Pain

Pain Is Subjective

There is no objective way to measure pain; therefore, doctors refer to pain as being subjective. In order to determine level of pain, doctors will generally refer to a classification such as listing 1 through 10, 10 being the worst pain and 1 being very little pain, and the doctor will ask you to classify your pain on a scale of 1 to 10 to try to get an idea of how severe the pain is.

Pain and the Brain

Pain, as in all sensation, is really in the brain because the area of the body that is either inflamed or damaged will send a message to the brain that something is wrong. So, if a bone is broken, a ligament torn, a tendon torn, a muscle bruised, if there is an abnormal growth such as cancer to a particular part of the body, the signals will go from that part of the body up to the brain and will tell the brain that there is something wrong and the person will feel pain. For further information see BRAIN INJURY.

Pain and Cause & Effect

Pain is usually related to cause and effect. If you fall down and bruise your knee, generally you will feel pain. If you go to the doctor and he says, “Where does it hurt?”, and you say, “It hurts in my knee, ” then the doctor will take a history. A history is the best way for the doctor to be able to find out whether or not you have pain and the cause of the pain and the nature of the pain. So if you go to the doctor and say, “I fell down and banged my knee on the ground and my knee hurts,” the doctor will say through cause and effect that you really do have pain in the knee. On the other hand, if you walk into the doctor and say, “I have a pain in my elbow,” and the doctor takes a history and you have not done anything to the elbow, the doctor may be more perplexed, and will X-ray the elbow and put it through various movements in order to do an analysis of whether or not there is an objective cause for the subjective pain. That is basically what doctors are looking for: that the pain is a mechanism for the body to tell the person or the doctor that there is something wrong with that particular part of the body. When you describe the nature and the extent of the pain and the location of the pain, the doctor, through his training and experience, will try to analyze what is causing the pain and therefore try to reach the solution of how to fix the pain.

It’s All in Your Head Theory!

Sometimes when doctors cannot find the cause of the pain, they get very frustrated, and they tend to believe that the person is faking the pain or is not really in pain, especially if the person has another motive for saying that they are pain, such as they have been in an accident and are trying to collect money. The mere fact that the doctor is unable to properly diagnose the pain does not mean the person does not feel it. It just may be that the doctor, for whatever reason, is unable to tie the pain in to the particular accident or the particular cause of the pain.

Acute Pain vs Chronic Pain

Pain: Acute as Opposed to Chronic Acute pain is pain that comes about at one time, such as being rear-ended in an automobile accident and having the pain come on immediately. Chronic pain is pain that stays with you and comes over a long period of time, such as arthritis or degenerative disc disease, and causes pain over a long period of time. Trauma, meaning a blow or an injury, is the usual cause of acute pain. Back pain is one of the most usual causes of pain relating to an automobile accident.

Medical Tools for Diagnosis

CT Scan & Diagnosis

A CT Scan is performed after contrast material is injected into the disc space.

MRI Scan & Diagnosis

An MRI Scan is performed when the patient is placed in a horizontal cylinder and exposed to a strong magnetic field. Radio waves are beamed into the patient and a receiver detects their frequency as they interact with matter. The variations produced in the magnetic field are mathematically transformed into televised images showing differences in body tissues.

Treatments for Pain Symptoms

Back pain is usually treated conservatively at first. Conservative treatment would be things such as medication, bed rest, exercise, posture training, medication, heat treatment, low back supports and braces, ultrasonic treatment, traction, massage, manipulation, possibly acupuncture, epidural injection, tens unit stimulation. These types of conservative treatments will usually go on for a period of approximately three months. If the person was not receiving relief from these types of treatments, and the doctor did not feel that the person was getting any better, then the doctor would probably have the person go through an MRI or a CT scan to see if there is any sign of nerve entrapment, bulging disc or herniated disc, or other more severe injury.

Treatment for Soft Tissue Injury

These conservative types of treatment would generally be good for what is considered to be soft tissue injury, which is stretching or pulling of the muscles, ligaments or tendons. If none of these types of treatments were successful, then after the doctor gave the patient an MRI scan or a CT scan and found nerve impingement, there may be an indication for the need of surgery.

Surgery as Treatment to Relieve Pain

The purpose of the surgery would be primarily to relieve the pain, reduce the pain, or correct any mechanical instability in the spine. One type of spinal surgery would be a discectomy, which is a standard method of surgical decompression. Stabilization would be achieved by vertebral fusion, or by internal fixation with screws. This is where the doctor actually goes in and puts in screws and plates to hold the two vertebrae firmly in place so they cannot move around. In a discectomy, the entire disc is removed, i.e., the part of the spine that is acting as a cushion between the two vertebrae.