What is Pain?

by National Institute of Health

Receptor nerve cells in and beneath your skin sense heat, cold, light, touch, pressure, and pain. You have thousands of these receptor cells, most sense pain and the fewest sense cold. When there is an injury to your body — in this case surgery — these tiny cells send messages along nerves into your spinal cord and then up to your brain. Pain medicine blocks these messages or reduces their effect on your brain.

Sometimes pain may be just a nuisance, like a mild headache. At other times, such as after an operation, pain that doesn't go away- -even after you take pain medicine — may be a signal that there is a problem. After your operation, your nurses and doctors will ask you about your pain because they want you to be comfortable, but also because they want to know if something is wrong. Be sure to tell your doctors and nurses when you have pain.

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Purpose of this Booklet

This booklet talks about pain relief after surgery. It explains the goals of pain control and the types of treatment you may receive. It also shows you how to work with your doctors and nurses to get the best pain control.

Reading the booklet should help you:

• Learn why pain control is important for your recovery as well as your comfort.
• Play an active role in choosing among options for treating your pain.

Treatment Goals

People used to think that severe pain after surgery was something they "just had to put up with." But with current treatments, that's no longer true. Today, you can work with your nurses and doctors before and after surgery to prevent or relieve pain. Pain control can help you:

• Enjoy greater comfort while you heal.

• Get well faster. With less pain, you can start walking, do your breathing exercises, and get your strength back more quickly. You may even leave the hospital sooner.

• Improve your results. People whose pain is well-controlled seem to do better after surgery. They may avoid some problems (such as pneumonia and blood clots) that affect others.

Pain control: What are the options?

Both drug and non-drug treatments can be successful in helping to prevent and control pain. The most common methods of pain control are described below. You and your doctors and nurses will decide which ones are right for you. Many people combine two or more methods to get greater relief.

Don't worry about getting "hooked" on pain medicines. Studies show that this is very rare — unless you already have a problem with drug abuse.

Pain Control Methods You May Be Using

To get the best results, work with your doctors and nurses to choose the methods that will work best for you.

Your nurses and doctors want to make your surgery as pain free as they can. But you are the key to getting the best pain relief because pain is personal. The amount or type of pain you feel may not be the same as others feel — even those who have had the same operation.

Before surgery

Drug treatment: Take pain medicine.

Non-drug treatment: Understand what operation the doctor is doing, why it is being done, and how it will be done. Learn how to do deep breathing and relaxation exercises

During surgery

Drug treatment: Receive general anesthesia, spinal anesthesia, or nerve blocks, or take a pain medicine through a small tube in your back (called an epidural).

After surgery

Drug treatment: Take a pain medicine as a pill, shot, or suppository, or through a tube in your vein or back.

Non-drug treatment: Use massage, hot or cold packs, relaxation, music or other pastimes to distract you, positive thinking, or nerve stimulation (TENS).

What can you do to help keep your pain under control? These seven steps can help you help yourself.

Before surgery

1. Ask the doctor or nurse what to expect.

• Will there be much pain after surgery?
• Where will it occur?
• How long is it likely to last?

Being prepared helps put you in control. You may want to write down your questions before you meet with your doctor or nurse.

2. Discuss the pain control options on pages 2 and 3 of this booklet with your doctors and nurses.

Be sure to:

• Talk with your nurses and doctors about pain control methods that have worked well or not so well for you before.
• Talk with your nurses and doctors about any concerns you may have about pain medicine.
• Tell your doctors and nurses about any allergies to medicines you may have.
• Ask about side effects that may occur with treatment.
• Talk with your doctors and nurses about, the medicines you take for other health problems. The doctors and nurses need to know, because mixing some drugs with some pain medicines can cause problems.

3. Talk about the schedule for pain medicines in the hospital.

Some people get pain medicines in the hospital only when they call the nurse to ask for them. Sometimes there are delays, and the pain gets worse while they wait.

Today, two other ways to schedule pain medicines seem to give better results.

• Giving the pain pills or shots at set times. Instead of waiting until pain breaks through, you receive medicine at set times during the day to keep the pain under control.

• Patient controlled analgesia (PCA) may be available in your hospital. With PCA, you control when you get pain medicine. When you begin to feel pain, you press a button to inject the medicine through the intravenous (IV) tube in your vein.

For both ways, your nurses and doctors will ask you how the pain medicine is working and change the medicine, its dose, or its timing if you are still having pain.

4. Work with your doctors and nurses to make a pain control plan.

You can use the form on pages 12 and 13 to begin planning for pain control with your nurses and doctors. They need your help to design the best plan for you. When your pain control plan is complete, use the form to write down what will happen. Refer to it after your operation. Then keep it as a record if you need surgery in the future. After surgery

5. Take (or ask for) pain relief drugs when pain first begins.

• Take action as soon as the pain starts.
• If you know your pain will worsen when you start walking or doing breathing exercises, take pain medicine first. It's harder to ease pain once it has taken hold. This is a key step in proper pain control.

6. Help the doctors and nurses "measure" your pain.

• They may ask you to rate your pain on a scale of 0 to 10. Or you may choose a word from a list that best describes the pain.

• You may also set a pain control goal (such as having no pain that's worse than 2 on the scale).

• Reporting your pain as a number helps the doctors and nurses know how well your treatment is working and whether to make any changes.

• They may ask you to use a "pain scale".

7. Tell the doctor or nurse about any pain that won't go away.

• Don't worry about being a "bother."
• Pain can be a sign of problems with your operation.
• The nurses and doctors want and need to know about it.

Stick with your pain control plan if it's working. Your doctors and nurses can change the plan if your pain is not under control. You need to tell the nurses and doctors about your pain and how the pain control plan is working.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.