Everything You Need to Know About Pain

Alternaleaf Team
Written by
Alternaleaf Team
May 20, 2024
Last updated:
May 21, 2024

Pain management has long been a critical focus in healthcare, with the quest to alleviate suffering dating back centuries. Yet, as modern medicine evolved, so too did the approach to pain relief, leading to the widespread use of pharmaceutical painkillers, including opioids. 

However, the alarming rise in opioid addiction and overdose deaths has sparked a reevaluation of pain management practices. 

Let’s delve into the history of pain management, our evolving understanding of pain, and the potential of natural painkillers to offer safer and more sustainable alternatives amidst the ongoing opioid crisis.

Understanding Pain

Pain is a multifaceted sensation that serves as a crucial warning mechanism for the body, signalling potential harm or injury. It comes in various forms, from acute pain resulting from tissue damage to chronic pain persisting beyond average healing time, often lasting for months or even years. 

An Acute History of Pain

Pain management has evolved over centuries, shaped by cultural beliefs, medical advancements, and scientific discoveries. From ancient times to the present day, humanity's understanding and treatment of pain have undergone significant changes.

  • Ancient Beliefs: Early civilisations attributed pain to supernatural forces or divine punishment and sought relief through rituals, herbs, and spiritual practices.
  • Ancient Medical Practices: Ancient cultures, such as the Greeks and Egyptians, laid the groundwork for medical understanding and treatment of pain using primitive surgical techniques and herbal remedies.
  • Renaissance and Scientific Progress: During the Renaissance, a resurgence of scientific inquiry led to significant advancements in medicine and pain management, with the introduction of anesthesia and the exploration of herbal remedies.
  • Modern Medicine: The 19th and 20th centuries witnessed remarkable progress in pain relief, marked by the discovery of analgesic drugs, the development of surgical techniques, and the emergence of specialised fields like anesthesiology and pain management.
  • Contemporary Approaches: In recent decades, a shift towards holistic and multidisciplinary approaches to pain management has gained traction, emphasising personalised care, non-pharmacological interventions, and patient-centred strategies.

Today, pain management encompasses diverse treatments and modalities, reflecting both the rich historical legacy and ongoing innovations in medical science and healthcare delivery.

What Causes Pain?

Pain can come from different places and reasons, such as:

  1. Injury: When you hurt yourself, like getting a cut or breaking a bone, your body's pain sensors react, warning you to be careful and protect the injured area.
  2. Medical Conditions: Some diseases, like cancer, arthritis, or problems with your back, can cause pain as a major symptom. Treating this pain often means looking at the disease itself and finding ways to help you feel better.
  3. Surgery: Even though surgeries are meant to fix problems, they can also cause pain during healing. Good pain management is crucial for helping you recover well after surgery.

Understanding where pain comes from and why it happens helps doctors create plans to help you feel better. Knowing what's causing your pain, they can find the best ways to treat it and improve your quality of life.

Types of Pain

There are two main types of pain.

  1. Acute Pain: This kind of pain happens when you get hurt or have a medical problem. It usually starts suddenly and doesn't last long. Acute pain is like a warning signal, telling your body something's wrong and needs attention.
  1. Chronic Pain: Unlike acute pain, chronic pain lasts for more than three months, even after the injury has healed. It can range from mild discomfort to severe agony and can really affect your daily life. Managing chronic pain requires many different treatments to help you feel better.

Pain can feel different for everyone—it might be a dull ache or a sharp pain, and it can be in one spot or spread out. Knowing how pain feels helps doctors find the best way to help you feel better.

Types of Chronic Pain

Long-lasting pain, known as chronic pain, comes in different forms, each with its own set of challenges and symptoms. Knowing about these different types of chronic pain is vital for finding the best ways to treat and manage them. 

Chronic pain usually falls into three main categories: nociceptive, neuropathic, and nociplastic pain. Sometimes, people may have a mix of these types.

Nociceptive: Pain from Tissue Damage

Nociceptive pain comes from tissue injury or damage. It happens when special nerve endings, called nociceptors, send signals to the brain about potential harm. Chronic nociceptive pain conditions include osteoarthritis, pelvic pain, rheumatoid arthritis, and ankylosing spondylitis.

Neuropathic: Nerve Pain

Neuropathic pain comes from problems with nerve tissue caused by injury or disease. This type of pain makes nerves work differently, leading to abnormal sensations. Conditions causing neuropathic pain include shingles, sciatica, nerve root compression, trigeminal neuralgia, and diabetic neuropathy.

Nociplastic: Pain without Clear Nerve Damage

Nociplastic pain happens when the nervous and immune systems change without clear nerve damage or disease. Conditions causing this type of pain include Complex Regional Pain Syndrome (CRPS), Fibromyalgia, and non-specific lower back pain.

The Many Pain Medications

Most people will need pain relief medication at some point, whether for a sore arm or something more severe like broken bones. Knowing about the types of pain medicines and what they do helps make better decisions about managing pain.

Types of Pain Medicines

  1. Paracetamol: Often the first choice for short-term pain relief, paracetamol helps with pain and reduces fever.
  2. Aspirin: Good for short-term relief from fever and mild to moderate pain, like headaches or period pain. It also fights inflammation.
  3. Non-steroidal Anti-inflammatory Drugs (NSAIDs): Drugs like ibuprofen help with pain and reduce swelling. They're helpful for arthritis and muscle injuries.
  4. Opioid Medicines: Strong pain relievers, like codeine, morphine, and oxycodone, are used for severe or cancer-related pain. They change how the brain deals with pain, but they can be addictive.
  5. Local Anesthetics: These are applied directly to the painful area as drops, sprays, creams, or injections to block pain signals.
  6. Antidepressants and Anti-epilepsy Medicines: Some medicines used for depression or epilepsy also work for certain types of pain, especially nerve pain.

Choosing the right pain medicine involves thinking about a few things:

  • What kind of pain you have, how bad it is, and how long it lasts
  • Your lifestyle and any other health problems you have
  • Any other medicines you're taking

Talking to a healthcare professional can help you find the safest and most effective pain relief.

It's super important to follow the instructions for how much medicine to take:

  • Taking the right amount helps manage pain well and lowers the chance of harmful effects.
  • Keeping in touch with your healthcare provider allows them to check if the medicine is working or if anything needs to be changed.

Pain Medication Side Effects

Most medicines can have unwanted effects, even if you take them just as your doctor recommends.

Here are some common side effects of pain medicines:

  1. Acetaminophen (Paracetamol):
    • Rare but serious side effects may include liver damage or allergic reactions like rash or swelling.
  2. Aspirin:
    • It can cause stomach upset, heartburn, or nausea.
    • Serious side effects may include gastrointestinal bleeding or allergic reactions.
  3. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
    • It may upset the stomach or cause heartburn.
    • Long-term use can lead to gastrointestinal ulcers or kidney damage.
  4. Opioids:
    • Common side effects include drowsiness, constipation, nausea, or dizziness.
    • Opioids can cause respiratory depression, physical dependence, or addiction with long-term use.
  5. Local Anesthetics:
    • It may cause temporary numbness or loss of sensation at the application site.
    • Rare side effects may include allergic reactions or nerve damage.
  6. Antidepressants and Anti-epilepsy Medicines:
    • Common side effects may include drowsiness, dizziness, or dry mouth.
    • Some antidepressants can cause weight gain, sexual dysfunction, or mood changes.
    • Anti-epilepsy medications may lead to dizziness, fatigue, or coordination problems.
    • Serious side effects include suicidal thoughts, allergic reactions, or liver problems (rare).

Knowing about these side effects and talking to your healthcare provider about any worries is crucial for managing pain safely.

Some side effects might go away after you've been taking the medicine for a while. But if you're thinking about stopping your medicines or changing your dosage, you must talk to your doctor or pharmacist first. They can help you understand what to expect.

Some medicines, like opioids, can cause serious side effects at any time, including breathing problems that could be life-threatening.

If you're experiencing side effects that worry you, don't hesitate to talk to your doctor or pharmacist immediately. Every medicine has its list of possible side effects.

The Impact of Chronic Pain on Australians

Chronic pain poses a significant challenge for Australians, affecting a substantial portion of the population:

  • Nearly 1 in 5 Australians aged 45 and above grapple with chronic pain, which adds up to about 1.6 million. 
  • But when you look at the whole population, Chronic Pain Australia says it's more like 3.6 million Australians dealing with chronic pain, making chronic pain the leading cause of disability nationwide.
  • Chronic pain also costs a lot of money. In 2018, it cost about $139.3 billion, and experts say it could reach $215.6 billion by 2050. 
  • Only 1 out of every 100 Australians with chronic pain can get the special care they need to manage it. 

These big numbers show we need to do more to help people with chronic pain, and we need to find better ways to manage it that don't rely so much on solid pain medicines like opioids.

Addressing the Rising Tide of Opioid-Related Harm

Prescription opioids are causing significant problems in Australia. 

  • Between 2007 and 2016, opioid-related deaths surged by 62%, with a corresponding 25% increase in hospitalisations due to opioid poisoning.
  • In 2016–17 alone, over 5,000 emergency room visits and nearly 10,000 hospital stays were attributed to opioid poisoning.
  • Prescription opioids are now causing more harm than illegal drugs like heroin, underscoring the urgency of the crisis.

In response, the Australian Government has taken decisive action:

  • The Therapeutic Goods Administration (TGA) initiated regulatory reforms, including the introduction of smaller opioid pack sizes in February 2020 and modifications to fentanyl indications.
  • Awareness campaigns have been launched to educate both consumers and healthcare professionals about safe opioid use.
  • Public consultation has been integral, with feedback shaping ongoing efforts to combat opioid-related harm.

These measures represent critical steps towards mitigating opioid-related harm and promoting safer prescribing practices, underscoring the commitment to safeguarding public health while ensuring access to essential pain relief.

Managing Pain Without Medicines

There are many ways to manage pain without relying on traditional medicines or opioids. Often, combining these methods can work better than just using one.

Here are some options:

  • Heat or Cold Therapy: Putting ice packs on right after an injury can help with swelling, while heat packs can ease chronic muscle or joint pain and help you relax.
  • Physical Therapies: Activities like walking, stretching, or strengthening exercises can reduce pain, improve your ability to move, and boost your mood. Just make sure to start slowly and gradually increase the intensity to avoid making the pain worse.
  • Massage Therapy: Massages can be helpful, especially for soft tissue injuries. But if your pain is in your joints, it's best to avoid massage therapy. While it might help manage pain, it's usually not recommended as the only long-term treatment.
  • Relaxation and Stress Management Techniques: Practices like meditation, yoga, and deep breathing exercises can help you deal with pain by helping you relax and reduce stress, which can make pain feel worse.
  • Cognitive Behavioral Therapy (CBT): This type of therapy focuses on changing negative thoughts and behaviours related to pain. By teaching you how to think differently about pain and how to respond to it, CBT can help you manage chronic pain better on your own.
  • Acupuncture: Acupuncture is part of traditional Chinese medicine and involves putting thin needles into specific points on your skin to trigger your body's natural pain-relieving systems, like releasing endorphins. Some people find that acupuncture helps reduce their pain and improves their ability to move, but more research is needed to be sure it works for everyone.
  • Transcutaneous Electrical Nerve Stimulation (TENS) Therapy: TENS therapy uses low-voltage electrical currents delivered through electrodes on your skin to help your body produce pain-relieving responses. While it's not clear how well it works for all types of chronic pain, some people who don't get relief from other treatments find it helpful.

It's important to talk to your doctor or healthcare provider to determine which treatments are best for you and your pain. They can help you navigate the many options available and find ways to manage your pain effectively, improving your quality of life.

The Rise of Natural Painkillers

With growing worries about the risks linked to opioid drugs, natural pain remedies have stepped into the spotlight as promising alternatives. These natural solutions, sourced from plants, herbs, and other natural sources, offer an intriguing path for managing pain with fewer side effects and less risk of dependency compared to traditional medicines like opioids.

A number of natural substances have been investigated for their ability to relieve pain. Some standouts include turmeric, ginger, willow bark, and capsaicin. These natural helpers work in different ways in the body, like reducing inflammation, soothing pain, and protecting nerves. By tackling various pain pathways, natural painkillers offer tailored relief for different types of pain, whether it's from inflammation or nerve issues.

Harnessing the Power of Cannabinoids

One exciting area in the world of natural pain relief is the study of cannabinoids, the active substances found in cannabis plants. These cannabinoids, like tetrahydrocannabinol (THC) and cannabidiol (CBD), have grabbed attention for their possible health benefits, including easing pain, all without the addictive qualities linked to opioids.

Studies suggest that cannabinoids interact with the body's endocannabinoid system, a complex network of receptors and chemicals that regulate many bodily functions, including pain and inflammation. By working with these receptors, cannabinoids can help reduce pain and inflammation, promising to relieve discomfort.

What's more, cannabinoids seem to be safer than opioids, with less risk of addiction or overdose. That's why cannabinoids, especially CBD, are becoming popular as alternatives for managing chronic pain. They offer a natural option that might effectively ease symptoms without the downsides of typical pain medicines.

The Role of Healthcare Providers in Pain Management

Good pain management depends significantly on the relationship between patients and healthcare providers. This teamwork involves talking openly, making decisions, and accessing different types of care.

  1. Effective Communication: Patients and healthcare providers must chat openly and honestly about pain. Patients should feel comfortable sharing their worries, goals, and pain experiences, while providers need to listen carefully and offer understanding. Good talks help build trust and ensure everyone's on the same page about treatment.
  1. Shared Decision-Making: When patients and providers make decisions together, it's called shared decision-making. Patients share what they prefer and hope to achieve with treatment, while providers give advice and explain the options. This way, treatment plans fit the patient's needs and make sense for them.
  1. Access to Multidisciplinary Care: Pain is complicated, so it often needs different care types to be managed well. Multidisciplinary care involves a team of various healthcare professionals, like doctors, nurses, therapists, and psychologists. They look at all aspects of pain, including physical, emotional, and social factors, to create a personalised treatment plan. Access to this kind of care means patients get support from various angles, increasing the chances of feeling better and living well.

In short, healthcare providers are crucial for managing pain by talking openly, making decisions together, and offering access to various types of care. By working together and focusing on what's best for the patient, providers help people manage pain more effectively and improve their quality of life.

The Path Forward

In our journey through pain management, turning to natural remedies and holistic methods offers a hopeful way forward. By tapping into the natural healing resources around us and embracing a comprehensive approach to pain relief, we can reduce the dangers linked with opioids. This approach empowers people to lead healthier, more satisfying lives, liberated from the weight of chronic pain.

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