Keep a pain diary

Keep track of your stubborn pain to manage it well. It will alert your doctor of the type of pain and the effect of the medicines you have been taken

dairyPain can be of two types—acute and chronic. Acute pain usually develops after an injury [maybe a fall or after an operation] and resolves completely after some time with the help of painkillers. Stubborn pain or chronic pain is more difficult to treat. It often develops without a known cause; and it does not subside with routine painkillers.

Suffering from such stubborn pain constantly restricts mobility and disrupts your daily activities. It decreases your ability to concentrate, disturbs your sleep, and affects your moods. It is this constant nagging pain that leads to depression and suicidal tendencies in individuals.

A diary that tracks pain

Since nobody understands your pain as much as you do; keep a pain diary that records the following points:

  • Nature of pain—whether burning, throbbing, or shooting.
  • Intensity of pain—make an imaginary scale from 0 – 10 and record your pain. Zero being no pain and 10 means the most excruciating pain.
  • Location of pain—for example, migraine headaches are usually on one side, whereas sinus headaches are on both the sides of forehead.
  • Duration of pain—record the number of times in a day you had pain.
  • Factors aggravating the pain—sometimes specific food products like cheese, chocolates or wine can increase pain.
  • Factors relieving the pain—hunger headaches are relieved after taking food while simple painkillers reduce some other types of pains. You may also note down the number of painkillers you had to take to get some relief. Also, note if there was any change in the nature of pain.

A pain diary will not only alert your doctor of the type of pain, but also inform him the efficacy of the medications that you have taken. This can then form the basis of your pain management plan.

Treatment becomes easy

Depending on symptoms and investigations, the doctor may initially start medications, which suit you the best. He may even recommend some blood tests, X-rays or some advanced investigations like CT scan or MRI to further detect the reason behind the pain.

He may also start some other medications, which are known to have a good response in specific type of pain. Unlike acute pain, where the treatment goal is to relieve you completely of pain, in case of chronic pain, the doctor tries to minimise your pain, thereby giving you the best lifestyle suggestions possible under the given set of circumstances.

Most people with chronic pain take long time to recover. Sometimes, the doctor may prescribe medications, which are also used to treat depression or seizures. Anti-depressant and anti-convulsant medications have a definite role to play in treatment of chronic pain. Sometimes, even high doses of narcotic substances [morphine-like substances] are required in the treatment of pain. Hence, these medicines are best prescribed by physicians who specialise in chronic pain treatment.

Self-medication, in case of stubborn pain, is often dangerous. Regular unsupervised popping of OTC [over the counter] medications can damage your kidneys and liver.

Besides, regular intake of OTCs masks clinical signs and hence may cause a delay in accurate diagnosis and treatment of a serious medical disorder. It is always better to talk to your doctor and rule out any sinister problems, which may aggravate if left untreated.

A ray of hope

There are a group of doctors who specialise in the treatment of chronic pain. They work in special pain clinics, which also have the services of anaesthesiologists, orthopaedic surgeons, spine specialists, psychiatrists, physiotherapists and occupational therapists.

These doctors together offer a comprehensive evaluation of your pain and can give you a multi-modal therapy of treatment. Such multi-modal therapy involves treatment modalities which are non-medical [behavioural and lifestyle modifications] and includes physiotherapy, trans-cutaneous electrical nerve stimulation [TENS], occupational therapy, counselling and medications. All this will not only reduce your pain but will also make your life easier.


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