Pain, Pain, Go Away

Everybody hurts sometimes. We might burn ourselves cooking or bang a knee against a hard surface. That acute pain is normal and subsides as your injury heals. But what should you do if your pain doesn't go away? Or, if it fades but eventually returns?

If you've been hurting for over three months, you could have chronic pain. This pain can persist all the time or come and go. Chronic pain could be residual from an injury or illness, but what caused it could also be a mystery. If this describes you, you're not alone.

The CDC reports that 50 million American adults battle chronic pain. While previous surgery, injury, infection or disease can be to blame, other common causes of chronic pain are nerve damage, arthritis, migraines and cancer. Psychological distress also can manifest as physical pain. According to a study in Scientific American, one-third of pain patients have depression or anxiety. Half suffer from both.

If you're in pain, you should talk to your healthcare provider. However, sometimes that conversation can be difficult to have if you struggle to quantify pain on a 1 to 10 scale. Several studies have found that patients were better able to express their symptoms through metaphors. While these studies examined different chronic ailments, each concluded that patients describe the pain as either coming from an internal source or an external source.

For example, an internal pain might feel "like a burning inside" while an external pain might feel like an attack from an outside source, "like being hit by a bus." The British Journal of Health categorizes pain types as the following to make it easier for patients to describe:

• Insertion of pointed objects (e.g., stinging pain)
• Sharp objects (e.g., stabbing pain)
• Pulling/tearing (e.g., wrenching pain)
• Pressure/weight (e.g., crushing pain)
• A malevolent agent (e.g., torturing pain)
• High/low temperature (e.g., burning pain)
• Movement (e.g., shooting pain)

It's important to be able to express what you're feeling, especially if the pain is so severe that it interferes with daily life. Your doctor can diagnose the cause of your pain through x-rays, MRIs, CT scans, nerve tests and blood tests. These will help your physician determine whether you have any fractures, arthritis, pinched nerves, cancers, inflammation or other abnormalities.

Once the cause is determined, your provider may prescribe OTC medicines, antidepressants, muscle relaxers or prescription pain medicines. People with chronic pain may be at higher risk for substance abuse, so be sure to discuss that with your providers, too. Topical products, hot or cold treatment, a TENS unit or steroid injections may also be recommended. Be prepared to consider lifestyle changes such as diet and physical or occupational therapy as well. If your pain stems from stress or other mental health issues, your doctor may suggest you seek psychological counseling.

As you receive treatment for your pain, keep a diary between provider visits to track how often you continue to feel pain or when you find relief, if the pain changes in severity or if you observe certain triggers that cause your pain to worsen. It's important to document how your body responds so that your provider can track your progress and make adjustments to your treatment plan, as needed.

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