Everyone person experiences pain at some point in their life.  Pain is an indication that something is wrong and needs our immediate attention to fix the problem or change behavior.  Every person feels pain differently and in different intensities.  This is commonly referred to as the pain threshold.

There are two basic types of pain known as acute and chronic.  Acute pain starts suddenly and is generally sharp in nature.  It warns the body of a problem that is going on such as trauma or an infection.   Acute pain can be treated easily many times.  However, acute pain can become chronic after six months if the body was unable to heal or the issue was not treated effectively.  

Chronic pain persists even when the initial injury has “healed” or the infection has been treated.  The nerves that signal pain remain active causing tense muscles, leading to limited mobility and a decrease in energy.  Chronic pain can elicit several different emotional responses.  The emotional effects usually seen are depression, increased anxiety from fear of re-injury or other issue, and anger.

There are basically three categories of chronic pain called somatic, visceral and neuropathic pain.  Somatic pain is pain originating from the outer body structures such as the fascia, ligaments, and muscles.  Fibromyalgia and chronic back pain are examples of conditions that cause pain in this category.  Visceral pain is pain from the internal organs.  Gall stones or irritable bowel syndrome are examples of pain in this category.  Neuropathic pain arises from pain nerves transmitting a constant signal to the brain.  Diabetic neuropathy or pinched nerves from a herniated disk are examples of pain in this category.

Chronic pain can be difficult to treat.  If the original problem can not be fixed for whatever reason then pain management becomes the goal of treatment.  In pain management the goal is to improve function so that the patient can still engage in daily activities such as work or school.  Some of the therapies that help fix pain conditions can also be helpful in the management of pain.

Treatment modalities range from manual techniques, surgery, and prescription medications.  Manual techniques can be simple to complex depending on the situation and type of pain being treated.  In many musculoskeletal pain conditions massage, soft tissue adjustments, cranial sacral therapy, and acupuncture can be very helpful in the management of pain.  There are also many relaxation techniques, biofeedback and imagery exercises that can be used to effectively treat some types of pain.   

One of the first treatments for nearly all of the pain conditions is physical therapy.  Physical therapies combine manual techniques with exercise and when appropriate the use of hydrotherapy, electrical stimulation, or ultrasound.  Exercise helps to keep painful areas mobile.  The moment inactivity sets in the pain can start to escalate and joints become stiff to the point of locking. Light to moderate exercise such as walking, swimming, or Yoga can keep muscles loose and joints mobile.  If done lightly enough and not overdone, exercise can help some pain conditions improve.

Surgery and injection therapies can also help treat many pain conditions.  Surgery can be helpful to fix broken bones, correct structural abnormalities, remove growths, or sever nerves.  In each case surgery may or may not be appropriate and should be entered with caution.  There are risks of increased pain, no improvement in the pain, or death.

Injectable therapies range from spinal nerve blocks to subcutaneous injections.  Injectable solutions can have steroids, an anesthesia agent (pain blocking agent like Lidocaine), normal saline, vitamin and mineral complexes, or even homeopathic solutions.  The solutions are chosen according to the type of injection being done and the type of pain being treated.  A spinal nerve block is generally a mix of an anesthesia agent, normal saline, and possibly a steroid.  A prolotherapy injection can vary on the doctor giving the injection and the area being treated.  A trigger point injection generally is a mix of an anesthesia agent and normal saline.

Homeopathic solutions are now been done in an injectable form to help treat certain types of pain conditions.  There are only a few doctors using these remedies and finding that they can be very effective treatments if applied correctly over time.

The medications available to treat pain vary according to the type of pain.  There are anti-inflammatories and muscle relaxants to treat musculoskeletal pain.  There are nerve stabilizers and anticonvulsants that can help treat neuropathic pain.  There are also some types of pain that will respond to antidepressant medications.  For severe pain there are narcotic pain medications that can cause addiction, tolerance and other serious consequences if not used appropriately. 

Pain should be treated integratively dealing with the physical, mental, and emotional aspects of pain.  If only the physical aspects are treated other conditions can arise such as depression, overwhelming fatigue, and increased pain.  Activities of daily life start to be put on hold and the strain of the pain on one family member is spread through their family.  The effects can be detrimental over time.