Pain

What is pain?

Pain is an unpleasant sensation that may indicate an underlying problem, such as an injury or infection. There are many different types of pain, such as aching, stinging and burning sensations. The type of pain and it’s severity can indicate the underlying cause. Pain treatment can focus on resolving the underlying cause or treating the pain directly.

What are common types of pain?

Pain can affect many different areas of the body and can have many different causes. Here we summarise some of the most common types of pain:

• Chronic pain is classified as pain that persists for longer than 12 weeks despite pain relief medication. It can be difficult to treat chronic pain, and pain medications may work best when combined with various lifestyle changes where possible. 
• Muscle & joint pain is pain that specifically affects certain muscles or joints. It is often caused by exercise, but can also be caused by poor posture, sporting injuries or degenerative or inflammatory conditions such as arthritis. 
  • Knee pain is often caused by an injury to the knee or general wear and tear from overuse. If the knee pain comes on very gradually over time, it could be due to a degenerative condition such as osteoarthritis. You should see your doctor if your knee pain is severe, if it is accompanied by any other symptoms such as swelling, or a fever.
  • Shoulder pain can have many different causes, including sports injuries, inflammation of the joint, trapped nerves, arthritis, joint instability and other damage to the joint. Shoulder pain often resolves on its own, but you should see a doctor if it does not resolve within 2 weeks or more. 
  • Back pain often becomes more common as we get older, but it can also be caused by a lack of exercise, lifting heavy objects and being overweight. Back pain can also be related to a number of other medical conditions such as osteoarthritis, ankylosing spondylitis and some types of cancer. You should see your doctor if your pain does not get better within a few weeks, if it is very severe, or if it starts impacting your day-to-day life. 
• Period pain can be used to refer to stomach cramps, back ache or other symptoms associated with your period. Period pain is often related to increased levels of inflammatory chemicals called prostaglandins in your body. Anti-inflammatory medications such as ibuprofen can be an effective treatment for period pain. 
• Toothache is often caused by tooth decay, but may also be caused by infections or damage to your teeth. Many people also experience tooth pain in relation to cold foods and drinks. If you have a toothache for more than one or two days, you should see your dentist for treatment and advice. In the meantime, ibuprofen or paracetamol may provide some relief.

Can pain be psychological?

People can experience psychological pain. This may be as a result of a mental health condition such as depression, or as a natural response to life events such as grief or trauma. Pain can also be psychosomatic. This is when a physical sensation of pain is experienced or aggravated in response to a psychological factor such as stress.

When to see a doctor about your pain?

You should see a doctor about your pain in the following situations:

• If you have symptoms of a heart attack:
  • Chest pain that feels crushing or tight in the centre of your chest
  • Pain that travels to other parts of your body i.e. your arm, neck or jaw
  • Feeling lightheaded or dizzy
  • Shortness of breath
  • Sweating
  • Nausea or vomiting
  • Coughing or wheezing
  • Overwhelming feeling of anxiety or panic
• If your pain is associated with other symptoms such as wound infection, nausea, hallucinations, blood or pain when urinating etc.
• If over the counter painkillers, such as ibuprofen and paracetamol, do not sufficiently control your pain
• If your pain is significantly affecting your life i.e. you cannot go to work, you are having difficulty sleeping etc. 
• If you feel that your pain is severe

Different types of pain

Pain can feel very different depending upon the specific cause of the pain. To ensure you get the best treatment, it can be helpful to consider exactly what your pain feels like and if it appears alongside any other symptoms. The following list may help you identify the specific features of your pain:

• Site - Where is your pain located? 
• Onset - When did you first become aware of the pain? What were you doing at the time? Do you know what might have caused your pain?
• Character - What does your pain feel like? Burning, stabbing, aching, stinging etc.
• Radiation - Does your pain radiate (move) to other parts of your body?
• Associated symptoms - Are there any other symptoms you’re experiencing related to your pain? Nausea, a fever, inflammation, an injury etc.
• Time - How long have you had this pain? Have you had it before? Does the pain come and go? How long does the pain last?
• Exacerbating factors - Is there anything that makes the pain worse? Exercise, moving the joint, putting weight on the area etc.
• Severity - How severe is the pain? On a scale of 1 to 10, where would you rate this pain?

How pain affects the body

Pain can affect the body in a number of different ways:

• Can pain make you feel sick? - Intense pain can cause nausea in some people. There also may be an underlying disease that is causing both nausea and sickness. 
• Can pain make you tired? - Pain can make you tired. Pain uses physical and emotional energy which can make you feel tired if prolonged.
• Can pain make you pass out? - In cases of severe pain, some people do lose consciousness. This is because pain can stimulate the vagus nerve, which can affect your blood pressure and make you pass out. People may also lose consciousness due to squeamishness around the cause of the pain i.e. fainting at the sight of blood. 
• Can pain cause fever? - Pain itself does not cause fever. However, both pain and fever can be a symptom of inflammation in the body. If you have an infection, you may experience both pain and fever, but it is the infection, not the fever, that is causing the pain. 
• Can pain make you sweat? - Intense pain can cause cold sweats. However, if you are experiencing pain in a specific area, and night sweats, you should speak to a doctor to check for any concerning underlying causes. 
• Can pain cause diarrhoea? - Pain does not actually cause diarrhoea, however, the diarrhoea and pain may have the same cause, such as a bowel infection. Period pain can refer to a range of different symptoms, including stomach cramps. Some people also experience diarrhoea during their period due to the changing hormone levels at this time. If you have taken any pain relief medication, this could also lead to diarrhoea in some people. 
• Can pain cause high blood pressure? - Pain can temporarily increase your blood pressure. This is because pain causes release of adrenaline in your body, which also has the effect of increasing your blood pressure.

Types of pain relief

Paracetamol

Paracetamol is one of the most popular painkillers in the UK. It is particularly suited to the treatment of headaches, stomach aches, sunburn and toothaches. As a registered pharmacy, paracetamol is available from Dr Felix in larger quantities than you can buy in most high street stores and supermarkets.

NSAIDs

NSAIDs are a popular group of anti-inflammatory drugs that include medications such as ibuprofen, naproxen, diclofenac and aspirin. They reduce inflammation, which then alleviates inflammatory symptoms such as pain and swelling. For this reason, they are particularly suited to certain types of pain with an inflammatory component such as: back pain, joint pain,muscle pain, period pain, and migraines. NSAIDs are most commonly taken as tablets, but various gels, such as Voltarol and ibuprofen gel are also available for more targeted pain relief. 

Anaesthetics

Local anaesthetics, such as lidocaine and benzocaine, stop the nerves from sending pain signals to the pain. This makes them very effective for treating pain in a specific area,including pain that is not caused by inflammation. 

Opioids

Opioid painkillers include a range of drugs such as codeine and morphine. They can be highly effective and are used to treat more severe pain. However, opioids are not available through Dr Felix, as they can become addictive. However, if appropriate, medications such as codeine may be supplied under the supervision of a pharmacist or prescribed by your doctor.

Treatment for mouth ulcers and oral pain

A range of different gels & liquids is available to treat mouth ulcers and areas of soreness caused by braces & dentures. These medications typically contain a local anaesthetic to treat the pain alongside an antiseptic, to help prevent infection. Anbesol and Bonjela are available from Dr Felix.

Treatment for muscle and joint pain

Muscle and joint pain is most commonly treated by anti-inflammatory medications such as ibuprofen gel and diclofenac (Voltarol). These medications reduce inflammation, which then alleviates symptoms of inflammation such as pain and swelling. Other products such as FlexiSEQ can also be used. FlexiSEQ works by lubricating the joint surfaces, allowing them to slide over each other more easily.

What pain relief can I take when pregnant?

Paracetamol is usually the best choice of pain relief during pregnancy. If you do take paracetamol during pregnancy, you should take the lowest effective dose for you and you should take it for the shortest time possible. Medications can travel across the placenta and may cause harm to your child, so it is always best to speak to your pharmacist or GP before taking any medication during pregnancy.

Which pain killer after COVID vaccine?

After a COVID vaccine, you may experience side effects such as pain, a headache, a high temperature or feeling shivery. You can take paracetamol or ibuprofen to treat these symptoms, providing it is usually safe for you to take these medications. You may choose to take paracetamol or ibuprofen shortly after the vaccine to try and avoid some of these side effects. Both paracetamol and ibuprofen act as painkillers and can reduce a temperature, which may help you to avoid these side effects.