Pain is one of the commonest symptoms which forces people to seek medical help; it is also one of the leading causes of chronic disability and adverse quality of life. It may arise from trauma, disease, inflammation or nerve damage. Pain can be classified in various ways. Duration wise, it can be classified as acute and chronic; it is termed chronic when lasting for more than three months. There are different known types of pain and these include breakthrough pain, bone pain, nerve pain, phantom pain, soft tissue pain and referred pain.
Pain perception is determined by a persons’ genetics, personality, emotional build, lifestyle and the memory of past experience. The need for pain control medications can be significantly reduced with the help of relaxation, meditation, deep breathing, music therapy, yoga and tai-chi, positive thinking and mind-body techniques which combine imagery with relaxation as well as biofeedback. Such mind-body techniques include altered focus, dissociation, sensory splitting, mental anesthesia, mental analgesia, pain transfer, time transfer, symbolic and positive imagery, and counting. These strategies can be used for about half an hour, thrice a week. It is best to take professional help to get started with such techniques.
Physical therapy and occupational therapy can help with both acute and chronic pain. Simple, everyday activities like walking, swimming, gardening and dancing can ease some of the pain directly by blocking pain signals to the brain and also by stretching and relaxing stiff and tense muscles, ligaments and joints. Hypnosis, joining pain counseling groups, sharing experiences, and meeting with family and friends also helps to reduce the burden of pain perception. Spiritual help may also help to cope up with chronic pain.
Diluted essential oils can be used for local application as well as for inhalation to relieve various pains such as headache, toothache, muscular sprain, arthritis and neuropathic pain. These oils include lavender, rosemary, peppermint, eucalyptus, cloves, and capsaicin. Ginger and turmeric powder can be used both orally as well as for local application. Fish oil taken orally has also demonstrated good pain control.
Therapeutic massage can be used for pain relief since it relaxes muscles, ligaments, tendons and joints and helps reduce inflammation. The application of cold press and ice, as well as heat application also helps in a similar manner. Cold applications are usually used within the first 48 -72 hours, after which heat application is more beneficial. Both are used for about 20-30 minutes 2 or 3 times daily. Neurostimulation can also be used for pain control; these include TENS, spinal cord stimulator, acupressure and acupuncture.
It may be necessary to use pain control medications to control and treat acute pain, and also in some instances of chronic pain. These medications include non-steroid anti-inflammatory drugs, muscle relaxants, analgesics, antidepressants and neuromodulators. The most commonly used over-the-counter drugs are NSAIDs such as paracetamol, aspirin, ibuprofen, etc. Drugs should be used preferably with professional medical advice. If these do not work, doctors may use more potent analgesics, steroids, local injections, or give surgical advice.
Certain lifestyle changes can relieve pain. For the obese or overweight people, the best recommendation is to reduce some weight. People who eat a balanced diet, drink plenty of water, get enough sleep and manage stress levels may be less likely to have chronic pain.
Ayurvedic pain management is a complete system which includes different modalities like medications, snehan, swedan, blood-letting, agnikarma, vedhan, basti, localized treatments, and mind control. These will be discussed elsewhere.
In this way, people affected with chronic pain can use a combination of relaxation, medicines, local applications, diet, exercises and mind-body techniques to treat their pain on a long term basis. An accurate diagnosis by a qualified and experienced medical practitioner is a must. Likewise, it is best to take professional help for handling acute pain and for planning long term treatment, and long term pain management. What works best for one person may not work for someone else; also, different stages of pain-causing diseases may require different management in the same individual. However, it is an established fact that regular adherence to an effective pain management programme can significantly reduce and treat pain.
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