Pain and pain management

Pain is more than just a feeling of discomfort. It can affect the way you feel overall. It may also lead to mental health conditions like depression and anxiety. The amount of pain you experience can tell your doctor a lot about your overall health.

Acute pain happens suddenly, usually in a matter of days or weeks. It tends to resolve within a few weeks. Chronic pain is ongoing. Some guidelines consider pain to be chronic when it lasts beyond three months. Others say pain is chronic when it lasts longer than six months.

Pain-relief methods range from at-home treatments and prescriptions to over-the-counter (OTC) medications and invasive procedures like surgery. Pain relief doesn’t usually happen overnight, but it can. Each person’s pain experience is unique to them.

To treat the source of chronic pain, you may need to visit your doctor. Use this easy scale to help you describe your pain so you can get the relief you need.

There are two main types of pain: nociceptive and neuropathic.

Nociceptive pain is a nervous system response that helps protect your body. It makes you pull your hand back from a hot stove so you don’t get burned. Pain from a sprained ankle forces you to rest and give the injury time to heal.

Neuropathic pain is different, because it has no known benefits. It may be a result of misread signals between your nerves and brain or spinal cord. Or it could be because of nerve damage. Your brain interprets faulty signals from the nerves as pain.

Examples of neuropathic pain type include:

To get effective pain relief, you first need to find the source of the pain. Learn what causes the most common type of pain.

Make an appointment with your doctor if your pain:

  • hasn’t gone away after two to three weeks
  • is causing you stress, anxiety, or depression
  • prevents you from relaxing or sleeping
  • stops you from exercising or participating in your normal activities
  • hasn’t improved with any of the treatments you’ve tried

Living with chronic pain can be emotionally and physically challenging. Many types of treatments can help you find relief.

OTC pain relievers like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) are available to buy without a doctor’s prescription.

NSAIDs block substances called COX-1 and COX-2. They relieve pain related to inflammation.

These drugs are helpful for conditions like:

Common NSAIDs include:

  • aspirin
  • ibuprofen (Advil, Motrin)
  • naproxen (Aleve)

Take only the amount of pain reliever recommended on the package. Using too much of these drugs can increase your risk of side effects. These can include:

  • kidney injury
  • excessive bleeding
  • stomach ulcers

Learn more about NSAIDs, their side effects, and how they work.

You can’t buy some stronger pain relievers over the counter. Certain NSAIDs, such as diclofenac (Voltaren), are only available with a prescription from your doctor. The selective COX-2 inhibitor, celecoxib (Celebrex), is also effective for treating inflammation-related pain. It’s available only with a doctor’s prescription.

Stronger opioid drugs, like hydrocodone and oxycodone, treat more severe pain, such as from surgery or a serious injury. These medications are related to the illicit drug opium. They tend to produce a euphoric effect while they relieve pain.

Opioids can be risky, as they’re very addictive. They create a pleasurable feeling that some people want to replicate over and over again, all while causing tolerance and need for higher doses to achieve the same effect.

A few other prescription drugs are also known for their addictiveness. They should be used with caution as well. Here are the most additive prescription drugs on the market.

Corticosteroids work by suppressing, and thus reducing, the immune system’s inflammatory response. By reducing inflammation, these drugs also relieve pain.

Doctors prescribe steroids to treat inflammatory conditions, like inflammatory arthritis. Examples of steroid drugs include:

Corticosteroids can cause side effects like:

  • weight gain
  • osteoporosis
  • difficulty sleeping
  • mood changes
  • fluid retention
  • high blood sugar
  • increased risk for infections

Taking the lowest possible dose for the shortest period of time can help prevent side effects. Also be wary of these potential drug interactions when you take a corticosteroid drug like cortisone.

Opioids are powerful pain relievers. Some are made from the poppy plant. Others are produced in a laboratory. Those are called synthetic opioids.

You can take opioids to relieve acute pain, like after surgery. Or you can take them longer term to manage chronic pain.

These drugs come in immediate-release and extended-release formulas. Sometimes they’re combined with another pain reliever, like acetaminophen.

You’ll find opioids in products like:

Although opioids may be highly effective, they’re also very addictive. Misuse can lead to serious side effects or an overdose and possibly death.

Follow your doctor’s directions carefully when taking these medications. Learn what other precautions to take when using opioids.

Antidepressants were designed to treat depression, but they also help with chronic pain from certain conditions, like migraine and nerve damage.

Doctors still don’t know exactly how these drugs work to relieve pain. They might reduce pain signals by acting on and increasing activity of chemical messengers called neurotransmitters in the brain and spinal cord.

Doctors prescribe a few different antidepressant classes to treat pain:

Antidepressants can cause side effects such as:

  • drowsiness
  • difficulty sleeping
  • nausea
  • dry mouth
  • dizziness
  • constipation

Report any side effects to your doctor. If they continue, your doctor can adjust the dose or switch to another antidepressant.

Drugs that treat seizures also do double duty by relieving nerve pain. Nerves damaged by conditions like diabetes or shingles and nerves that are oversensitized like in fibromyalgia overreact and send too many pain signals.

Doctors don’t know exactly how anticonvulsants work against pain. They believe these drugs help block abnormal pain signals between the damaged nerves and the brain and spinal cord.

Examples of antiseizure drugs that treat pain are:

Some of these drugs cause side effects such as:

  • nausea and vomiting
  • drowsiness
  • headache
  • dizziness
  • confusion

Antiseizure drugs might also increase the risk of suicidal thoughts and suicide. Your doctor will monitor you for side effects while you take these medications.

An ice pack or hot compress is an easy way to relieve minor pain. The question is, which one should you use?

Cold therapy narrows blood vessels. This reduces inflammation and swelling and numbs pain. It works best right after an injury or during a flare-up of a painful condition, like gouty arthritis.

Heat therapy works by increasing blood flow to the injured area. This relaxes tight muscles. It comes in two forms: dry heat from a heating pad or pack, or moist heat from a warm wet washcloth or bath. Use heat for pain that’s lasting more than a few weeks.

Apply heat or cold for about 15 minutes at a time, several times a day.

Use caution if you have diabetes or another condition that affects your circulation or ability to feel pain. Here are a few other reasons to avoid hot or cold therapy.

When you’re in pain, you might be tempted to take it easy until the soreness goes away. That’s why doctors used to recommend rest for people in pain. Yet newer research suggests otherwise.

A 2017 review of studies suggests exercise is an effective way to ease pain. It may also improve physical function and quality of life. Moreover, exercise causes only a few side effects, aside from muscle soreness.

Researchers do note many of the studies on exercise for chronic pain are of poor quality, but point out the overall research does suggest physical activity can reduce the severity of pain.

Aerobic exercise also promotes weight loss. This could take some of the strain off painful joints if you have osteoarthritis. Resistance training might help your body heal injured spinal discs. Here are a few of the other ways exercise can help you feel better.

Physical therapy (PT) combines exercise with hands-on manipulation and education. Experts prefer PT over prescription pain pills. This is because it can reduce pain without medication side effects and the potential for addiction.

A physical therapist will work with you to improve your strength and flexibility so you can move more easily. PT sessions can also help relax tight muscles and improve your tolerance to pain.

Some of the painful conditions physical therapy can help with are:

  • arthritis
  • fibromyalgia
  • postsurgical pain
  • nerve pain

Yoga combines poses with deep breathing and meditation. It’s been practiced for thousands of years. Yet only recently have researchers begun to discover yoga’s full potential as a health intervention.

In addition to improving strength, balance, and flexibility, yoga improves posture. Better posture can bring relief from many of the aches and pains linked to muscle tension.

Yoga can also relieve pain and improve function in people with chronic conditions like arthritis, back pain, and fibromyalgia.

How exactly it helps with pain isn’t clear. It may work by triggering the release of natural pain-relieving chemicals called endorphins or by promoting a state of relaxation.

Yoga comes in many styles and intensities. Explore the different practices to see which one is the best fit for you.

Music has the power to move us and transport us back in time. Listening to music could also help relieve pain — in part by reducing stress and helping us cope more effectively with discomfort.

In one small study of people with pain caused by nerve damage, listening to classical (Turkish) music reduced pain scores. The longer participants listened, the more their pain receded.

A 2018 review of more than 90 studies found that listening to music eases anxiety and pain before, during, and after surgery. Listening to music every day could help people with chronic pain conditions like fibromyalgia or arthritis feel more comfortable and less anxious.

During a massage, a therapist uses rubbing and pressure to loosen up tight muscles and tendons and help you relax. The practice could help ease aches by blocking pain signals and relieving stress. Massage generally also soothes tight muscles by improving blood flow to them.

Another upside to massage is its lack of side effects. Unless you have a skin rash, certain types of cardiovascular disease, or infection, there are virtually no risks.

Just check with your doctor first if you have any chronic conditions that might make the experience uncomfortable or less recommended. If so, your massage therapist can modify their technique.

Massage therapists use varying amounts of pressure, from light touch to deep muscle massage techniques. Which one you choose depends on your tolerance and personal preference. Learn about some of the most common types of massage used in the United States.

Chronic pain is a major health issue. It’s one of the most common reasons why adults see a doctor in the United States. Up to 40 percent of Americans live with chronic pain.

Although some pain-relieving drugs can be addictive, there are a number of nonaddictive medications available today. Work with your doctor to find the best one for you.

There’s also a range of nondrug therapies available to ease chronic pain. Interventions like exercise, massage, and yoga can improve quality of life without causing harmful side effects in the process.