Pain management and assisting a client living with acute or chronic pain are some of the most common duties of a caregiver.
Living with pain can be exhausting both mentally and physically, which is why proper support is crucial. Teamwork between the healthcare providers and the caregiver enables everyone to give the client the best possible care they can get.
There are plenty of ways a caregiver can support and assist their client who struggles with pain. However, in order to be able to help in the most efficient way, it’s useful for a caregiver to know what types of pain exist and what the most common treatments are.
What Is Pain?
The international association for the study of pain defines pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
If this technical definition sounds vague, that’s because pain is an abstract concept and how we perceive pain is different for each person.
But why does pain exist and why is it necessary? Pain is an evolutionary protective mechanism. It motivates us to withdraw from damaging situations. For instance, if we accidentally touch a hot surface, we immediately pull away.
Pain is telling us to immediately stop doing whatever it is we’re doing and helps us prevent serious damage and protect the damaged area while it heals. Pain teaches us to avoid the damaging conditions in which we experienced it in the first place.
Types of Pain
Not all pain has the same causes or mechanisms. The most common types of pain are nociceptive and neuropathic. In terms of duration, pain can be acute and chronic.
Nociceptive pain is associated with tissue damage or inflammation, whereas neuropathic pain comes from a lesion, disease, or injury affecting the nervous system.
Chronic pain is persistent, long-lasting, or recurring, while acute pain usually lasts less than 3 months.
Treating Pain
If you have ever known or cared for someone living with chronic pain, you know that finding the right treatment option is critical. Unfortunately, it can be difficult because every person is unique and responds to pain treatments differently. Here are some of the most common treatments for pain.
Medication for Pain Treatment
When experiencing any type of pain, most of us reach for an aspirin or a Tylenol. Pain medications can be very beneficial in reducing pain, but it is only one component of managing pain. Pain medications, also known as analgesics, work best when combined with other pain management strategies. The two types of analgesics are non-narcotic and narcotic.
Non-Narcotic Analgesics
There are two types of non-narcotic analgesics, Acetaminophen and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) such as Aspirin are effective pain relievers that reduce swelling. Frequently used as the first choice for muscle strains, sprains, or arthritis, NSAIDS are manufactured under many brand names, such as Motrin, Aleve, and Voltaren.
They are available as both legend, or prescription only, and non-legend, or over-the-counter medications in various forms, such as tablets or capsules, creams, and ointments, or patches placed on the skin.
Acetaminophen is most commonly known as Tylenol, which is the popular brand name of the drug. Acetaminophen is the most widely prescribed non-narcotic analgesic because it is very safe when used correctly and has fewer side effects than other pain medications.
Narcotic Analgesics
Narcotic Analgesics, also called opioids or opiates, are a stronger class of painkillers and are available only by prescription.
Some common narcotic painkillers are:
Vicodin
Percocet
Morphine
Oxycontin.
Narcotic analgesics can be very effective at reducing pain, but they come with more side effects and risks. Developing a tolerance, dependence on, or addiction to these medications are important risks to be aware of.
A physician will determine if and when narcotic analgesics are appropriate for treating pain. Narcotic analgesics can cause drowsiness and sometimes dizziness. Other common side effects include nausea, vomiting, itching, and constipation.
Abuse of prescription painkillers is a huge problem. According to the National Institute on Drug Abuse, over 9 million people in the US reported misusing prescription painkillers in 2020. It's important to use these drugs only as prescribed, only for as long as needed and never to share or give away prescription painkillers.
If you ever have leftover medicine, you should make sure you dispose of it safely.
Electricity Treatments for Pain
Using electricity to reduce pain is not a new idea. It has been around since the late 1960s. Using electricity might not be one of the options that come to mind, but it can be an effective short-term option for pain relief, and has been used by physicians and other professionals since the late 1960s.
This kind of therapy is called Transcutaneous Electrical Nerve Stimulation or TENS for short. TENS involves placing small electrode devices on the skin, over the parts of the body that are in pain. The electrodes are then attached to a machine that releases small waves of electricity, sending tiny electrical impulses, to the painful area of the body.
The electrical impulses then interrupt messages about pain sent from the nerves to the brain. The electricity blocks the activity of the brain pain receptors. If the brain does not get the messages from the nerves, then it does not know that there is pain and it is relieved for a while, but not permanently.
Effective TENS therapy is often considered a form of complementary or alternative medicine. Some people have reported good pain relief using TENS, others have not found relief from it like pain medication offers. TENS does not offer a cure, but only temporary relief from pain.
Physical Therapy
Even though moving when you hurt sounds awful, sometimes exercise is one of the best pain management options for chronic pain.
One of the goals of physical therapy is to help chronic pain clients get stronger. They are usually weak from not moving very much. Exercise increases muscle strength, endurance, and stability in the joints.
Physical therapy can also teach people how to move safely and in ways that minimize discomfort. There are a number of different pain management methods used in physical therapy. Some of them are:
Massage manipulation of joints and bones
Manual therapy using hands or tools on soft tissues
Cold laser therapy to reduce inflammation and to release endorphins
Acupuncture
Acupuncture is a form of Chinese medicine that has been practiced for centuries. It’s based on the theory that energy called Chi flows through and around your body along pathways called meridians. Acupuncturists believe that illness occurs when something blocks or unbalances your Chi.
Acupuncture is done by placing very thin, flexible needles into your skin at certain points on the body. This is done to direct the energy flow. Most people find that it does not hurt, but the areas may tingle, feel a little numb or itch, or be a little sore.
The needles remain in place for anywhere from 15 minutes to an hour, usually for several visits. Acupuncture is used to treat chronic pain, especially for conditions like chronic headaches or migraines, fibromyalgia, osteoarthritis, lower back pain and carpal tunnel syndrome.
Hot/Cold Therapy
Heat therapy and Cold therapy can be very effective methods for treating chronic pain, especially arthritis and chronic muscle pain.
Heat therapy works by helping muscles relax, and that can reduce both pain and stiff muscles.
Cold therapy works best on swollen joints and muscles that are causing pain. Cold therapy reduces blood flow to the area and that can reduce swelling and inflammation.
Cold therapy slows down the pain messages going from your nerves to your brain. Some ways of using cold therapy are to soak the affected area in a cold tub of water or apply an ice pack. You can use a chemical cold pack found in many first aid kits, or a washcloth that has been soaked in cold water as a cold compress.
Do not leave a cold pack on for longer than 10 to 30 minutes. Cold can damage the skin just like heat. If the skin has turned purple, it's a sign that the ice was left on too long.
Complementary Therapies
Complementary therapies, also referred to as Alternative Medicine, can offer substantial relief for many with chronic pain. Complementary therapies are called that because they are usually used along with or in addition to more mainstream techniques or conventional medicine.
Complimentary therapies can take an important role in relieving chronic pain. Some of these therapies include: biofeedback, aroma therapy, guided imagery, hypnosis, meditation, yoga, and naturopathy.
Surgery as Pain Treatment
Surgery is not often used to treat chronic pain, but it is worth mentioning because sometimes it can be effective if other less invasive treatments have failed. It is usually only considered after other treatments have been tried and only when it is considered medically necessary.
Common surgical treatments for pain include:
Intrathecal Drug Delivery – this procedure involves placing a small tube in the spinal canal where the pain signals go into the brain. The tube is connected to a small reservoir of medicine which is placed under the skin.
Spinal Cord Stimulation – this procedure uses an electrical current to treat chronic pain. An electrical generator is placed under the skin and the generator sends electrical pulses to a certain area in the spinal cord through electrodes.
Nerve Decompression – this type of surgery treats nerve pain. The surgeon cuts into the skin and attempts to move away vessels or other body structures that are pressing on the nerves and causing pain.
Radiofrequency Ablation - is a procedure that disrupts the flow of pain signals using heat. The heat stems from the nerve response, blocking the nerves from sending pain signals to the brain.
Psychotherapy as a Complementary Pain Therapy
Psychotherapy is the general term for all kinds of counseling. In itself, psychotherapy is not a treatment for physical pain, but it can be a useful additional tool.
Pain has an emotional component too, which, especially in cases of chronic pain, can cause mental health issues such as depression or anxiety. These conditions can be just as disabling as chronic pain itself.
The basics of all talk therapy types are similar. They all involve a qualified counselor and the client exploring how the pain affects the patient mentally and emotionally. They also try to find methods for living with the symptoms and ways to cope with situations that could make the symptoms worse.
If you are in the caregiving industry, it is not jor job to diagnose or treat pain. What you can do is - educate yourself on the mechanisms of pain and pain management and try to support your clients the best you can. Establish trust in your caregiving relationships and become the ally your clients need to deal with their challenges.
If you want to learn more about how to assist your client, check out our course CE302 | Assisting a Client Living with Chronic Pain. You'll be able to discover effective methods for supporting your clients and also earn your 2 CE credits. Click on the image below for more information.
