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Pain Management

The main causes of pain include medical conditions (such as cancer, arthritis and back problems), injuries and surgery. Sometimes, the cause of the pain can't be found or there are no available treatments for it. In other cases, the cause may be remedied, but the associated pain lingers on.

Chronic pain is defined as pain that persists for longer than three months. At any given time, up to one third of people are in pain. Management strategies include pain-killing medications, and complementary therapies (such as acupuncture and massage). Studies suggest that a person's outlook and the way they emotionally cope with chronic pain influence their quality of life. It has been shown that people who learn self-management skills lower their levels of felt pain. It is important to learn these skills, and to deal with the associated stress and depression in constructive ways.

The epidemiology of pain

A study in 1986 found that certain groups are more likely to suffer chronic pain than others. The findings of this study were similar to research findings from other countries. Selected statistics include:

  • The incidence of pain rises with advancing age.
  • Women are more likely to be in pain than men.
  • The most commonly reported pain is back pain.
  • The most severe pains include those of the back, head, neck and leg.
  • The pain is constant for around one fifth of people.
  • The cause is unknown in around one third of cases.
  • One fifth of cases were caused by work-related accidents.
  • Most people surveyed had suffered chronic pain for longer than three years.
  • Seven out of 10 people sought professional help.
  • The most common source of professional help was the family doctor (80 per cent).

Pain-killing medications

The type of medication you are prescribed depends on your pain. The issues you need to discuss with your health care professional include: the location, intensity and type of pain; which activities ease or exacerbate it; the impact your pain has on lifestyle factors, such as appetite and quality of sleep. Medications for chronic pain are best taken regularly. If your pain is well managed, you are less likely to take large doses of painkillers, and the risk of side effects is reduced.
The medications available for the management of chronic pain include:

  • Aspirin and aspirin-like drugs
  • acetaminophen
  • Opioid drugs, such as codeine and morphine
  • Local anaesthetics.

Long term use of some medications can have side effects which affect a person's quality of life. They may also lose their ability to reduce pain. Some studies have shown that medication can undermine the value of developing self-management skills. This occurs because the person believes they are coping better with pain due to the medication, not because they may have learnt effective coping skills.

Complementary therapies

Numerous studies have found that certain complementary therapies are effective in pain management. Some of these therapies include:

  • Acupuncture - a component of traditional Chinese medicine. Acupuncture involves the insertion of slender needles into specific points on the skin.
  • Massage - better suited to soft tissue injuries and should be avoided if the pain originates in the joints.
  • Relaxation techniques - including meditation and yoga.
  • Transcutaneous electrical nerve stimulation (TENS) therapy - a minute electrical current is passed through the skin via electrodes, prompting a pain-killing response from the body.
  • Cognitive-behavioral therapy - this is a process of learning to change how you think and, in turn, how you feel and behave about pain. It is part of a process of self-management of chronic pain.

Carpal tunnel syndrome/repetitive stress injuries

What is Carpal tunnel syndrome?

According to the Bureau of Labor Statistics, 60% of all work-related injuries are repetitive stress injuries. Many of us spend hours chained to a workstation, diligently typing away with our hand clamped around a mouse. All of those repetitive movements without a break can leave your hands, wrists, arms, and shoulders in tense, knotted ruins. Unfortunately, most guys would rather live with the pain than admit to being sore after a typing workout. Repetitive stress injuries shouldn't be ignored, however, and can be easily avoided.

Who is at risk for Carpal tunnel syndrome?

Power tools, assembly lines and keyboards are the leading causes of repetitive stress injuries and carpal tunnel syndrome. Women are more likely to get carpal tunnel syndrome than men, but that doesn't mean that guys don't get it: Men are most likely to get repetitive stress injuries in middle age. If your job requires repetitive, forceful, awkward or stressed motions with your hands and wrists, you're at risk. Buzzing power tools like chippers, grinders, chain saws, and jackhammers can cause a lot of damage. Being hunched over a keyboard can hurt your wrists, shoulders, back, and eyes.

What are the symptoms of Carpal tunnel syndrome?

The carpal tunnel is a small pipeline in your wrist that houses the median nerve, which sends and receives signals to and from the thumb, index finger, middle finger, and half of the ring finger. When the tunnel gets inflamed or irritated, it pinches the nerve, causing tingling, numbness, weakness or pain in the fingers.

What are the solutions for Carpal tunnel syndrome?

If you have pain in every finger but your little finger, chances are you have carpal tunnel syndrome. The nerve that connects to the little finger takes another route back to your brain and isn't affected when the tunnel contracts. Your doctor will look for that sign and others, and may perform an electromyogram.

The procedure isn't as scary as it sounds. A tiny needle electrode is inserted into the muscles to measure electrical activity. Using this procedure, doctors can determine whether there is any muscle damage. Your doctor can also test the conductivity of the median nerve by transmitting a tiny electrical impulse through it.

Wrist splints, worn at night, are a great way to give the carpal tunnel some relief, and they are usually the first method of treatment. NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen can also help, and corticosteroids can be injected near the carpal tunnel to decrease inflammation. If those treatments don't work, surgery may be your best option. A surgeon may decide to use any number of techniques to take the pressure off the median nerve.

Next Steps:

While you may find this medical information useful, as the next step we strongly recommend that you make an appointment to see one of our physicians to ensure that your health issues are properly addressed.

To schedule an appointment with our physicians, please call our patient coordinator at 1-212-679-9667, send the form below or an email to: info@patientsmedical.com. We are currently accepting new patients and look forward to being of assistance.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, NYC, New York, NY 10017.

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Article Last Updated: 08/26/2015