COPING WITH PAIN

Pain is the body’s way of telling you that something is amiss, but it is often hard to pin down. No two people experience pain in the same way, and controlling it is frequently a matter of trial and error. Still, most people can find relief.

THE NATURE OF PAIN

Pain occurs when certain nerve endings are stimulated to send pain messages to the brain. In general, widespread chronic pain is usually due to an illness, such as arthritis or cancer, or to a structural problem, such as a ruptured spinal disc. Localized acute pain, such as a headache, heartburn, toothache, or cramps, may stem from temporary ailments. Injuries also can trigger pain.

Although pain is usually a symptom of an underlying disease, it has its own harmful effects, such as inflammation and muscle spasms. Note any other problems that could provide telling clues to what’s causing the pain.

Does stress bring on the pain? If so, consider a psychological rather than a physical source. Even if the pain turns out to be psychosomatic, don’t discount it. Psychosomatic pain is just as real and stressful as organic pain and should be dealt with.

Does rest bring relief? Poor circulation may be the problem because the tissue that does not get enough oxygen sends out pain messages. Common examples include angina, which is chest pains that develop when the heart muscle is starved for oxygen, and intermittent claudication, which is calf pain due to clogged arteries in the legs.

Pain that ls unusually intense lasts for more than a few days, grows steadily worse, or is accompanied by fever, vomiting, and other symptoms warrant prompt medical attention.

NONPRESCRIPTION PAINKILLERS

Most pain can be controlled with nonprescription drugs. Here’s what you should know to make the best choice.

Aspirin, the most common painkiller, also lowers fever, and, because it counters inflammation, it is especially effective against arthritis and other inflammatory disorders.

Ibuprofen, like aspirin, is a nonsteroidal anti-inflammatory drug. It is stronger than aspirin but less likely to cause stomach upset and bleeding.

Acetaminophen also controls pain and lowers fever, but it does not fight inflammation. It is easier on the stomach than aspirin and ibuprofen, and it does not cause bleeding. Chronic use, however, can damage the kidneys.

To minimize stomach upset, take aspirin or ibuprofen with food or an antacid. Buffered aspirin contains an antacid, but it’s more expensive than ordinary aspirin.

Coated, or enteric, aspirin dissolves in the small intestine rather than the stomach. It can be used as an alternative if other forms of aspirin cause stomach upset.

Caffeine increases the effectiveness of aspirin. Some brands contain caffeine; you can achieve the same effect by taking two regular aspirin with a cup of coffee, cola, or other caffeinated beverage.

Never give aspirin to anyone under the age of 18 who has a cold, flu, chickenpox, or other viral infection. In this setting, aspirin has been linked to Reye’s syndrome, a potentially fatal childhood brain, and liver disorder. Acetaminophen is a safe alternative but checks with your doctor before giving it to a baby.

When taking any painkiller, always follow instructions and be alert for side effects, especially stomach pain, dark, tarry stools, or other signs of intestinal bleeding. If these occur, see your doctor as soon as possible.

Try standard dosages first. Extra- strength painkillers often are not more effective than the regular dosage, but they are more likely to produce unwanted side effects owing to added ingredients.
Taking more than the recommended dosage of a painkiller may cause a rebound effect, in which the pain becomes greater once the medication wears off.

Avoid analgesics that combine aspirin and acetaminophen. These are more likely to cause kidney disease than acetaminophen alone.

Does aspirin bring on a runny nose, sneezing, itching, or difficulty breathing? If so, you are probably allergic to salicylate, which is the major ingredient in aspirin. Switch to another painkiller, such as acetaminophen.

BY PRESCRIPTION ONIY

For more serious pain, your doctor may prescribe a stronger analgesic. Many of these analgesics contain narcotics, and long-term use can produce addiction.

Codeine, often combined with aspirin or acetaminophen, can cause severe constipation. When taking these medications, increase your fiber and fluid intake; if this is not enough, add a stool
softener.

For chronic or recurrent Fah, try varied methods of reducing pain instead of relying on narcotic prescription drugs.

Alternative therapies, such as acupuncture, acupressure, meditation, yoga, and biofeedback, are gaining increased recognition as effective approaches to pain control. ln fact, most orthodox pain clinics employ these and other alternative therapies.

RELIEVING PAIN WITHOUT MEDICATION

There are numerous self-help techniques and alternative therapies that alleviate pain without drugs. Here are a few approaches.

Take a brisk walk or engage in some other form of vigorous exercise. During exercise, the brain steps up the production of endorphins, hormones that are chemically similar to opium. Regular exercise can also prevent menstrual cramps, migraine headaches, and other pain syndromes.

Heat relieves pain by relaxing the muscles and reducing nerve sensitivity. Take several hot baths or showers a day. A hot water bottle or hydro collator (a type of wet heating pad) may also help.

If heat alone doesn’t work, try contrast bathing. Soak in a hot tub for 10 minutes, then stand under a cold shower for a minute or so.

In some cases of acute pain, cold may be more effective than heat in reducing inflammation, relaxing muscles, and relieving pain. Try moist cold compresses or ice packs.

Massaging or rubbing a painful area helps block the pain message before it has a chance to reach the brain. Because massage combines rubbing and relaxation, it can be doubly effective.

Look for any distractions. Many people forget their aches and pains while watching a movie, reading a good book, or listening to music. Singing along may be even better. As the pain increases, sing louder as it, Iessens, sing more softly.

Try to get enough sleep every night. Fatigue often adds to muscle tension and pain perception.

Use your imagination. Think of a pleasant place and imagine being there. What sounds would you hear? What would the place smell like? Describing your imaginary place to someone else may also be helpful.

For intractable pain, ask your doctor for information about TENS, or transcutaneous electrical nerve stimulation. With this therapy, a special device delivers small amounts of electrical current just under the skin, short-circuiting the nerves’ pain messages.

Migraine sufferers may be especially sensitive to a Component of food and drink called tyramine. To minimize attacks, avoid cheese, chocolate, peanuts, and red wine.

THE SPECIAT CASE OF BACK PAIN

Most backaches are due to muscle spasms and clear up in a few days with no treatment. Without
preventive action, however, the pain is likely to recur.

Evaluate your daily activities and habits. Is stress aggravating the problem? Poor posture, wearing high heels, bending from the waist, sitting for long periods of time, and inadequate exercise can all contribute to back pain.

Sleep on your side or on your back (as shown below), not on your stomach. Placing a pillow between your knees (if you sleep on your side) or under your knees (if you sleep on your back) helps stabilize your back as you sleep.

Apply a cold pack during the first day or two of back pain to reduce any tissue swelling. After that, switch to a heating pad to help relax tensed muscles. Aspirin or ibuprofen may be used to help
ease the pain as well. Consult your physician.

Two days of bed rest is usually enough for most backaches. More than that may weaken muscles, making recurrent pain more likely.

A backache accompanied by sciatica-throbbing or shooting pains in the buttocks or down one leg or both legs- may signal a ruptured disc. See a doctor promptly, but don’t undergo disc-removal
surgery without getting a second opinion. Most disc problems are better treated with rest and special exercises.

After seeing a physician rule out possible nerve damage, consider a chiropractor to treat acute lower back pain. Studies have shown that one or two chiropractic adjustments bring relief to some patients.

Massage may also alleviate back pain, especially if it is due to muscle spasms. Avoid very deep or vigorous massage, such as rolfing, which can worsen a disc problem.

• If you prefer sleeping on your back, minimize back pain by placing pillows under your head and your knees.

• Another sleep position for those with back problems is on the side, with one pillow positioned between the legs and holding another big pillow close the chest.

• To get out of bed, roll onto your side and bend your knees. Using your arms, sit up, then stand up.

BACK-STRENGTHENING TIPS

Maintain your ideal body weight. Excess poundage strains back and abdominal muscles, increasing the chance of back pain.

When working out, concentrate on the abdominal muscles, which support the back. Try low-impact exercises, such as walking, swimming, or bicycling, to increase back strength. If you have back problems, see a doctor before undertaking an exercise program to strengthen your back.

To lift an object from the floor, first, bend at the knees, then at the hips. Hold the object close to your body and raise yourself to an upright position.

If you swim, choose the crawl over the breaststroke or butterfly, which may strain the back. Better yet, swim one lap with the crawl, then one with the backstroke. The variety promotes flexibility.

Consider a consultation with an Alexander-technique instructor. Many back problems are due to faulty posture, and practicing the Alexander technique can correct posture.

Some types of back pain require immediate medical attention. See a doctor if, ln addition to a
backache, there ls fever, stiff neck, headache, loss of bladder control, nausea, or pain or numbness in the legs. Consult a doctor if back pain is the result of an accident.