Managing pain can range from the very simple, such as using over the counter medications for a mild headache, through to being complex and involving multiple medical and allied health professionals. About one in five GP consultations are for managing pain.
There are lots of ways of categorising types of pain but a very simple way is to break it down into 3 types:
- Acute
- Chronic
- Cancer pain (a topic for another day).
Acute pain lasts for a short time following surgery or injury. The vast majority of the time it improves as the body heals. Occasionally, acute pain that is untreated or under treated can become chronic. Chronic pain lasts beyond the time that the body has healed after surgery or injury, but it can also occur for no clear reason. It can be the symptom of illness or it may be the illness itself when the central nervous system becomes dysfunctional.
Managing simple acute pain such as a sprain, strain or a headache associated with a cold can be done safely at home by following a few simple measures. Non-drug strategies such as Rest, Ice, Compression, Elevation (RICE) and physiotherapy are very helpful for simple injuries. Medicines that may help are simple painkillers like paracetamol (Panadol), which is very safe when taken as per instructions. Anti-inflammatories such as Ibuprofen can be used as well. Care must be taken with these as they could cause problems when combined with some prescription medications, such as blood pressure pills and also for some medical conditions such as asthma, heartburn and kidney problems. If you have any concerns, talk to your doctor or pharmacist. If you are unsure of the cause of your pain or it is lasting beyond a few days a check up is a good idea.
Acute pain after surgery or serious injury may require strong painkillers, such as morphine or oxycodone for a short period. Good pain control early reduces the risk of the pain becoming chronic. When used appropriately, these are very effective and the risk of addiction is low, however they require close monitoring by your doctor.
Chronic pain is a much more complex issue. The mainstay of managing it is to have a good relationship with one GP. It becomes very difficult when care is fragmented across different surgeries or doctors. Whilst medications play an important role here, there are non-drug interventions that are vitally important to successfully living with chronic pain. This may involve visits with a psychologist and other allied health professionals to develop positive coping skills, as well as getting advice on practical tips for daily activities. The aim of successful chronic pain management is to be able to manage daily activities without needing any or minimal strong painkillers.
In summary if the pain is acute and the cause is obvious, self-management with non-drug and simple pain medications is a reasonable course of action.
If the pain persists or the cause isn’t obvious it’s time to see your friendly GP for advice. If your pain is chronic find a GP that you are comfortable with, stick with them and be open to the idea of the many proven non-drug interventions available.
This article has been written by Dr Phillip Marmion
