Men's Health

Treating Pain

Written by Mark Abell

Pain is pain. Period. While there is not yet an instrument to be used in medicine that will measure pain, we treat pain as being real until proven otherwise. Pain is a "subjective" complaint in that health care workers are forced to consider pain, as stated by a patient, as being real. It hurts. The idea of treating pain is not so much in terms of why the pain is there, but rather what actually is causing the pain and how we can effectively treat the real problem. Sometimes, however, we fall into a situation where there is no real "reason" for the pain, and that is a whole different issue; we treat those patients differently. This article is intended to discuss "acute" pain and not "chronic pain". The approach to treating chronic pain, as in pain that is relentless and does not seem to "go away" with conventional treatment (i.e., medications, exercise, physical therapy, etc.) is left to the chronic pain clinics.

Acute pain occurs when something "out of the ordinary" has occurred and there is pain, as in when a child falls from a bicycle, lands on his knee, and gets hurt. The child screams because there is a "burning sensation" on the scrape and the child is scared. Nothing matters anymore except to find the quickest way to get mother's attention. So, what do we do about this kind of pain, and how do we comfort the child who is screaming, kicking, and reaching out to mother for help? How do we treat the person who bumped his elbow against a kitchen cabinet and finds that his elbow is red, swollen, and painful? How do we treat the pain from a sprained ankle?

The trick to treating "mild" pain, as in the examples above, is to first do our best to ensure that nothing more serious is wrong. For example, if the little boy who fell from the bike comes running in the house with nothing more than a scraped knee and screams because of the pain, then the injury is probably not severe. However, if there is any question (whatsoever) in the mother's mind as to the extent of the injury (i.e., broken bones, deep cut or laceration, etc.) then it would be best that the boy be taken to a clinic or even an emergency room where the injury can be assessed further. When in doubt, don't allow yourself to make the decision. Pain associated with a small scrape, however, need only be cleaned (thoroughly with betadine or warm water) and then inspected for any further injury which might not have been as apparent before the blood was removed. Applying ice to the injury for the first couple of hours will help reduce the pain as well as help bring down the swelling, which will also aid in pain relief. The same can hold true for other types of "superficial injuries".

Now, for the rest of the story. Pain is caused by the release of many "substances" in the body, one of which is prostaglandins. Other things, such as histamines, kinins, etc., are also released which tend to increase the swelling and warmth of the area, but prostaglandins are mainly responsible for the complaint of "pain". The idea, then, would be to reduce the affect as well as the "amount" of prostaglandins, which is what many of the drugs, which are available over-the-counter, do for us. For instance, let's consider Motrin (or Ibuprofen). This medication, or drug, is called a non-steroidal anti-inflammatory drug, or NSAID. It works by reducing the "synthesis" (production) and release of prostaglandins, which cause pain. In order for the medication to work, however, it must be used as designed. Okay, here goes.

Ibuprofen (Advil, Motrin, and the like) is to be taken at least three times a day (with food); the drug lasts about 8 hours in the blood stream; after that, it is "removed from the blood" by the liver and the kidneys. It doesn't last forever. Taking "one" pill is not going to do much good for you since there isn't enough medicine in one pill to do what it is designed to do. If you are in pain, meaning there is a dull, aching, uncomfortable "sensation", as in a joint (arthritis) or on the surface of the body (as in a scrape), you should start to take the Ibuprofen once every eight hours for a couple of days (unless you have a history of ulcers in the stomach). Along with the medications, try to elevate the extremity (leg, or arm), apply ice to the area twice or three times a day, and keep the area clean and dry.

Many of us stay tuned to television - and therefore we are bombarded with commercials about pain medications - amongst other things. Well, Tylenol (or acetaminophen), while it has a place in medicine, does not reduce pain caused by "inflammation". Acetaminophen is a good drug, and should be used for "non-inflammatory" pain, fevers, and for people who cannot tolerate aspirin or Ibuprofen. It will not do much good for the type of pain caused by a "bumped elbow" which has become red, warm, and swollen, and you will be throwing your money away. Tylenol does work, however, and has some good uses, if used correctly. Remember, however, that Tylenol can be dangerous if overdosed (as with a good deal other medications); Tylenol is toxic to the liver if a person gets more than six grams a day (each tablet contains anywhere from 325 to 1000 milligrams - 1000 milligrams equals one gram), and the effects can be fatal. Use it when appropriate, but watch the amount.

There are literally hundreds of sites on the WWW which deal with the treatment of pain; some of them are for the promotion of products to use. I searched "Pain" and "Acute Pain" - try it.

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