Guide to pain and pain relief
If you feel that you suffer from the kind of deep-seated aches and pains that seem to offer no respite, you're not alone.
According to the Arthritis Research Campaign, arthritis and rheumatic disease affect around eight million people in the UK, and are among the most common causes of illness, accounting for one fifth of all visits to the doctor.
What's more, according to the National Back Pain Association, around 60% of all adults suffer back problems every year. Back injury is the largest single recorded cause of long-term sick leave.
Pain can be wearing, depressing and can become a barrier to enjoying a normal life. But it needn't be. The fact is, there's a great deal you can do to relieve and control pain - and the first step is to understand the causes.
What is pain?
Pain is actually an essential warning system, alerting you to physical problems that need attention. It also protects you by discouraging the activity that is causing the damage, and so preventing further harm.
The pain process
What causes pain?
When pain goes on beyond a few days it stops serving a valuable function and becomes a problem in its own right. Backache, rheumatic and arthritic pain are the most common examples.
The proliferation of back pain, in particular, is easy to understand. The back has 149 joints, each with its own cluster of tendons and ligaments and a series of muscles. Each individual muscle cluster has the ability to be painful. Poor posture and careless lifting can cause agony through slipped discs and trapped nerves, leading to sciatica or lumbago.
Most joints can suffer, but hips, knees and hands are the most vulnerable. They can become swollen, stiff, inflamed - and constantly painful.
What can be done about pain?
There is a wide range of options for relieving pain. However, you should always consult your doctor before embarking on any treatment method.
Surgery
Clearly, this is an option only for more severe pain. Orthopaedic surgeons specialise in joint and spinal problems and may be involved in fitting artificial hips and knees. Your GP can tell you all you need to know.
Manipulation
Chiropractors specialise in correcting abnormalities of the spine. They manipulate the bones manually to free the joints and correct the spine's alignment with other parts of the body, including the pelvis. Osteopaths combine massage and manipulation with the aim of restoring normal movement in the affected area.
Chiropractic manipulation in particular can be quite vigorous, so talk to your GP first, who may be able to make a recommendation.
Corticosteroid Injections
A corticosteroid is a powerful anti-inflammatory drug used to relieve severe pain. This must be given by a doctor.
Physiotherapy
Physiotherapists treat mainly skeletal muscle, tendon and ligament problems through exercise and movement. With a programme of manipulation and mobilisation, passive and active exercise, they restore the movement to the damaged area. Exercise can help reduce both the pain and the likelihood of repeat injury. Physiotherapists use techniques such as heat treatment, massage and ultrasound, and recommend exercise for patients to do at home. Your GP can refer you to a physiotherapist, or you can go direct to a private physiotherapist.
Acupuncture
The use of fine needles to treat pain is based on an ancient Chinese therapy. Inserting the needles at special points in the body is thought to release endorphins, the body's natural painkiller. Acupuncture is offered by some GPs and physiotherapists.
The Alexander Technique
The Alexander Technique addresses the basic cause of many cases of back pain, breathing disorders, stress-related illness and general fatigue where incorrect posture and body use is a contributory factor. For more details, contact The Society of Teachers of the Alexander Technique (See 'Useful telephone numbers' below).
Hypnotherapy
Hypnotherapy generally aims to change your perceptions of pain rather than treating the cause. Once the cause of the pain has been diagnosed by your GP, hypnotherapy may be available on the NHS.
Muscle Relaxants
When a joint is injured, muscles may go into protective spasm to help prevent further damage. If the spasm fails to subside, you can ease the pain with a muscle relaxant, usually in the form of tablets which your doctor can prescribe.
Aromatherapy
Gentle massage using pure essential oils is considered therapeutic and very relaxing. A professional aromatherapist, following a consultation, will blend essential oils in a carrier oil thought to help alleviate both pain and stress.
Homoeopathy
Homoeopathy is a gentle holistic treatment intended to relieve such conditions as muscular pain, stiff necks and rheumatic conditions. For further information contact a professionally trained homoeopath.
Some lifestyle changes to avoid pain
Taking care of your muscles and joints is basic good sense. If you do not suffer from pain, exercise and good posture can do much to prevent it developing. If pain is already a problem, these factors become even more important.
Regular exercise
Gentle exercise, especially walking and swimming, is usually highly advisable both to prevent pain and to relieve it.
As well as strengthening muscles and improving joint flexibility, exercise is good for your overall health and a great stress reliever. Many specialists recommend gentle exercise rather than bed rest for back pain.
However, if you're in pain, before commencing any exercise, the best advice, as always, is to talk to your doctor.
Relaxation
Pain can cause muscle tension - and that can make the pain worse. Learning to relax effectively can bring both physical and psychological benefits. There are evening classes, books and tapes which can teach you what to do.
Posture awareness
Sitting, walking and lying down can all be root causes of pain if your posture is putting joints under strain.
When at a desk or driving, sit upright and straight. Choose a chair that supports the small of your back. Your feet should rest easily on the floor. Change your position frequently.
Try to stand tall when you're walking, with your back upright and your stomach in. And at night, choose a firm mattress and avoid sleeping curled up. If you have back pain, lie flat and support the small of your back with a lumbar support such as a rolled-up towel.
Careful lifting
One careless lift can cause a lifetime of pain. Always bend your knees, not your back, when you pick up anything heavy, and keep the load close to your body.
A good tip for shoppers is never to carry one heavy bag. Pack your shopping in two bags and spread the load, one in each hand.
IF YOU SUFFER FROM PAIN, YOU SHOULD ALWAYS CONSULT YOUR GP OR A PHARMACIST BEFORE COMMENCING TREATMENT
Self-help - what pain relief is available from your pharmacist
There are three main types of pain medication available to you:
Oral painkillers
There are a wide variety of oral painkillers available. Non-steroidal anti-inflammatory drugs (NSAIDs), in particular, are effective in easing mild to moderate pain and reducing inflammation. Oral NSAIDs can sometimes cause stomach irritation, especially when taken over a long period of time.
Topical painkillers
The latest generation of applied painkillers are topical NSAIDs. Topical NSAIDs share the same painkilling drugs as oral NSAIDs, but are in a form which can be applied externally to the skin.
They are designed to act directly at the point of pain, to provide rapid relief. For pain sufferers, the use of topical NSAIDs can help reduce the risk of side-effects such as gastric irritation, sometimes associated with oral painkillers.
Warming and cooling products
These traditional, somewhat old-fashioned, sprays, rubs and creams can ease mild aches and pains through a process of warming or cooling, rather than by blocking the synthesis of prostaglandins, in the manner of NSAIDs.
Topical NSAIDs - the clinical evidence
A recent British Medical Journal article reviewing published clinical data concluded that modern externally applied painkillers, such as a gel containing ibuprofen, provide a safe and effective way to obtain pain relief in many common conditions, ranging from sprains and strains to rheumatic and arthritic pain.
The article also suggested that topical NSAIDs reduce the risk of side-effects such as stomach irritation, which can be more of a problem with oral NSAIDs.
Ibuleve is the best selling topical NSAID in the UK, available in the widest range of formulations and presentations.
About Ibuleve
Ibuleve pioneered the development of topical NSAIDs - harnessing the painkilling power of ibuprofen in a gel, spray and mousse.
Ibuleve is formulated to be rapidly absorbed at the point of pain. It is designed to provide fast, effective relief for backache, muscular and rheumatic pain and for the pain of common arthritic conditions.
Ibuleve delivers the powerful anti-inflammatory ingredient, ibuprofen, in a unique formulation, designed to maximise penetration.
Using topical painkillers like Ibuleve can help reduce the risk of side-effects sometimes associated with oral painkillers.
Ibuleve is available from UK pharmacies without a prescription.
Ibuleve Gel
Available in a 30g tube, or 50g economy tube with unique 'Ibulever' key, for easy gel delivery.
Ibuleve Maximum Strength Gel
Available in a 30g tube, for maximum strength pain relief.
Ibuleve Sports Gel
Available in a 30g tube to kill pain and reduce swelling of sports injuries.
Ibuleve Spray
Available in a 35ml pump action bottle, ideal for hard-to-reach areas.
Ibuleve Mousse
Available in a large 125g or handy size 75g can, with an easy action pump dispenser, it is ideal for those with limited manual dexterity. Also an economical choice for regular users.
Useful telephone numbers
| Back Care www.backpain.org |
0208 977 5474 |
| Chartered Society of Physiotherapy www.csphysio.org.uk |
0207 306 6666 |
| British Chiropractic Association www.chiropractic.org.uk |
0118 950 5950 |
| General Osteopathic Association www.osteopathy.org.uk |
0207 357 6655 |
| Arthritis Research Campaign www.arc.org.uk |
01246 558 033 |
| International Federation of Aromatherapy www.int-fed-aromatherapy.co.uk |
0208 742 2605 |
| British Acupuncture Council www.acupuncture.org.uk |
0208 735 0400 |
| British Hypnotherapy Association | 0207 723 4443 |
| Yoga Therapy Centre www.yogatherapy.org |
0207 419 7195 |
| Society of Teachers of the Alexander Technique www.stat.org.uk |
0207 284 3338 |