Pain is an unpleasant feeling that tells your body you might be injured.
What causes pain?
Injuries, such as cuts, burns, fractures, sprains, and bruises, activate pain receptors around the injury. The pain receptors are on the ends of long nerve fibers. These fibers carry pain signals to your spinal cord. Other nerves in your spinal cord then carry the pain signals to your brain. Only when your brain processes the pain signals do you actually feel pain.
Sometimes your nerves send pain signals even when you haven't been hurt or injured. This can happen when your nerves have been damaged by a disease such as diabetes (called diabetic neuropathy Nerve damage in diabetes People with diabetes mellitus have many serious long-term complications that affect many areas of the body, particularly the blood vessels, nerves, eyes, and kidneys. (See also Diabetes Mellitus... read more ), or when your nerves were crushed or cut by an injury. Pain caused by nerve damage is called neuropathic pain Neuropathic Pain "Neuro-" refers to the brain, spinal cord, and nerves. Neuropathic pain is pain that comes from damage or problems in your nerves, spinal cord, or brain. Neuropathic pain is usually caused by... read more .
Referred pain is when pain from one part of your body is felt in a different part. For example, pain from a heart attack is usually felt in your chest, because that's where your heart is. But sometimes a heart attack causes pain in your neck or jaw, because pain signals from those areas travel along nerves that are near the nerves from your heart.
Anxiety, depression, or sleep problems can make pain more unpleasant than it would normally be.
How do doctors treat pain?
Doctors first treat the problem that's causing your pain. For instance, if you have a broken bone, they'll set it and put on a cast.
They also may give you medicine to stop the pain. Different types of medicine work on different parts of the pain pathway:
Numbing (anesthetic) creams and gels go on your skin to block pain receptors
Numbing shots in your skin or along major nerves block pain signals in those nerves
Pain pills and shots (analgesics), such as opioids and NSAIDs and other non-opioid medicines, affect pain signals all over your body
For neuropathic pain, doctors sometimes have you take an antidepressant Drug therapy for depression A short discussion of prolonged grief disorder. Depression is a feeling of sadness and/or a decreased interest or pleasure in activities that becomes a disorder when it is intense enough to... read more or antiseizure drug Antiseizure drugs In seizure disorders, the brain's electrical activity is periodically disturbed, resulting in some degree of temporary brain dysfunction. Many people have unusual sensations just before a seizure... read more . These drugs affect nerve signals in a way that relieves pain even if you're not depressed or don't have seizures.
What pain treatments don't involve drugs?
Some pain treatments don't involve drugs.
Transcutaneous electrical stimulation (TENS) applies a gentle electrical current to your skin through a small sticky pad. The current tingles but doesn't feel like a shock. It won't eliminate pain, but it can help some people.
Doctors can also apply electrical stimulation to your spinal cord. They implant a small wire electrode around your spinal cord and send signals that interfere with pain signals.
In acupuncture Acupuncture Acupuncture, a therapy within traditional Chinese medicine, is one of the most widely accepted CAM therapies in the Western world. Licensed practitioners do not necessarily have a medical degree... read more , practitioners place small needles in certain parts of your body and remove them after a few minutes. They may apply a small electrical current to the needle. These needles seem to help relieve pain, although doctors aren't sure why.
Special mind techniques such as biofeedback, relaxation training, breathing techniques, and hypnosis can help you cope with pain.
What are opioids?
Opioids are the strongest pain medicines. They’re called opioids because they first came from the opium poppy. Some opioids still come from plants, but many are made in a lab. There are many different opioids, including morphine, oxycodone, fentanyl, and codeine.
Opioids are good for relieving really bad pain, such as from a burn, broken bone, or cancer. But opioids can have serious side effects so doctors try not to use them for less severe problems.
What are the side effects of opioids?
Opioids make you sleepy and relaxed. If you take too much you may:
Become very confused
Stop breathing and die
Many people die each year from accidental opioid overdose.
Other common side effects of opioids include:
Nausea (wanting to throw up)
Constipation (can't poop)
Will I get addicted to opioids?
Opioids make you feel good. Once you start taking an opioid, it can be very hard to stop. That can lead to a substance use disorder Substance Use Disorders The use of some substances causes feelings of pleasure. The pleasure makes you want to keep using the substance. The substances can be legal drugs such as alcohol and tobacco, illegal drugs... read more . One reason it's hard to stop is that you get drug withdrawal symptoms.
Opioid withdrawal can develop even if you take opioids for less than a week. Withdrawal is worse the longer you take the drugs. Symptoms of opioid withdrawal include:
Feeling anxious and jittery
Runny nose and watery eyes
Yawning and sweating
Stomach cramps, nausea, and vomiting
Fortunately, opioid withdrawal won't kill you.
To minimize your chance of developing addiction, doctors:
Use opioids only for pain that can't be controlled with other treatments
Prescribe opioids for as short a time as possible
What are NSAIDs (nonsteroidal anti-inflammatory drugs)?
NSAIDs are pain medicines such as aspirin and ibuprofen. They are not opioids. They relieve pain and block inflammation, such as in joints inflamed from arthritis. Although they aren't as strong as opioids, they're very effective.
What are the side effects of NSAIDs?
Unlike opioids, NSAIDs don't make you sleepy or stop breathing. However, NSAIDs can:
Irritate your stomach and cause pain
Increase risk of bleeding, such as from your stomach or in your brain
Cause fluid retention and kidney problems
Some NSAIDs increase risk of heart attack and stroke
What are other pain medicines?
Acetaminophen (Tylenol®) is a very common pain medicine. It's not an opioid and is about as effective as NSAIDs, but doesn't irritate your stomach or increase risk of bleeding. However, too much acetaminophen can damage your liver.