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Pain

Pain needs to be classified by the cause of the pain, the symptoms (or the nature and severity) of the pain, and the frequency of the pain.  A proper diagnosis of the pain is essential for the best treatment outcomes. 

Everyone has different perceptions of pain based on a large range of factors including, other illnesses a person may have, past experiences with pain, coping strategies they may have been taught, cultural differences, current social issues or stress that may be impacting on the perception of pain and psychological issues.

Causes of Pain

1. Nociceptive - Superficial Somatic
Caused by injury to the skin, subcutaneous tissue, mucosa of mouth, nose, anus, sinuses, urethra. Examples include mouth ulcers, haemorrhoids, sinus pain, wounds, dental pain, etc.

2. Nociceptive – Deep Somatic
Caused by injury or disease to deeper tissues such as bones, tendons, joints, muscles, superficial lymph nodes, organ capsules or linings of the abdomen and lung cavities. Examples include sporting injuries, IBS, osteoarthritis, back pain, etc.

3. Nociceptive – Visceral
Caused by injury or disease to solid or hollow organs or deep tumour masses or deep lymph nodes. Examples include endometriosis, diverticulitis, period pain, heart attack, etc.

4. Neuropathic
Caused by damage or compression of the nerves and disease occurring in the nerves such as herpes. Examples include shingles, diabetic neuropathy, nerve pain, post stroke pain, phantom pain.


Symptoms of Pain

1. Nociceptive – Superficial Somatic
Pain is described as hot sharp or stinging pain and is localised to the site of injury

2. Nociceptive – Deep Somatic
Pain is described as dull, aching or throbbing and is often difficult to pinpoint the site of the pain

3. Nociceptive – Visceral
Pain is described as dull, deep, gnawing, colicky, cramping, pressure or tightness and is often difficult to pinpoint the site of pain

4. Neuropathic
Pain is described as pins and needles, electric shocks, burning, stinging, radiating down arms or legs.  May be pain experienced in a missing limb. Pain is often experienced in the area supplied by a nerve

In the diagnosis of the pain it is important to find out the symptoms experienced, the severity of the pain, the history of pain and the length of time the pain has been experienced.

Further testing can be done depending on which type of pain is being described.  For Superficial somatic pain usually the area can be examined.  For other types of pain further investigations may be needed such as CT scans, Ultrasounds, MRI scans and for nerve pain a test called EMG (Electromyogram) may be done to measure the conductivity of the nerve to see if there is an injury or compression to a particular nerve. Chronic pain is pain that is present for longer than 3 months and is a complex and very involved problem involving psychological and physical factors.


Treatment of Pain

Treatment depends on the type of pain, the severity of pain, the history of analgesics and other medications used, and medical conditions the individual may be suffering from.

Treatment of pain may involve topical analgesics or anti-inflammatories, ultrasound treatment, heat or cold pack application, oral pain relievers such as paracetamol or anti-inflammatories or stronger analgesics which may include codeine.

It is important to answer any questions the Pharmacist may have to establish the best pain relief for your condition.  Many people are unaware that in some instances specific analgesics are more effective, for example in dental pain, anti-inflammatories are far more effective than paracetamol based pain relievers.


Next Steps

Talk to your Pharmacy 777 Pharmacist about the pain you are experiencing.
Answer all their questions to ensure you are taking the best pain reliever for your pain.

Effectively managing your acute pain can prevent your pain developing into chronic pain which can continue on even after the offending physical impediment is removed.

The Pharmacist may also choose to perform an in-store medicine review to help establish the best course of action for managing your symptoms with medication.

If our Pharmacists feel it is necessary you will be referred to a GP and on request the Pharmacist can write a referral outlining the treatment used to date and the concerns that need to be investigated.

 

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