Treatment

Various Possibilities

Effective and early treatment1 of acute pain is of major importance for preventing the chronification of pain. If pain remains untreated for a longer period, the nervous system may be altered, and the pain can persist after the injury has healed. This phenomenon is defined as “pain memory”.

Pharmacologic pain treatment includes a wide range of analgesics for different pain levels. For the treatment of mild pain non-opioids are used. These are also called “peripherally acting analgesics”, as they predominantly have peripheral effects. For more severe pain opioids can be applied, which are also known by the term “centrally acting analgesics” (CAA) since they primarily have a central effect (in the brain or spinal cord). Based on the mode of application one can distinguish between systemic treatments (taken orally or administered parental) and topical treatments (being applied directly to the painful area e.g. plaster).2 In addition, so-called co-analgesics are used when appropriate. Co-analgesics are medications whose primary indication is for a purpose other than pain relief, but that demonstrate some analgesic effects (e.g. antidepressants).

Additionally, non-pharmacologic approaches such as transcutaneous electrical nerve stimulation (TENS), acupuncture or hypnosis may support pain control.

WHO Pain Management Guidelines

As a guide for using analgesic drugs appropriately, the World Health Organization (WHO) developed the so-called “Pain Relief Ladder”. It was originally developed for cancer pain therapy but is now widely established in managing chronic pain. It recommends a progressive, stepwise use of analgesics based on patients’ level of pain:

Pain Relief Ladder WHO

In case you experience severe pain, please contact your doctor.

1 The International Association for the Study of Pain (IASP): Acute and postoperative pain. Accessible at http://www.iasp-pain.org/AM/Template.cfm?Section=Home&Template=/CM/ContentDisplay.cfm&ContentID=2003, last accessed February 25, 2011
2 Galer BS: Topical analgesic medication – The dawn of a new era. Pain, 2009, 147: 5-6

online:  23 Sep 2012