Pain

Share:

Also indexed as: Aches and Pains

About This Condition

Pain is a sensation that is transmitted from an area of tissue damage or stress along the sensory nerves to the brain. The brain interprets the information as the sensation of pain.

Substances that decrease pain either interfere with the ability of nerves to conduct messages, or alter the brain’s capacity to receive sensations.

Pain may be a symptom of an underlying pathological condition, such as inflammation. It may also be due to other causes, such as bruising, infection, burns, headaches, and sprains and strains. Use caution when treating pain without understanding its cause—this may delay diagnosis of conditions that could continue to worsen without medical attention.

Symptoms

Symptoms of pain include discomfort that is often worsened by movement or pressure and may be associated with irritability, problems sleeping, and fatigue. People with pain may have uncomfortable sensations described as burning, sharp, stabbing, aching, throbbing, tingling, shooting, dull, heavy, and tight.

Healthy Lifestyle Tips

Body weight may be related to pain tolerance. One study indicated women who are more than 30% above the ideal weight for their age experience pain more quickly and more intensely than do women of ideal weight. No research has investigated the effect of weight loss on pain tolerance.

Exercise increases pain tolerance in some situations, in part because exercise may raise levels of naturally occurring painkillers (endorphins and enkephalins). Many types of chronic pain are helped by exercise, though some types of physical activity may aggravate certain painful conditions. People who want to initiate an exercise program for increasing pain tolerance should first consult a qualified health professional.

Holistic Options

Transcutaneous electrical nerve stimulation (TENS) is a form of electrical physical therapy that has been used in the treatment of pain since the early 1970s. Pads are placed on the skin and a mild electrical current is sent through to block pain sensations. Many TENS units are small, portable, and may be hidden under clothing. A review of the first ten years of research on TENS described success rates in treating chronic pain varying from 12.5% to 92% after one year of treatment. Variations in success rates were attributed to differences in the type of pain the TENS was treating. More current research identifies specific conditions that consistently respond well to TENS therapy:rheumatoid arthritis, osteoarthritis, low back pain, phantom limb pain, and post-herpetic nerve pain (shingles). Pain caused by pinched nerves in the spine responds poorly to TENS therapy. While a small number of controlled trials have reported no benefit, most evidence suggests TENS is an effective form of therapy for many types of pain.

Relaxation exercises may decrease the perception of pain. Pain increases as anxiety increases; using methods to decrease anxiety may help reduce pain. In one controlled hospital study, people who were taught mind-body relaxation techniques reported less pain, less difficulty sleeping, and fewer symptoms of depression or anxiety than did people who were not taught the techniques.

Acupuncture has been shown to decrease pain by acting on the enkephalin-based, pain-killing pathways. In 1997, the National Institutes of Health (NIH) stated that acupuncture is useful for muscular, skeletal, and generalized pain, as well as for anesthesia and post-operative pain. The NIH statement was based on a critical review of over 67 controlled trials of acupuncture for pain control.

Practitioners of manipulation report that it often produces immediate pain relief either in the area manipulated or elsewhere. Controlled trials have found that people given spinal manipulation may experience reduction in pain sensitivity of the skin in related areas, a reduction in joint and muscle tenderness in the area manipulated, and a decrease in elbow tenderness when the neck was manipulated. One study showed no effect of lower spine manipulation on sensitivity to deep pressure over low back muscles and ligaments. Some researchers have speculated that joint manipulation affects pain by enhancing the effects of endorphins. However, only one of three controlled studies has shown an effect of manipulation on endorphin levels.

Hypnosis has been shown to significantly reduce pain associated with office surgical procedures that are performed while the patient is conscious (i.e., without general anesthesia). People undergoing office surgical procedures received standard care, structured attention or self-hypnotic relaxation in one study. Those using self-hypnosis had no increases in pain during the procedures, compared to those in the other groups. Hypnosis also appeared to stabilize bleeding, decrease the requirement for narcotic pain drugs during the procedure, and shorten procedure time.

References

1. Pradalier A, Willer JC, Dry J. Pain sensitivity in obese individuals. Ann Med Interne (Paris) 1982;133:528–31.

2. Guieu R, Blin O, Pouget J, Serratrice G. Nociceptive threshold and physical activity. Can J Neurol Sci 1992;19:69–71.

3. Fordyce W, McMahon R, Rainwater G, et al. Pain complaint—exercise performance relationship in chronic pain. Pain 1981;10:311–21.

4. Schwarz L, Kindermann W. Changes in beta-endorphin levels in response to aerobic and anaerobic exercise. Sports Med 1992;13:25–36 [review].

5. Ferrell BA, Josephson KR, Pollan AM, et al. A randomized trial of walking versus physical methods for chronic pain management. Aging (Milano) 1997;9:99–105.

6. McCain GA. Nonmedicinal treatments in primary fibromyalgia. Rheum Dis Clin North Am 1989;15:73–90.

7. Kottke TE, Caspersen CJ, Hill CS. Exercise in the management and rehabilitation of selected chronic diseases. Prev Med 1984;13:47–65 [review].

8. Cowan P, Lovasik DA. American Chronic Pain Association: strategies for surviving chronic pain. Orthop Nurs 1990;9:47–9 [review].

9. Tapio D, Hymes AC. New Frontiers in TENS. Minnetonka, MN: LecTec Corporation, 1987, 63–9.

10. Nicholas JJ. Physical modalities in rheumatologic rehabilitation. Arch Phys Med Rehabil 1994;75:994–9.

11. Gersh, MR. Transcutaneous electrical nerve stimulation (TENS) for management of pain and sensory pathology. In Electrotherapy in Rehabilitation. Philadelphia: F.A. Davis Company, 1992.

12. Long DM. Fifteen years of of transutaneous electrical stimulation for pain control. Stereotact Funct Neurosurg 1991;56:2–19.

13. Carroll D, Tramer M, McQuay H, et al. Randomization is important in studies with pain outcomes: systemic review of transcutaneous electrical nerve stimulation in acute postoperative patients. Br J Anaesth 1996;77:798–803.

14. Oliveri AC, Clelland JA, Jackson J, Knowles C. Effects of auricular transcutaneous electrical nerve stimulation on experimental pain threshold. Phys Ther 1986;66:12–6.

15. Lander J, Fowler-Kerry S. TENS for children’s procedural pain. Pain 1993;52:209–16.

16. Long DM. Current status of electrical stimulation on the nervous system for the relief of chronic pain. Surg Neurol 1998;49:142–4.

17. Robin O, Vinard H, Vernet-Maury E, Saumet JL. Influence of sex and anxiety on pain threshold and tolerance. Funct Neurol 1987;2:173–9.

18. Rybarczyk B, DeMarco G, DeLaCruz M, Lapidos S. Comparing mind-body wellness interventions for older adults with chronic illness: classroom versus home instruction. Behav Med 1999;24:181–90.

19. U.S. Department of Health and Human Services. Public Health Service. Acupuncture. NIH Consensus Statement 1997;15:1–34.

20. Vernon H. Qualitative review of studies of manipulation-induced hypoalgesia. J Manipulative Physiol Ther 2000;23:134–8.

21. Glover JR, Morris JG, Khosla T. Back pain: a randomized clinical trial of rotational manipulation of the trunk. Br J Indust Med 1974;31:59–64.

22. Terrett ACJ, Vernon HT. Manipulation and pain tolerance: a controlled study of the effect of spinal manipulation on paraspinal cutaneous pain tolerance levels. Am J Phys Med 1984;63:217–25.

23. Vernon HT, Aker P, Burns S, et al. Pressure pain threshold evaluation of the effect of spinal manipulation in the treatment of chronic neck pain: a pilot study. J Manipulative Physiol Ther 1990;13:13–6.

24. Vicenzino B, Collins D, Benson H, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylagia. Pain 1996;68:69–74.

25. Cote P, Mior SA. The short-term effect of a spinal manipulation on pain/pressure threshold in patients with chronic mechanical low back pain. J Manipulative Physiol Ther 1994;17:36–48.

26. Vernon HT, Dhami MS, Howley, TP, et al. Spinal manipulation and B-endorphin: a controlled study of the effect of a spinal manipulation on plasma B-endorphin levels in normal males. J Manipulative Physiol Ther 1986;9:115–23.

27. Christian GF, Stanton GJ, Sissons D, et. al. Immunoreactive ACTH, B-endorphin and cortisol levels in plasma following spinal manipulative therapy. Spine 1988;13:141–7.

28. Sanders GE, Reinnert O, Pepe R, et al. Chiropractic adjustive manipulation on subjects with acute low back pain: visual analogue scores and plasma b-endorphin levels. J Manipulative Physiol Ther 1990;13:391–5.

29. Lang EV, Benotsch EG, Fick LJ, et al. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet 2000;355:1486–90.

30. Santos AR, Calixto JB. Ruthenium red and capsazepine antinociceptive effect in formalin and capsaicin models of pain in mice. Neurosci Lett. 1997;235:73–6.

31. Otsuki T, Nakahama H, Niizuma H, Suzuki J. Evaluation of the analgesic effects of capsaicin using a new rat model for tonic pain. Brain Res 1986;365:235–40.

32. Nolano M, Simone DA, Wendelschafer-Crabb G, et al. Topical capsaicin in humans: parallel loss of epidermal nerve fibers and pain sensation. Pain 1999;81:135–45.

33. Kingery WS. A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes. Pain 1997;73:123–39 [review].

34. Hautkappe M, Roizen MF, Toledano A, et al. Review of the effectiveness of capsaicin for painful cutaneous disorders and neural dysfunction. Clin J Pain 1998;14:97–106 [review].

35. Fusco BM, Giacovazzo M. Peppers and pain. The promise of capsaicin. Drugs 1997;53:909–14 [review].

36. Robbins WR, Staats PS, Levine J, et al. Treatment of intractable pain with topical large-dose capsaicin: preliminary report. Anesth Analg 1998;86:579–83.

37. Zhang WY, Li Wan Po A. The effectiveness of topically applied capsaicin. A meta-analysis. Eur J Clin Pharmacol 1994;46:517–22 [review].

38. Ellison N, Loprinzi CL, Kugler J, et al. Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients. J Clin Oncol 1997;15:2974–80.

39. Rains C, Bryson HM. Topical capsaicin. A review of its pharmacological properties and therapeutic potential in post-herpetic neuralgia, diabetic neuropathy and osteoarthritis. Drugs Aging 1995;7:317–28 [review].

40. Bernstein JE, Korman NJ, Bickers DR, et al. Topical capsaicin treatment of chronic postherpetic neuralgia. J Am Acad Dermatol 1989;21:265–70.

41. Bernstein JE, Bickers DR, Dahl MV, Roshal JY. Treatment of chronic postherpetic neuralgia with topical capsaicin. J Am Acad Dermatol 1987;17:93–6.

42. Haze JJ. Toward an understanding of the rationale for the use of dietary supplementation for chronic pain management: the serotonin model. Cranio 1991;9:339-43.

43. Leiberman HR, Corkin S, Spring RJ, et al. Mood, performance and pain sensitivity: changes induced by food constituents. J Psychiatr Res 1982;17:135–45.

44. Shpeen SE, Morse DR, Furst ML. The effect of tryptophan on post-operative endodontic pain. Oral Surg Oral Med Oral Pathol 1984;58: 446–9.

45. Ekblom A, Hansson P, Thomsson M. L-tryptophan supplementation does not affect postoperative pain intensity or consumption of analgesics. Pain 1991;44:249-54.

46. Ceccherelli F, Diani MM, Altafini L, et al. Postoperative pain treated by intravenous L-tryptophan: a double-blind study versus placebo in cholecystectomized patients. Pain 1991;47:163-72.

47. Seltzer S, Stoch R, Marcus R, Jackson E. Alteration of human pain thresholds by nutritional manipulation and L-tryptophan supplementation. Pain 1982;13:385-93.

48. Mitchell MJ, Daines GE, Thomas BL. Effect of L-tryptophan and phenylalanine on burning pain threshold. Phys Ther 1987;67:203-5.

49. Seltzer S, Dewart D, Pollack RL, Jackson E. The effects of dietary tryptophan on chronic maxillofacial pain and experimental pain tolerance. J Psychiatr Res 1982-1983;17:181-6.

50. Brady JP, Cheatle MD, Ball WA. A trial of L-tryptophan in chronic pain syndrome. Clin J Pain 1987;3:39–43.

51. Stockstill JW, McCall WD Jr, Gross AJ, Piniewski B. The effect of L-tryptophan supplementation and dietary instruction on chronic myofascial pain. J Am Dent Assoc 1989;118:457-60.

52. Lin DZ, Fang YS. Modern Study and Application of Materia Medica. Hong Kong: China Ocean Press, 1990, 323–5.

53. Ehrenpreis S. Analgesic properties of enkephalinase inhibitors: animal and human studies. Prog Clin Biol Res 1985;192:363–70.

54. Guisti P, Carrara M, Cima L, Borin G. Antinociceptive effect of some carboxypeptidase A inhibitors in comparison with D-phenylalanine. Eur J Pharmacol 1985;116:287–92.

55. Walsh NE, Ramamurthy S, Schoenfeld LS, Hoffman J. D-phenylalanine was not found to exhibit opiod receptor mediated analgesia in monkeys. Pain 1986;26:409–10.

56. Ehrenpreis S, Balagot R, Comaty JE, Myles SB. Naloxonr reversible analgesia in mice produced by D-phenylalanine and hydrocinnamic acid, inhibitors of carboxypeptidase A. In Bonica JJ, et al., eds. Advances in Pain Research and Therapy, Vol. 3. New York: Raven Press, 1979.

57. Ehrenpreis S. Pharmacology of enkephalinase inhibitors: animal and human studies. Acupunct Electrother Res. 1985;10:203–8.

58. Balagot RC, Ehrenpreis S, Kubota K, Greenberg J. Analgesia in mice and humans by D-phenylalanine: relation to inhibition of enkephalin degradation amd enkephalin levels. In Bonica JJ, et al., eds. Advances in Pain Research and Therapy, Vol. 5. New York: Raven Press, 1983

59. Mitchell MJ, Daines GE, Thomas BL. Effect of L-tryptophan and phenylalanine on burning pain threshold. Phys Ther 1987;67:203–5.

60. D’Alessandro R. D-Phenylalanine does not affect nociceptive, flexion reflex thresholds in normal humans. Anesth Analg 1983;62:857–8.

61. Budd K. Use of D-phenylalanine, an enkephalinase inhibitor, in the treatment of intractable pain. In Bonica JJ, et al., eds. Advances in Pain Research and Therapy, Vol. 5. New York: Raven Press, 1983.

62. Donzelle G, Bernard L, Deumier R, et al. Curing trial of complicated oncologic pain by D-phenylalanine. Anesthesie, Analgesie, Reanimation 1981;38:655–8 [in French].

63. Balagot RC, Ehrenpreis S, Kubota K, Greenberg J. Analgesia in mice and humans by D-phenylalanine: relation to inhibition of enkephalin degradation and enkephalin levels. In Bonica JJ, et al., eds. Advances in Pain Research and Therapy, Vol. 5. New York: Raven Press, 1983.

64. Walsh NE, Ramamurthy S, Schoenfeld LS, Hoffman J. Analgesic effectiveness of D-phenylalanine in chronic pain patients. Arch Phys Med Rehabil 1986;67:436–9.

65. Sicuteri F. Enkephalinase inhibition relieves pain syndromes of central dysnociception (migraine and related headache). Cephalalgia 1981;1:229–32.

66. Kitade T, Minamikawa M, Nawata T, et al. An experimantal study on the enhancing effects of phenylalanine on acupuncture analgesia. Am J Chin Med 1981;9:243–8.

67. Takeshige C, Mera H, Hisamitsu T, et al. Inhibition of the analgesia inhibitory system by D-phenylalanine and proglumide. Brain Res Bull 1991;26:385–91.

68. Kitade T, Odahara Y, Shinohara S, et al. Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia by D-phenylalanine (first report)—effect on pain threshold and inhibition by naloxone. Acupunct Electrother Res 1988;13:87–97.

69. Kitade T, Odahara Y, Shinohara S, et al. Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia bu D-phenylalanine (2nd report)—schedule of administration and clinical effects in low back pain and tooth extraction. Acupunct Electrother Res 1990;15:121–35.

70. Santos AR, Filho VC, Yunes RA, et al. Analysis of the mechanisms underlying the antinociceptive effects of extracts of plants from the genus Phyllanthus. Gen Pharmacol 1995;26:1499–506.

71. Cechinel Filho V, Santos AR, De Campos RO, et al. Chemical and pharmacological studies of Phyllanthus caroliniensis in mice. J Pharm Pharmacol 1996;48:1231–6.

72. Miguel OG, Calixto JB, Santos Ar, et al. Chemical and preliminary analgesic evaluation of geraniin and furosin isolated from Phyllanthus sellowianus, Planta Med 1996;62:146–9.

73. Syamasundar KV, Singh B, Thakur RS, et al. Antihepatotoxic principles of Phyllanthus niruri herbs. J Ethnopharmacol 1985;14:41–4.

74. Hanck A, Weiser H. Analgesic and anti-inflammatory properties of vitamins. Int J Vitam Nutr Res Suppl 1985;27:189–206.

75. Hieber H. Treatment of vertebragenous pain and sensitivity disorders using high doses of hydroxocobalamin. Med Monatsschr 1974;28:545–8 [in German].

76. Hedner T, Everts B. The early clinical history of salicylates in rheumatology and pain. Clin Rheumatol 1998;17:17–25.

77. Cherng CH, Wong CS, Ho ST. Spinal actions of non-steroidal anti-inflammatory drugs. Acta Anaesthesiol Sin 1996;34:81–8.

78. Robbers JE, Tyler VE. Tyler’s Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York: Haworth Press, 1999, 200–4.

Natural treatment options for Pain

Read what others are saying about these natural treatment options for Pain.

Trivestin [Trevistat Forte] by Covaxil Laboratories
"The first day of one capsule stopped the pain in my left hand and hip. This product is fast acting almost unbelievable. I can highly recommend the product. ..."

Pain-Rx by Hi-Tech Pharmaceuticals
"This is one product I don't want to be without...."

Wobenzym N by Garden of Life
"It really works !..."

Topricin by Topical Biomedics Inc.
"This stuff is just amazing. Works so great for carpal tunnel, helped me get through to my surgery. Now my SIL uses it because she wont go for surgery. ..."

More Weight Loss Supplements

More Bodybuilding Supplements

More Bath & Beauty...

More Herbal Supplements

More Pet Care

More Sexual Health

More Kids Vitamins

Pain

Related Topics

About This Condition

Symptoms

Healthy Lifestyle Tips

Holistic Options