Q: What are the risks associated with pain medication?
A: Pain medication can have side effects, including drowsiness, nausea, constipation, and addiction. It is important to work closely with a pain physician to both manage the pain and also keep the side effects minimum.
Q: Can pain management help reduce or eliminate the need for surgery?
A: In many cases, surgery is done as patient cannot tolerate pain. So, Pain management techniques can often help reduce or eliminate the need for surgery as it relieves pain and improves function. However, in some cases, surgery may be necessary.
Q: How long does pain management treatment take?
A: The length of pain management treatment varies depending on the underlying condition and the individual patient. Some patients may require short-term pain management, while others may require long-term management.
Q: What should I expect during a pain management appointment?
A: During a pain management appointment, the pain management specialist will assess your pain, review your medical history, and develop a treatment plan tailored to your individual needs. They may also order diagnostic tests, such as imaging or blood tests, to help diagnose the underlying condition. They often use modern equipment at OPD only, such as USG
Common Misunderstandings in Pain Patients
Misunderstandings are a common obstacle to proper treatment. These are incorporated in the chronic pain patients’ mind by our society. These make the patient suffer as he do not avail the option of certain treatment modalities.
1: This is only treatment of pain. What about the actual treatment.
Pain treatment is not a partial treatment. Patient shall receive advice about all the treatment options, whatever available in the country. In a chronic pain patient, once pain is relieved, it means disease has been treated.
2. A pain physician does not do surgery, so, he will waste my time.
Pain physicians treat by nonsurgical method, but they evaluate a patient first to reach at a diagnosis. Whenever, surgery is necessary, they will surely refer the patient to a surgeon. In fact, ‘pain physician’ community includes neurosurgeon, neurologist, orthopaedic, anaesthesiologists, radiologists, physical medicine, and psychiatrists.
3. Pain killers will damage my kidney.
It is true that all allopathic medicines have side effects (as it produces effect). Pain killers are prescribed very cautiously by the physicians for a short period of time. Patients need to understand that side effect of a drug is never more than the side effect of the disease. Overall, taking pain killer by a doctor’s advice does not harm your kidney.
4. I am taking pain killers from a local pharmacy, so what is more to achieve from a pain doctor?
For public or patient, the word ‘pain’ means similar experience. For a pain physician, there are various types with completely different treatment. These treatments are not referred as ‘pain killer’.
5. I shall not take Steroid.
Pain treatment rarely require steroid. You need to understand that steroid is also a medicine. If prescribed in the correct way, it can save crores of patients as it did during COVID outbreak.
6. They do acupuncture, massage, technique which include producing sounds from the joints etc.
Pain physicians are allopathic doctors. Most of them are specialists as I mentioned above. So, these techniques are not practiced by us.
7. I shall not consume opioid type of drugs. I shall become addicted.
These are not prescribed in a noncancer patient. Development of addiction in a cancer patient neither develops nor is a concern.
8. I take pain when it is unbearable.
We should start taking the pain medicine (but not the common pain-killers like diclofenac or ibuprofen) even when pain is mild, as longstanding pain changes character and becomes resistant to treatment
9. My family members say it is all psychological, as investigations are all normal.
It is true that common investigations like X-ray or MRI can not detect pain. But we have ‘Functional MRI’ type of experimental modalities to detect pain activity in the brain. So, at present, we must believe a patient who is experiencing pain. Psychological component may increase the pain perception, but it does not start pain.
10. How safe are these procedures (injections)?
These procedures are extremely safe. All interventions are done either under X-ray guidance or Ultrasound guidance. It is always expected that within 2 hours patient can go back home safely.