pain management specialistOne of the areas of medicine that we specialize in here at MTV IR is pain management. We use our skills as the best interventional radiology (IR) doctors in Dallas to treat many conditions, but a common attribute of most of these conditions is that they can cause a great deal of chronic pain. So, naturally, a big part of our practice consists of using our IR skills to help patients eliminate or manage their pain.

Over the years, so many patients have asked us questions about pain that we’ve decided to create a resource here on our blog that we can refer people to for answers to those questions. It’s sort of an “overview course” on what pain is and how it’s managed, as if you were studying it in a college course – “Pain 101.”

Because it’s a big subject, we’re going to do this in three separate articles:

  • Pain 101A – What Exactly IS Pain?
  • Pain 101B – Basic and Mid-level Pain Management
  • Pain 101C – Advanced Pain Management using Interventional Radiology

This is the first of the articles. In the second, we’ll deal with some of the ways pain is treated medically, and in the third we’ll deal with some of the specialized interventional pain management procedures we offer at MTV IR.

What is pain?

If you are experiencing pain, it is hard to view that pain as a Good Thing.

But it actually is. Pain is your body’s mechanism for detecting potentially dangerous changes and alerting you to them. For example, if you touch your finger to something hot, you experience pain, and in response you jerk your finger away from the hot object. If you had not felt the pain, you might have kept holding onto the hot object, and burned yourself more seriously.

Where do you experience pain?

Some pain – as in the example of burning your finger above – feels as if it is happening in the area of the body in which you feel it. You burn your finger, and you associate the source of the pain with your finger. But there is also referred pain, such as the pain people feel in the shoulder during a heart attack. The pain is not really occurring in the shoulder, but the brain feels as if it is.

But in both of these examples, the pain isn’t really happening where you feel it.

Pain happens in your brain.

Pain is the result of your brain evaluating a complex set of data that it receives from your nervous system. Sometimes the brain can correctly identify the source of the pain, and sometimes it can’t. But it knows that the pain is real, and that it’s a signal that something is wrong, and needs to be treated.

Why is pain sometimes difficult to diagnose and treat?

Pain is subjective. It’s happening to you, not to your physicians. Your doctors, no matter how well trained they are, have no real way to test for pain or to measure its severity. All they have to go by is how you describe your pain and its severity.

Thus when you are speaking to your doctors or to pain management specialists, you should try to be as clear as you can in your descriptions of what you are experiencing. For example, is it a sharp pain, or a dull one? Does it burn or ache? Does the pain seem to originate in one specific area of the body? Does it occur all day, or primarily in the mornings or the evenings? The more clearly you can describe the pain you are feeling, the better your doctors can evaluate it and find ways to help you eliminate or manage it.

Types of pain

Medical doctors tend to divide pain into two major categories, depending on whether it is short term or long term:

  • Acute pain is a severe or sudden pain that occurs immediately after an illness, injury, or surgery. Acute pain usually resolves itself within a short period of time (no longer than 2 months).
  • Chronic pain is persistent, and can last for six months or longer. Chronic pain is harder to diagnose, because its exact cause can be difficult to pinpoint. Also, chronic pain varies from person to person. Two people with what appears to be the same kind of chronic pain may need very different treatments to resolve it. But treatment is necessary, because chronic pain is considered a medical condition in itself. It “wears you down” so much – mentally, emotionally, and physically – that it can seriously impact your overall health and quality of life.

If you are experiencing acute pain, you usually know what the source of the pain is in the body. If you cut or scrape your arm, you feel pain at the site of the injury. Acute pain is triggered by tissue damage, so the source of the pain is usually the location where the tissues have been damaged by injury or disease.

Chronic pain is not so clear-cut. You may not be able to pinpoint the exact location or cause of the pain. It may persist – or become more intense – long after an injury has healed, or it may occur without any history of injury or illness.

Severity of pain

Another factor that makes diagnosing and treating pain difficult is determining its severity. Again, your doctors have no objective scale by which to measure “how bad” the pain is, and must go by what you tell them. To do this, they may ask you a number of questions, to help them develop a pain history that tells them how severe your current pain is, compared to your past experiences of pain.

Doctors use different scales to measure pain. They may ask you to rate your pain numerically, on a scale of 1 to 10, with 0 meaning no pain at all, and 10 meaning the worst pain you can imagine. They may ask you questions about how your pain affects your moods, your sleep patterns, your activity level, and your relationships with other people. Again, try to be as clear as possible when describing your pain and the impact it is having on your life, because that will help your doctors find ways to manage the pain.

What’s next in “Pain 101”?

Now that you understand a little more about the basics of what pain is and where it’s really experienced (in the brain), in our next article we’ll explain more about the different ways that pain is treated. This will include discussions of basic and mid-level pain treatments. Then, in our third article we’ll explain more about the advanced pain management options we offer at MTV IR.