How to cope with acute pain

Pain is a defense reaction of the body.Without it, a person would not know about an illness, injury, burn or frostbite and could easily be crippled or even die.But despite such an obvious benefit of pain, most people prefer not to face it or at least get rid of it as soon as possible.In this article we will tell you why pain occurs and what it can be, how to treat and prevent it correctly, as well as - in which cases you need to immediately run to the doctor.

Pain is considered the most common reason for seeking medical help. It can be acute or chronic and arise for different reasons.

Acute pain develops in response to inflammation or tissue damage due to irritation of nociceptors (peripheral pain receptors). Chronic pain is the result of long-term, ongoing tissue damage. It can also be caused by a malfunction of the central or peripheral nervous system, in which case doctors speak of neuropathic pain.

Other differences in pain:

• Acute - often associated with sympathetic nervous system hyperactivity and anxiety. It may be accompanied by increased heart rate, increased respiratory rate, increased blood pressure, profuse sweating, and dilated pupils;
• chronic - vegetative manifestations usually come to the fore. Patients may complain of constant fatigue, depression, depression, anxiety, loss of appetite, decreased libido.

The ability to tolerate pain varies greatly from person to person, so its severity does not always correspond to the degree of damage.

How and why does pain occur?

In the human body there are many pain receptors - somatic and visceral. Somatic receptors are located in the skin and subcutaneous fatty tissue, periosteum, joint capsules, fascia and other connective tissue structures. Their irritation provokes the appearance of localized pain - sharp or dull (but not burning!).

Visceral receptors are located in most internal organs and their surrounding connective tissue. If the hollow organ is overstretched, the pain may be widespread, deep, sometimes contraction-like or projected to distant areas of the skin surface. If the capsule of the organ is damaged, the pain syndrome becomes more “delineated” (the patient can indicate the place of greatest pain) and acute.

The main causes of acute pain:

• dental -dental caries, pulpitis, periodontitis, tooth trauma, flux, hypersensitivity of teeth, improper eruption of wisdom teeth, gingivitis and periodontitis. Sometimes the pain is reflected - for example, in inflammation of the paranasal sinuses, inflammation of the trigeminal nerve (neuralgia) or even myocardial infarction, a person has tooth pain;
• headache - tension headache, cluster pain or migraine. However, the head can also hurt against the background of other diseases (secondary headache) - acute respiratory viral infections and influenza, sinusitis, meningitis, increased blood pressure, vascular disorders, trauma, aneurysms, brain tumors, alcohol abuse, sleep deprivation and poor diet, problems with the cervical spine, stress and anxiety, taking certain medications (including painkillers);
• muscle pain - sprains and tears, muscle spasm, hypertonus, inflammation (myositis), fibromyalgia, neuralgia, cramps on the background of magnesium and potassium deficiency, side effects of some drugs (e.g. statins), growth pains in children;
• back pain - osteochondrosis, protrusion and intervertebral hernia, sciatica, intercostal neuralgia, fatigue, muscle strains, back injuries, vertebral dislocation and fractures (eg, compression), myositis, gastritis, kidney inflammation (pyelonephritis), renal colic, gynecological diseases, painful periods, pneumonia. Please note: the cause of constant (including night) back pain can be metastases to the spine or primary tumors (kidneys, bronchi, lungs, stomach, pancreas);
• abdominal pain - infections, inflammatory diseases of the digestive tract, peptic ulcer disease, intestinal or renal colic, tumors, algodismenorrhea (painful menstruation), bowel obstruction, diseases of the female genital system, ectopic pregnancy, vascular disorders (mesenteric thrombosis, abdominal aortic aneurysm), psychogenic pain, irritable bowel syndrome, allergies or intolerance to certain foods (e.g., lactase deficiency);
• chest pain - heart attack (angina or myocardial infarction), intercostal neuralgia, digestive problems, pleurisy, pneumonia, inflammation of the lungs, inflammation of the bone and rib joints, problems with the thoracic spine.

Independently determine the source of pain is not always easy (if we are not talking about an obvious cause - for example, trauma), so when it appears, it is very important to see a doctor in time. For example, myocardial infarction can manifest itself with pain in the lower jaw, left shoulder or even the shins - and a person far from medicine (and sometimes even closely familiar with it) is difficult to link the place of pain with its cause. And late diagnosis and lack of treatment can lead to very sad consequences.

How to cope with pain - the main methods of treatment

Analgesics are used to treat acute pain (toothache, headache, etc.). Usually these are drugs from the group of non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol (analgesic-antipyretic). They are often lumped together in the group 'Non-opioid analgesics'.

Analgesic drugs (for back pain, toothache, headache or muscle pain) are represented by tablets, capsules, injections, “ointments” (gels or creams), as well as granules for the preparation of oral suspension. The most popular NSAIDs are:

• ibuprofen;
• nimesulide;
• diclofenac;
• dexketoprofen;
• naproxen;
• ketorolac;
• meloxicam;
• celecoxib.

Paracetamol has a very weak anti-inflammatory activity, so it is considered an analgesic-antipyretic, but sometimes it is also referred to the group of NSAIDs (such information can be found even in the medical literature).

On the Internet, it is very common to wonder how to relieve pain and what medications to take first. To the most “conditionally safe” painkillers can be attributed paracetamol - according to indications, it is allowed for pregnant and lactating women, as well as children (in the form of a solution for infusion - from birth, and in the form of oral suspension - from 3 months).

Next comes ibuprofen. It is usually well tolerated, infrequently shows side effects (if the doctor's recommendations and instructions are followed) and is effective for many different types of pain - headache, toothache, muscle pain, algodismenorrhea (painful menses) and rheumatic diseases.

The pharmaceutical company Sanofi produces a whole line of preparations based on ibuprofen:

• Ibalgin (200 and 400 mg tablets, gel and cream);
• Ibalgin Forte (400 mg tablets);
• Ibalgin Duo (tablets - ibuprofen + caffeine; cream - ibuprofen + heparin);
• Ibalgin Express (400 mg capsules);
• Ibalgin Junior (oral suspension);
• Ibalgin Rapid (400 mg tablets).

Ibalgin Forte 400 mg, 12 tablets, Sanofi

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Ibalgin Express 400 mg, 10 capsules, Sanofi

7.30 €

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Ibalgin gel 5% 100 g

11.20 €

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Ibalgin cream 100 g

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Ibalgin Duo Effect Cream 100 g

15.10 €

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Diclofenac was previously called the “gold standard” of rheumatology. Indeed, it has a pronounced anti-inflammatory and analgesic activity. But the side effects of this drug manifests much more often than other NSAIDs. To date, in rheumatic diseases, it is actively replaced by meloxicam and celecoxib.

Nimesulide is a powerful nonsteroidal anti-inflammatory drug, but it can be used only as a second-line drug - when other analgesics are ineffective.

Meloxicam and coxibs (including celecoxib), as mentioned above, are widely used for rheumatic diseases and problems with the musculoskeletal system.

What is the correct way to use NSAIDs?

NSAIDs are divided into two groups - non-selective COX inhibitors (for example, ibuprofen, naproxen) and selective COX-2 inhibitors (celecoxib). The risk of side effects is lower with the second group, but it is there nonetheless. All nonsteroidal anti-inflammatory drugs can damage the mucous membranes of the digestive tract, cause ulcers and bleeding.

General rules for the use of NSAIDs:

• the drug should be taken in the minimum effective dosage in a short course;
• if there is no effect, the minimum dose can be carefully increased to the maximum safe dose - if relief does not occur, the drug should be canceled and another NSAID should be tried;
• if prolonged therapy is necessary, as well as patients from risk groups (e.g., peptic ulcer disease or bleeding in the past), it is better to give preference to selective COX-2 inhibitors (coxibam);
• in case of severe pain, analgesia is started with injections of NSAIDs (1-2 days) and then transfer the patient to tablets, capsules or oral solution;
• in case of bruises, sprains, osteoarthritis, treatment is started with topical forms (e.g. gels or creams);
• all non-steroidal anti-inflammatory drugs (including coxibs) should be used with caution in patients with renal impairment;
• long-term treatment with NSAIDs requires mandatory monitoring of general and biochemical blood tests, electrolyte balance, and periodic stool analysis for hidden blood is also recommended.

Antispasmodics

These drugs relax the smooth muscles of internal organs - gallbladder, bladder, ureters, intestines, uterus, and blood vessels. They are effective for kidney and liver colic, intestinal spasms, painful periods, tension headaches.

Popular antispasmodics are drotaverine and mebeverine.

Anticonvulsants

Anticonvulsants, namely gabapentin and pregabalin, began to be widely used in neurology over the past decades. But while earlier doctors mainly prescribed them for epilepsy, now they are the main tool in the fight against neuropathic pain.

Anticonvulsants are effective for pain caused by diabetic and alcoholic polyneuropathy, trigeminal neuralgia, postherpetic neuralgia, fibromyalgia (muscle pain), and restless legs syndrome.

In addition, doctors recommend them for certain types of chronic pain (for example, against the background of radiculopathy, multiple sclerosis) and hyperalgesia (increased pain sensitivity).

Opioid analgesics

Opioid analgesics are narcotic analgesics that can be used for both acute and chronic pain. They include butorphanol, morphine, fentanyl, oxycodone, hydromorphone.

The main indications for the use of opioid analgesics are:

• acute pain (for short-term therapy only!);
• pain syndrome in oncologic diseases;
• end-of-life pain (relief of symptoms of a dying patient).

They are also used as part of palliative care.

Alternative methods of pain management

Alternative methods of pain management are commonly used for back pain as well as headaches and muscle pain. These include:

• massage;
• acupuncture (acupuncture);
• percutaneous electrical stimulation;
• physical therapy treatments (e.g., magnet therapy, electrophoresis);
• yoga and stretching;
• behavioral-cognitive therapy;
• meditation and breathing techniques;
• heat and cold therapy.

In severe pain syndrome (in diseases of the joints and spine), doctors may use invasive methods - blocks and ablations of nerves, injections into the joints, epidural injections, stimulation of peripheral or spinal nerves.

Folk remedies for pain

Folk methods of pain relief have fewer contraindications and side effects, but still with them you should also be careful not to aggravate the disease.

Popular “folk analgesics”:

• herbal decoctions and infusions (chamomile, Ivan tea, willow bark);
• compresses - warm for muscle spasms, cold - for bruises and sprains;
• dry heat - for intercostal neuralgia;
• inhalations with essential oils - lavender oil reduces tension headaches (but only if the normal tolerance of the aroma);
• baths - with sea salt or decoctions of relaxing herbs;
• deep breathing;
• self-massage and others.

However, with some “folk analgesics” need to be very careful - for example, with homemade rubs (turpentine and others). Unfortunately, in folk medicine and still meet such recipes from which any medical expert would be horrified. Therefore, we strongly recommend that you do not use dubious “Internet medicine” or the advice of friends, and fulfill the appointment of a doctor.

When should I consult a doctor?

Although pain is a very unpleasant symptom, it is not always necessary to go to the doctor. For example, with occasional headaches or painful menstruation is enough to take an analgesic, with a bruised leg - to apply a cold compress, and with a sore throat - to suck a therapeutic lollipop and drink warm tea.

But if the pain is increasing or becomes constant, lasts a long time or bothers you at night, prevents you from sleeping - youneed to see a doctor. And the sooner the better. The doctor will conduct a detailed examination (blood and urine tests, ultrasound, radiography, FEGDS, colonoscopy, CT or MRI, other studies), which will help to establish the correct diagnosis.

Pain prevention

To prevent pain is easy and difficult at the same time. In order not to be bothered by anything - it is necessary not to be nervous, not to be sick and not to be injured. But in life it usually does not work out that way. Still, physical activity, regular exercises, proper dental care, balanced diet, weight control, protection from injuries, adequate rest and timely treatment of diseases will help to maintain health and prevent unpleasant sensations.

Be healthy and enjoy life without pain!