Written by Candace Pierce, DNP, RN, CNE, COI.
Whether a sore back, a broken bone, or an achy muscle, pain is a universal part of the human experience. In a healthy body, pain functions as an alarm, alerting the body that something is happening that should not be happening.
What is pain?
The Integrative Pain Institute says that “. . . pain lets a person know that they have injured themselves and [conveys the] need to protect that area while it heals. Once the body part has healed, the nerves in that area ‘calm down’ and stop sending messages to the brain.”
Unfortunately, that alarm system can occasionally malfunction. When the nerves remain “excited,” even without an injury, this can cause unexplained, sometimes debilitating pain. If it continues long-term, that pain becomes chronic pain.
Chronic pain
The Centers for Disease Control and Prevention (CDC) estimate that 50 million Americans have chronic pain, and 19.6 million have high-impact chronic pain. Chronic pain is the most common reason adults seek medical care, become dependent on opioids, suffer from depression and anxiety, and have restricted mobility.
Because chronic pain is becoming more prevalent, Healthy People 2020 developed objectives to decrease the rampancy of debilitating pain in adults.
Learn more about chronic pain in our course, Chronic Pain: A National Problem.
Treatment theories
The Pain Gate Control Theory may offer some insight into how the body processes pain. Sensations travel throughout the body through many nerve pathways and networks, relaying pertinent information such as temperature, pressure, and textures for our brain to interpret. The theory hypothesizes that a gate controls what sensations enter the brain, allowing the brain to perceive one sensation at a time — in other words, whichever sensation arrives first.
As an example, one treatment intended to close that gate is Transcutaneous Electrical Nerve Stimulus (TENS). However, a simple massage or vibration may also function in a similar way, closing the gate and suppressing the pain sensation. The theory has also led to the development of pain management techniques ranging from vibrations during injections to the timing of massages and other sensations for women in labor.
While other non-pharmacological pain management techniques may help with managing acute and chronic pain, it is recommended that patients consult with their primary care provider or pain specialist to develop an individualized, multi-faceted plan that works for them.
Pain management techniques
Below are some techniques that may be included in a pain management care plan as determined in conversation with a healthcare professional.
Exercise
It may seem counterintuitive to exercise while in pain, but exercise can be helpful. Increasing exercise can heighten aerobic capacity, flexibility, strength, and quality of life, and may eventually reduce pain.
Some great exercises include:
- Walking. Walking for 30 minutes, three to five times per week, increases strength, endurance, and heart health. Try working your way up to 30 minutes — start with a 10-minute walk!
- Stretching. Stretching helps to loosen sore muscles and increases the range of motion.
- Yoga. Hatha yoga practice reduced pain and psychological symptoms in women with fibromyalgia.
- Pilates. A 2015 study found that pilates can reduce back pain.
- Biking. Biking is low impact and can be done in short bursts rather than long workouts.
Supplements
Before starting any supplements, it is recommended that patients speak with their provider to ensure they can take them safely. Here are several supplements that research indicates may reduce pain:
- Capsicum/capsaicin. This remedy has been around in over-the-counter pain-numbing agents for quite a while and is known to be effective. Capsaicin is found in chili peppers.
- White willow bark. Known as nature’s aspirin, white willow bark contains salicin and may effectively treat headaches and low back pain.
- Omega-3 fatty acids. These ‘good fats’ may reduce inflammation and help with joint pain and stiffness, menstrual cramps, and back pain. Consuming foods rich in omega-3 fatty acids, such as fatty fish and canola oil, can be helpful. It can also be consumed as a supplement.
- Probiotics. Probiotics are alive in our gut and help us to stay healthy. Consuming additional probiotics lessens inflammation and reduces other symptoms, such as irritable bowel syndrome.
Food
Pain is related to inflammation in the body. Consuming foods with anti-inflammatory properties may not stop pain entirely, but they may help lessen it.
- Hot peppers. Hot peppers contain capsaicin, which may help reduce joint pain. Capsaicin is found in many over-the-counter analgesic creams and has antioxidant effects as well as anti-inflammatory properties.
- Turmeric. A popular seasoning in Indian food, turmeric contains curcumin, which is the part of the spice that has anti-inflammatory properties. According to Healthline, “it matches the effectiveness of some anti-inflammatory drugs, but without the side effects. It does so by blocking the molecule that moves to the cells’ nuclei and activates genes related to inflammation.”
- Garlic. Garlic contains anti-inflammatory sulfur compounds, which may reduce joint pain. In addition, it has antimicrobial properties and may promote heart health and fight cancer.
- Cherries. Cherries contain anthocyanins, which are antioxidants that tend to reduce pain. Consuming tart cherry juice rich in anthocyanins often reduces pain and inflammation.
The bottom line . . .
Patients struggling with chronic pain should work with their healthcare provider to develop a multi-faceted approach to pain management, as this approach has shown to be the most effective strategy for managing chronic pain.
Dive in deep with the latest science on pain and pain treatment in our course, Pain Management: Principles and Practice, 3rd Edition.
Resources
- Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., Kerns, R., Von Korff, M., Porter, L., & Helmick, C. (2018). Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR. Morbidity and Mortality Weekly Report, 67(36), 1001–1006. https://doi.org/10.15585/mmwr.mm6736a2
- How and Why to Exercise with Chronic Pain. (2016, December 28). INTEGRATIVE PAIN SCIENCE INSTITUTE. https://www.integrativepainscienceinstitute.com/exercise-chronic-pain/
- Mitchell, K. (2017, December 17). 7 Exercises For Chronic Pain That Can Actually Help You Manage It. Bustle. https://www.bustle.com/p/7-exercises-for-chronic-pain-that-can-actually-help-you-manage-it-7524955
- Olsen, N. (2018, July 30). 5 Anti-Inflammatory Eats That Will Help Ease Your Pain. Healthline. https://www.healthline.com/health/anti-inflammation-foods-less-pain-arthritis
- Ratini, M. (2017, October 17). Natural Pain Relief: Supplements for Chronic Pain. WebMD. https://www.webmd.com/a-to-z-guides/prevention-15/vitamins/chronic-pain-relief?page=1
- Uma, B., & Clement, I. (2020). Gate control theory of pain. IDC International Journal, 7(3). http://doi.org/10.47211/idcij.2020.v07i03.014
