What is Pain?
Pain is part of the human condition; it is something that we all experience at one time or another, from infancy to old age. According to the International Association for the Study of Pain, pain is defined as: an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage . Other than clinical definitions, or those provided by dictionaries, pain is a hard thing to define. No person can feel another’s pain—despite the popular saying—and therefore cannot objectively evaluate or analyze one’s pain.
What is Pain Management?
Pain management is a multidisciplinary approach to making pain tolerable by learning physical, emotional, intellectual, and social skills. This may include exercise, physical therapy, medication, holistic therapies, and counseling .
There are four types of pain associated with the neck and back: acute, chronic, neuropathic, and nociceptive.
> Acute Pain is severe short-term pain. It is considered self-limiting because the pain acts to stop or limit an activity so that further tissue damage does not occur. Breaking your arm while climbing a tree or post-surgery pain are examples of acute pain. The longer the duration and the more severe the pain, the more likely it is to turn chronic. This is because, during pain, nerves that block pain die off and nerves that transmit pain create new paths and become more sensitive.
> Chronic Pain is pain that lasts long term—defined as longer than six months—after an injury. It can last years, decades, or even for the rest of your life. About 100 million Americans suffer from chronic pain. Chronic pain can be mild or excruciating, episodic or continuous, just inconvenient or completely debilitating . Chronic pain can take an emotional toll on a person, causing sadness, anxiety, stress, depression, anger, and fatigue. The most common sources of chronic pain stem from headaches, joint pain, injury, and neck/back injuries .
> Neuropathic Pain has been described by patients as a burning, electric, tingling, and/or shooting sensation. Neuropathic pain usually cannot be controlled by traditional pain medications. It is considered chronic pain that is usually accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional, or injured, sending incorrect signals to other pain centers. Nerve fiber injuries change the nerve function, both at the site of the injury and the areas around it. Phantom limb syndrome is an example of neuropathic pain .
> Nociceptive Pain is caused by tissue damage and is localized to one area. It is described as sharp, aching, or throbbing. Nociceptive pain usually responds to non-steroidal anti-inflammatory drugs (NSAIDs) and narcotic pain medications.
Pain Managements Role in Back Pain
Pain management is usually differentiated from surgical treatment options. It can be used for a variety of different things, besides to relieve pain. Pain management can be used to:
> Help identify the source of a patient's back pain
> As an alternative to surgery
> To help determine the areas to be addressed surgically
> To help rehabilitate the patient after surgery
> For patients after surgery to cope with residual pain 
What can be done about the pain?
> Self-care refers to taking care of yourself so as to manage the pain naturally. This is often the first step in pain management. Stress makes pain worse, so managing it will be very helpful in pain reduction. Taking care of yourself in other ways will be helpful also, like getting enough sleep, maintain your weight, eating healthy, and restraining from bad habits like smoking and alcohol.
> Exercise is empirical to reducing pain since flexible, toned muscles feel less pain than taught, weak ones. No matter the level of pain you are in, there is always some level of exercise that is doable and tolerable.
> Alternative Medicines like natural products, vitamins, diet, herbal medicines, and dietary supplements may help.
> Alternative Techniques like meditation, deep-breathing exercises, guided imagery, progressive relaxation, biofeedback, hypnotherapy, tai chi, qi gong, yoga, prayer, music/dance/humor therapy, and Pilates may be helpful for some.
> Alternative Medicine Systems like acupuncture, Ayurveda, homeopathy, Native American healing practices, traditional Chinese medicine, and naturopathic medicine have been reported by some patients to be helpful.
> Spinal Manipulation like chiropractic, osteopathic, and massage therapy will help in the same way that exercise will, only it will be more controlled and administered by a professional.
> Spinal Surgery includes a multitude of options, each with their own success rate. 
Medications are a common option for those suffering from chronic and acute neck or back pain. Although it has its limitations and drawbacks, it is very effective. For this reason, it is almost always part of a multidisciplinary treatment plan.
> Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Motrin, Advil), and naproxen (Aleve) are used to reduce inflammation and relieve pain. Long-term use of analgesics and NSAIDs can cause other health problems, like stomach ulcers, and kidney and liver problems.
> Analgesics like acetaminophen (Tylenol) and tramadol (Ultram) can provide some pain relief, but don't have the anti-inflammatory properties of NSAIDs.
> Muscle relaxants are used to treat pain associated with muscle spasms and spasticity.
> Antidepressants/Anticonvulsants, while not traditional pain medications, can be used to relieve pain specific to the nerves.
> Steroids can be used to reduce the swelling and inflammation of the nerves. They have the advantage of providing pain relief within a 24-hour period, but are temporary. Steroids can be administered orally or by injection.
> Narcotics/Opioids are very powerful pain relievers that actually deaden a person’s perception of pain. For this reason, they can be very effective. They are used for a short period, usually 2 to 4 weeks, after an acute injury or surgery. Narcotic medications cause impaired mental function, drowsiness, nausea, constipation, and can be addicting. They should be used with caution.
> Injections, also known as Blocks, deliver steroids or anesthetic directly into joints, ligaments, muscles, or around nerves. Although they are temporary, they can provide significant relief and help your doctor pinpoint the location of the injury or pain. 
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