What a pain! http://www.telegraphindia.com/1141229/jsp/knowhow/story_5590.jsp
Your Health - Dr. Gita Mathai
Everyone feels pain at some point in their lives. Unfortunately, there is no machine to objectively assess pain. Physicians have to rely on what the patient says. Sensitivity to pain varies - acute pain may make a person only grit her teeth and wince whereas the same injury can produce "severe, unbearable pain" with weeping and wailing in others.
Pain forces a person to take notice of a body part they had probably taken for granted. This is particularly true of acute pain such as a toothache, sinusitis, appendicitis or urinary tract infection.
Our bodies are plentifully supplied with "nociceptors" in the skin, bones, muscles and internal organs. Noxious stimuli, (either injury or infection) activates them. They release electrical currents and biochemical agents. These travel along the nerves, up the spinal cord and eventually reach certain areas in the brain. The reaction occurs in a flash and the perception of pain is instantaneous.
A number of medications can be used to treat acute pain. Many of these are available OTC (over the counter). Commonly used medication is paracetemol (10 mg /kg/dose in children 500 mg per dose in adults). It can be repeated every four hours. Paracetemol helps with fever as well, so if the aches and pains are due to seasonal flu, there is rapid improvement. It also blocks the areas of the brain that recognise pain. NSAIDs (non steroidal anti inflammatory drugs) like ibuprofen (Brufen) and nalidixic acid relieve pain but do not have much effect on fever. They act by blocking prostaglandin, one of the chemicals responsible for feeling pain. Topical anti-inflammatory medications, particularly those containing capsaicin are very effective. They should be applied lightly over the painful area followed by an ice pack.
Pain is chronic if it lasts for more than six weeks. It may be due to a simple, correctable cause. Wearing flip-flops while walking for long periods of time can cause heel pain. Speaking on a cell phone wedged between your shoulder and ear causes neck pain and headaches. Playing computer games on cell phones also causes neck pain. Frequent texting causes pain in the thumbs. Long-term computer use causes pain in the wrist.
More often chronic pain is due to the various types of arthritis (rheumatoid, osteoarthritis), autoimmune diseases, gout and mechanical problems like a disc prolapse. It needs to be diagnosed correctly so that appropriate treatment can be started. The medications taken may be steroids, opiods or the coxib group of drugs.
The brain has to be retrained in its perception and response to pain. This can be done with a combination of physiotherapy and aerobic exercise. Judiciously used, these interventions help to reduce long-term dependence on pain medication.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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