Primary Pain Management

Written by PathologyPrevention
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Pathology prevention practices that provide pain management can be divided into two types, those addressing acute pain, and those addressing chronic pain.

Acute pain – a normal response to an injury or medical condition. It starts suddenly and is usually short-lived.

Chronic pain – continues beyond the time expected for healing. It generally lasts for longer than 3 months.

Normally, those concerned with pathology prevention aren’t addressing pain as much as those things that might cause the pain. However, there are times that pain must be addressed in pathology prevention, especially with chronic diseases.

Acute pain and chronic pain may present anything from a dull ache to a sharp stab and can range from mild to extreme. You may feel pain in one part of your body, or it may be widespread.

In primary care, the “go-to” medicine may be ibuprofen (ADVIL™) to increase blood flow, reduce swelling, and reduce localized pain. Or you may go to acetaminophen (TYLANOL™). When you consider acetaminophen, think of “the Head”. This pain killer reduces the pain response in the head and is much more effective for generalized pain.

When your management strategy is off the shelf pain medicines, these are typically your choices. Acetaminophen works in the brain to reduce pain and fever, while ibuprofen has the added benefit of reducing inflammation and swelling at the site of an injury.

As you may have guessed from the descriptions above, acetaminophen is best used for fever, aches, and pains, but will not be very helpful if the pain is due to inflammation. Ibuprofen is more helpful for these symptoms when inflammation is the cause. Inflammation examples include menstrual cramps and arthritis.

Your specific pain management strategy can be a mixture of both ibuprofen and acetaminophen as is normally used after dental work. This is leveraged by either consuming both medicines together, or by rotating them between a shorter period of time, i.e. 3 ibuprofen followed by 2 acetaminophen every 4 hours or 3 ibuprofen followed by 2 acetaminophen 2 hours later.

Key pain management strategies in primary care other than pain medicines include:

  • Physical therapies (such as heat or cold packs, massage, hydrotherapy, grounding, acupuncture, and exercise)
  • Psychological therapies (such as cognitive behavioral therapy, relaxation techniques and meditation)
  • Mind and body techniques (such as magnetism)
  • Community support groups.

As a reminder, we point out that the Health Guardian is the primary care provider for the individual or family working in collaboration with other professionals. In this article we only covered a few of the physical therapies and will leave the rest pain management strategies for another article.

When it comes to pain management, the differentiator can be about severity as much it is about duration. The Health Guardian normally must choose a strategy while considering all else that’s going on.

The specific strategy chosen might be a combination of not only a medicine strategy, but methods from other strategies as well. Our advice is not to fall into the trap of a single method all the time, but to be as ‘holistic’ as possible, considering multiple strategies working together. This should be an example of collaborative medicine, and consulting with the rest of their trusted health providers when appropriate.

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