How to Relieve Pain, Part 2

Part 2: Actually Relieving the Pain

The most complete way to relieve pain comes ultimately from healing and of course, "time heals all wounds." The phrase has endured because when it comes to pain from damaged tissue, when the tissue heals, the pain impulse ceases to exist. For nerve pain, it typically takes more time.

Until enough time has passed to allow for healing, the cheapest and least risky way to relieve pain is with pain medication: anti-inflammatory meds, opioids, and analgesics.* Now, because of the way the media has portrayed the matter, they would have the general public believe that there is a better way... medications that don't have any side effects or at least not any that are so dangerous as the ones that lead to the "epidemic of overdose deaths" that have been occurring. However, at the present time, only medication can relieve pain by reducing or dulling the pain signal, and opioids do that "best." By best, I mean the combination of magnitude and duration.

Opioids work primarily on the brain and are also versatile, coming in both short-acting and long-duration formulations. Natural or synthetic, opioids have been further perfected beyond what the earth naturally provides. Unfortunately, two of the key side effects of opioid use is to depress/repress vital functions and nearly all stimulate the pleasure centers of the brain along with reducing the pain. Some medications--analgesics--will completely desensitize nerves, but need to be applied directly to the nerves either at the source of pain or between the source and the brain before perception occurs. Unfortunately, while fantastic for the magnitude of relief that they provide, analgesics are very short acting. Anti-inflammatory medication is the least versatile of the three types because it works mainly to limit the reaction of the swelling of soft tissue that has been damaged, and thereby minimize the pain signal at its source.

To repeat and emphasize the main point, let me say again, taking medication is the cheapest and least risky way to relieve pain. Other methods vary based on the area of the body in pain and what is causing it, but most are very invasive because they involve surgery--removing something from the body or implanting something into the body... or both. Some, like implanting a neurostimulator and connecting to the spinal cord can work like an analgesic creating what's called parasthesia and replacing the pain signal with a sort of tingly-numbing sensation. The advantage is that such procedures will reduce or eliminate the need for medication, but are obviously incredibly invasive and may have permanent consequences.

Personally, I was on the operating table for nearly four hours with only a local anesthetic while parts of my vertebrae were chipped away and a network of wires was laid down and sealed in. The risk for infection is high and even with the most advanced technology in play, the implants still need to be replaced periodically (every 3-9 years) and need recharging every one to two weeks. Thankfully, only the actual neurostimulator unit needs replacing; my wires are "permanent" and my implant replacement surgeries have only been hour-long procedures with just 2-3 days' recovery. I'm on my third implant in nearly 11 years now and should be good until 2025. Another disadvantage to neurostimulation is that it is not always perfectly precise; I feel extra jolts of electricity in my legs (particularly my left leg) which impacts my ability to walk or run normally, but an acceptable trade-off for the increased relief I get from the parasthesia.

Other than combinations of the above (implanting a drug pump that delivers analgesics and opioids directly to the spinal cord) or the radical surgeries involving amputation, organ removal, or nerve extraction, there is nothing more than this that can be done to relieve pain in any significant way. So doctors, and more importantly those enduring pain, are quite limited on ways to relieve pain. This situation is further complicated by cases where even after the damaged area has healed, there is a malfunction that keeps the pain impulse active. This is the disorder that qualifies a person for the designation of "chronic pain victim" and it is a lot more prevalent than is portrayed by the media. Its prevalence, so grossly understated, means that primary care doctors are overwhelmed with complaints of pain and a lack of genuinely-qualified, pain-management doctors to whom to refer these individuals.

Next blog: The Facts on Addiction vs. Dependency (on or around February 26, 2017)

*Note that I did not distinguish between non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, which are also considered anti-inflammatory, but use a slightly different mechanism within the body. I also did not include the pain relieving effects which can be had with muscle relaxers, antidepressants, anti-anxiety drugs, anticonvulsant drugs, and a few others--which have been known to help relieve pain, but are usually more individualized in that they do not consistently work as anti-inflammatory meds, opioids, and analgesics do.