What is the difference between acute and chronic pain?
Pain is an experience that is produced by the brain and we can identify many contributing factors to our pain experience like stress, our environment, injury or joint issues.
Acute pain comes about when pain is prevalent for just a few days or weeks and can occur after an injury or a surgical operation. Repair of damaged tissue causes acute pain as a warning to us, so it is essentially a ‘necessary’ form of pain. It is normal, useful and protects us.
Chronic pain can be classified as pain that continues for three months or more past the initial pain experience. Unlike acute pain, chronic pain may continue beyond the point of healing.
Who can help me to manage my pain?
Treating or managing pain may require a multimodal approach, including medicinal and non-medicinal options. Your pain management team is very personal and unique to you and may require a range of health professionals. These health professionals can include:
- Psychologist to manage the way we think about our pain,
- GP to have a full pain assessment and talk about prescription pain medication
- Physiotherapist/exercise physiologist to help you know how far to push an exercise activity using pacing techniques
- Pharmacist to discuss your pain medication medicine and supplements
- Dietician to optimise your diet and include a range of anti-inflammatory foods
Why do I have pain?
If you are experiencing pain, it is important that you speak to your health professional team to arrange a full and thorough pain assessment. This will better help you understand your pain and its cause.
What can I do if my pain is much worse?
If your pain symptoms start to worsen, it is important you reach out to your health professional team for advice.
How should I describe my pain to my doctor?
It is useful if you keep a record of your personal pain experiences to share with your doctor. Using a pain diary may support you in this. The pain diary is a written record of how your pain impacts your daily activities. It helps you describe to your health professional team how your pain has been affecting you over time. It also records how medicines, other therapies and your activities affect your pain levels throughout the day.
What is the best treatment for the chronic pain?
As our pain experience is impacted by many factors including stress, our environment, injury or joint issues, it is important to take a multimodal approach to treating pain to address all of these different factors. A multimodal approach includes both medicinal and non-medicinal treatment options.
What should I do when I can’t sleep because of chronic pain?
Getting a good night’s rest is critical to better managing your chronic pain. Sleep and rest calm the nerves and can reduce the inflammation that occurs when you have chronic pain. As such, improving your sleep quality can reduce your chronic pain the following day. Below is a list of good sleep hygiene tactics you can try to improve your quality of sleep.
- Stay active during the day
- Having enough to eat during the day is important so that you are not hungry during night, as this can affect your sleep. Some people find having a light snack before bed helps them sleep, however the main meal should be at least 2 hours before bedtime.
- Before bedtime, it is helpful to have a routine. For example, having a wind down time at night that is calming and relaxing is can help to reduce the activity of the nervous system. This could include:
- Having a warm bath
- Switching off all computers and mobile phones
- Refraining from alcohol and caffeinated drinks
- Being in a dimmed room
- Some people get so tired from poor sleep at night that they nap during the day. It is important to keep nap times to about 30 minutes only or 1 sleep cycle. Naps should not occur too late into the evening as that will affect your nights sleep.
If you have tried and cannot fall asleep within 20 to 30 minutes, it is recommended to get out of bed and go to a dark or lowly lit room and continue to calm your nervous system down with relaxing activities until you feel ready to sleep.
If sleep remains a challenge after trying the above techniques, it is important to discuss your sleeping problems with your doctor or pharmacist as they may need to investigate your sleep and check that there are no underlying sleep conditions that require diagnoses and medical treatment.
How do I cope with chronic pain?
How we see our pain changes the way we experience it. Seeking psychological help in managing your pain doesn’t mean that the pain is all in your head. It means that there are psychological things you can do to change the way you see and then experience pain.
Some of the techniques you might learn from discussions with a psychologist or psychiatrist include:
- Cognitive behaviour therapy (CBT) is known to help challenge the way you think to change the way you feel and then behave. This is done by seeing pain as a warning system designed to protect and safeguard the body from potential harm. Learning to see your pain differently and by challenging your beliefs can change your experience of pain.
- Mindfulness is being used with great success in the treatment of chronic pain. By learning to relax and remain grounded in the present moment rather than getting caught up in the future (which can appear hopeless and catastrophic) or the past (which by comparison appears a lot better), you can help reduce the stress contributing to your pain experience.
- Acceptance and Commitment Therapy (ACT) works on developing an acceptance of the pain. Acceptance does not mean giving up or surrendering to being in pain forever, but rather a decision to work alongside your pain rather than against it.
Chronic pain is very complex, so it is best to engage with a range of health professionals to develop the best pain management plan for you.
What are side effects of pain relief medications?
Different medications have different side effects. Some of the side effects can be reduced by taking the medication exactly as suggested and prescribed by your pharmacist and GP. At other times, you may need to speak to your health professionals to decide whether you need to stop the medication, take something else to help reduce the side effects, change the way in which the medication is delivered (for example swap from a tablet to a patch or a cream) or change to a different medication that is better suited to you.
Pain Relief Medication and Alcohol
Should I take pain medication only when I have a lot of pain?
In some instances, it is best to take pain medication on a regular basis. By taking a pain relief on a regular basis, you can stop the rollercoaster experience of pain. For example. If you take pain relief medication and then wait for the pain to come back before taking another dose, this makes it harder to manage your pain. In these situations, it is better to take pain relief regularly, even if you are not feeling pain in those moments, to help reduce the number of times you experience pain overall. This will help you stay active and allow you to participate in daily activities.
Should alcohol be consumed with pain medications?
Alcohol should not be mixed with any medications, including for the treatment of pain. Alcohol can interact dangerously with all medications. Some people have found alcohol to temporarily help them relax, however alcohol can worsen pain in the long run, so it is important that it is kept to a minimum or not consumed at all for people wanting to manage their pain well.
At other times, when pain is generally under control, you may take pain relief every now and again as required. Speak to your pharmacist to find out what is the best plan for you.
Will I be addicted to pain medications?
If you have any concerns about your pain medication, speak to your pharmacist of GP for information and advice.
What if I am addicted to my pain medication?
If you have any concerns about your pain medication, speak to your pharmacist of GP for information and advice.
Other Types of Pain
Why do my joint hurts?
It is important to talk to health professionals if you have pain, acute or ongoing, that is not resolving and is interfering with your daily functions or causing you distress. Your GP can conduct a pain assessment to help you understand your pain better.
It might be useful to keep a pain diary. This pain diary is a written record of how your pain affects your daily activities. It helps you describe to your health professional team how your pain has been affecting you over time. It also records how medicines, other therapies and your activities affect your pain levels throughout the day.
My pain medicine is no longer effective. What can I do?
Different pain medications work for different types of pain so if one is not working then having a medication review will help you work out whether it was the right one for you.
In some circumstances, taking pain medications for an extended period of time can make you get used to the ‘new level of pain’ and then we wonder if the medication is working or not. If you are ever unsure, you can speak to a pharmacist or your GP and gradually wean down and see if there is any increase in pain. You will be surprised that reducing pain relief can also lead to a decrease in pain.
If you have been taking pain medications for a while, it is recommended that you get your medications reviewed by a pharmacist or GP. Your pain needs may need to be reviewed again so that the medication assists with the type of pain you are experiencing.
When do you need to see a doctor for persistent pain?
You should seek help for persistent pain when:
- The pain has lingered for more than three months;
- The pain is not responding to usual simple treatment; and
- The pain is limiting your day-to-day function.
What helps lower back pain from lifting?
When lifting, use your legs and not your back. Hold objects as close to your body as possible and use both arms. See Back Pain section for tips on treating back pain.
How to treat neck and back pain naturally?
Supplements may be useful in some cases and pharmacists have the expertise to recommend the right ones suitable for the type of pain you are experiencing. Whether treating neck and back pain with supplements is right for you will depend on the types of medication you are currently on and what pain you are experiencing.
Some examples of ingredients that may be used in neck and back pain include:
- Willow bark
- Glucosamine and chondroitin
Pain and Nutrition
What are tips on anti-inflammatory foods + the anti-inflammatory diet?
Many common foods in our diet have been found in research to either increase or reduce inflammation in the body. Not surprisingly, the same foods that increase inflammation are generally considered bad for our health, including sugary drinks and refined or simple carbohydrates, as well as red and processed meats. The good news is that foods which we know are healthy, can reduce inflammation in the body.
Foods known to reduce inflammation include:
- A variety of protein foods
Tips for getting more ant-inflammatory foods in your diet:
- Eat a rainbow of colour when it comes to fruit and vegetables – this will give you a wider range of nutrients.
- Include more fish in your weekly shop. Eating oily fish such as salmon twice a week is a great way to get plenty of Omega-3 Fatty Acids and Zinc.
- Include more fresh or dried herbs and spices into your meals. In particularly try to include turmeric, ginger, garlic, onion, pepper, thyme, oregano, rosemary and cloves.
- Aim to have a handful of unsalted raw nuts most days. Variety is key so it may be easy to include a handful of mixed nuts, or almonds one day, brazil nuts the next day, cashews the next, and so on.
- Avoid over-grilling and over-frying food when cooking. The immune system picks up on damaged food particles and initiates the inflammatory response, so try steaming and boiling food where you can.
- Try to Keep caffeine to less than 2 to 3 cups of coffee per day.
- Keep alcohol to no less than 2 standard drinks per day which is around 1 large glass of wine or 2 mid-strength bottles of beer.
- Finally, try to keep your intake of meat to just small portions for e.g. red meat that is around the size of your palm, chicken to your knuckles and fish as big as your hand. Keep cheese to one small portion a day and choose low or no fat milk and yoghurt so that you get the protein and calcium without any of the saturated fat.
Pain and Relationships
My family and friends are always active and happy, and they do not understand my pain and depression. What can I do?
By writing down how you think and feel about your pain can help you develop a better understanding of your pain. For example, you could:
- Keep a pain diary.
- Jot down some notes on a piece of paper
- Write a letter to a loved one about your pain but instead of giving them the letter, organise a time with them to talk it through and share your experience
If you understand your own pain better, then you are more likely to be able to let a loved one know how they can best support you. Be mindful to:
- Acknowledge your own pain.
- Know that pain is subjective, which means that we can’t experience each other’s pain.
- Remember that close family and friends may lack an understanding of your pain and how to help. This does not translate into a lack of care.
- Be patient with loved ones who may not “get it”.
- Describe your pain without using extreme wording like “nothing works” or “this will never go away”. This will create a “fix it” response in our loved ones.
- Help loved one’s understand that you have down days and then every now and then you also have better days. This is not only important in helping loved one’s understand where you are but it also helps present you with a more balanced view of our pain without getting caught in the doom and gloom.
- It is important to make your loved ones aware that we are not after solutions but rather an empathic ear, which is someone who is prepared to listen without judgement or solutions.