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Dealing With Acute Pain: What Are The Treatment Options?

Whether caused by injury, surgery or a toothache so bad it slams you awake in the middle of the night, acute pain is difficult.  Receiving prompt and helpful treatment can make all the difference in the world.  But lack of care or inadequate care means that the acute pain may develop into chronic agony.

Fortunately, acute pain is not always long lasting or overwhelming, such as when you have a short severe cramp or multiple bee stings that can be handled with time, over-the-counter medication and other home remedies [See: Pain Treatment Options].

Since individuals’ tolerance for pain varies widely, the question of when pain itself requires urgent medical attention is difficult to answer.  Chest pain should prompt a visit to the emergency room, of course—but other types of pain are trickier to call. Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

How To Have A Pain-Free Hospital Stay

This is a guest post from Dr. Anita Gupta.


How To Have A Pain-Free Hospital Stay

Too often patients feel like they’re in the passenger seat when entering the hospital. Even in the best of circumstances — such as planned admissions — patients often don’t feel in control of their own care.

One of the most unnecessary issues facing patients when they enter the hospital is untreated (or undertreated) pain. Often the focus of the medical team is to treat a condition, and controlling a patient’s pain comes second. Fortunately, this doesn’t need to be the situation. Here are a few tips for patients to ensure that their pain does not go overlooked:

Let someone know if you are in pain. This may seem obvious, but patients often hesitate to question their doctor. Pain control during your hospital stay is not a luxury, and you need to know you have a right to pain control during your stay. If you doctor or nurse is not answering your questions regarding pain, ask to see pain specialist who will likely address your concerns as well as the concerns of the doctors and nurses taking care of you. Unfortunately when it comes to treating pain, not all doctors are trained equally.

Have a family member or good friend to act as your advocate. Have this individual get involved in your medical care and act on your behalf during your hospitalization. Read more »

Science And The Pain Scale

Every day in the emergency department I am confronted by pain. In fact, the treatment of pain is one of the most important skills emergency physicians, indeed all physicians, possess.

For instance, I recently cared for a child with sickle cell disease who was having a pain crisis which involved severe leg pain. His life is one of frequent, intense pain. I gently, and repeatedly, treated his pain with morphine until he had relief. I see hip fractures; all broken bones hurt. I am thrilled to alleviate that discomfort.  Pain is one of the things I can fix, if only temporarily. It makes me happy to see the relaxed face of a man or woman with a kidney stone or migraine, who suddenly smiles and says “thanks!”

But pain is also the source of so much subterfuge. Emergency department are full of individuals who use controlled substances for recreation. I know because they have pain that is entirely unverifiable. They have terrible right flank pain with no gall-bladder, no pancreatitis, no kidney stone (documented by CT), no pneumonia or rash. They have nothing to cause the pain. And yet, dose after dose of narcotic later, snoring in their ER stretcher, they look up at me with hazy eyes and say, thickly, “Cann I gettt somethinn elsss for paaiin…it hurtssss so…bad. zzzz.  Itzzz a tennn.”

So I began to wonder about science and the pain scale. Read more »

*This blog post was originally published at*

Pain Relief Study Has Potential — With A Spin

The development of drugs and other treatments for specific symptoms or conditions relies heavily on either serendipity (the chance finding of a beneficial effect) or on an understanding of underlying mechanisms.

In pain, for example, there are limited ways in which we can block pain signals –- such as activating opiate receptors, or inhibiting prostaglandins. There are only so many ways in which you can interact with these systems. The discovery of a novel mechanism of modulating pain is therefore most welcome, and has the potential of leading to entirely new treatments that may have a better side effect profile than existing treatments and also have an additive clinical effect.

A recent study by Nana Goldman et. al., published in Nature Neuroscience, adds to our understanding of pain relief by identifying the role of adenosine in reducing pain activity in the peripheral nervous system. The researchers, in a nice series of experiments, demonstrated that producing a local painful stimulus in mice causes the local release of ATP (adenosine triphosphate) that peaks at about 30 minutes. This correlates with a decreased pain response in the mice. Further, if drugs are given that prolong the effect of adenosine, the analgesic effect itself is prolonged. Read more »

*This blog post was originally published at Science-Based Medicine*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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