back pain

Pain is a condition that begins in your nervous system. When nerve cells (nociceptors) in your body encounter something that causes pain (a stimulus), they release electrical signals. These signals travel from the stimulus site to your spinal cord and then to your brain, which tells you it’s pain.

Everyone experiences pain. But how each individual does is personal, says Megan Driscoll, MOT, OTR/L, occupational therapist and chronic pain program director at UPMC Rehabilitation Institute. Below, Driscoll speaks further about pain and some of the chronic pain management techniques she uses with patients.

Are There Different Types of Pain?

People typically experience two types of pain:

  • Acute pain: Pain that occurs when you’re injured, when you have surgery, or when you have swelling (inflammation). Tissues become damaged, causing nociceptors to send pain signals to the brain. Acute pain usually resolves as the injury heals.
  • Chronic pain: Pain that continues over a long period of time. Chronic pain may result from nerve damage or from conditions like fibromyalgia, cancer, or inflammatory bowel disease.

Acute pain can sometimes turn into chronic pain, Driscoll says. She uses a broken wrist as an example. “There’s an amount of time we expect there will still be pain,” she says. “When pain continues 3 months beyond what we consider reasonable, we consider that chronic pain.”

According to a 2019 report from the Centers for Disease Control and Prevention (CDC), 20.4% of U.S. adults experienced chronic pain. A little over 7% of adults had pain that kept them from work or activities (known as high-impact chronic pain). Chronic pain was highest in people over age 65.

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Understanding Chronic Pain

“Chronic pain has to be treated differently than acute pain,” Driscoll says. Though you may learn to manage chronic pain at a certain baseline, it’s important to know what to do when pain worsens. “We call it a check-in point,” she says. “It’s the point where you say, ‘OK, I’m not feeling as good as I did. Maybe I need to go talk to my team of professionals.'”

If you have chronic pain, Driscoll recommends that you:

  • Make a plan: See your care team before pain becomes unbearable. Call your health care provider if pain keeps you from working, sleeping, or seeing friends.
  • Educate yourself: Know the triggers that may worsen your pain, such as stress or changes in the weather. Ask your health care professional about exercises you can do at home to reduce pain.
  • Build relationships: Seek a referral to a chronic pain management professional. Get to know your provider so you can work together to manage your pain.

Even if you’re managing chronic pain most days, you can occasionally have acute pain flare-ups, Driscoll says. Call your pain management specialist right away if pain worsens.

Pain Management Options

How health care professionals manage pain depends on whether it’s acute or chronic. Expect your doctor or pain management specialist to examine you and talk with you about your symptoms.

Acute pain management techniques

When you’re experiencing acute pain after injury or surgery, your doctor or pain management specialist may recommend:

  • Heat.
  • Rest, ice, compression, and elevation (RICE).
  • Stretching and exercise.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs).

Chronic pain management techniques

Pain management specialists use multimodal care, or more than one method, to manage chronic pain, Driscoll says. They may recommend:

  • Medications: Doctors may prescribe anticonvulsant (seizure) medications like gabapentin to dampen the nerve response.
  • Trigger point injections: Specialists inject drugs that reduce inflammation (corticosteroids) into painful knots of muscle to help them relax.
  • Exercises: Physical and occupational therapists teach you exercises to stretch and strengthen your ligaments, tendons, and muscles to improve how you move (mobility).
  • Body mechanics: Occupational therapists recommend changes to your environment (such as a new work chair) and daily activities (such as lifting or turning techniques). These improvements help reduce pain by changing how you hold or move your body.
  • Medical marijuana: Physicians may authorize you to use marijuana to reduce chronic pain, relax your muscles, and improve your sleep.
  • Surgery: Doctors may operate to repair damaged tissue or nerves or remove bone that causes chronic pain.

What Else Is There to Know About Pain Management?

Pain management techniques are about treating the whole person. If you have chronic pain, you may benefit from seeing a psychologist. When your brain fears pain, you move differently and change your behavior to avoid it, according to Driscoll.

“Psychology works on our beliefs about those fears,” she says. “Somebody who has experienced pain when they moved in the past may decide they’re not going to move anymore. But maintaining flexibility and muscle strength could improve their pain symptoms.”

To learn more about the Chronic Pain Program at UPMC Rehabilitation Institute, or to schedule an appointment, please call 1-888-723-4277 or visit our website.

Editor's Note: This article was originally published on , and was last reviewed on .

Harvard Health Blog, Medical Marijuana, Link.

MedlinePlus, Pain, Link.

National Institute of Neurological Disorders and Stroke, Chronic Pain Information Page, Link.

National Institute of Neurological Disorders and Stroke, Pain: Hope Through Research, Link.

About UPMC Rehabilitation Institute

The UPMC Rehabilitation Institute offers inpatient, outpatient, and transitional rehabilitation, as well as outpatient physician services so that care is available to meet the needs of our patients at each phase of the recovery process. Renowned physiatrists from the University of Pittsburgh Department of Physical Medicine and Rehabilitation, as well as highly trained physical, occupational, and speech therapists, provide individualized care in 12 inpatient units within acute care hospitals and over 80 outpatient locations close to home and work.