Pharmacologic and Non-Pharmacologic Approaches in Pain Management

What Is Pain?

Everyone had experienced pain in their life. Pain comes in many different forms. The perception and tolerance of pain vary widely from individuals and to cultures. Some people may have higher pain tolerance than others. Pain can be synonymous to suffering for many people. Pain is a sensation that hurts. It can be really hard to describe pain as it varies from individuals. A pain can be stabbing, sudden, intermittent, throbbing, pinching, or aching. Pain can be acute or chronic. Pain can be mild, moderate or severe. Assessment of pain is vital to treatment and management.

Assessment of Pain

Assessment has been vital for the treatment and management of pain. Health care providers seek subjective and objective cues in order to effectively manage it. A verbalization of pain or self-report should be considered as a cue that there is pain existing. However in some cases, a person may verbalize pain to get more pain relievers. Some pain relievers can be addictive that people can become very manipulative in order to get what they want so if this occurs, it is outright imperative to look for other signs or objective cues to establish the existence of pain. In psychology, a patient may not physiologically feel any pain but can also suffer emotional pain.

A famous assessment tool for pediatric patients is the Wong-Baker Faces Pain Rating Scale. It is widely used in many institutions worldwide and can also be used in adults. A set of faces depicts the severity of pain from no pain, slight pain, moderate pain, severe pain to very severe pain.


Pharmacological Treatment


A Morphine tablet

Analgesics are medications that reduce pain. Narcotic analgesics are opium-based pain relievers. Popular examples of this class are Morphine and Codeine which can be addictive. They are all potent and effective in treatment of pain when used in adequate doses. Adverse effects vary and are dosage related. Respiratory depression is one of the many adverse effects of narcotics that should be avoided.  Non-Steroidal Anti-inflammatory Drugs or NSAIDS are also effective medications for pain with anti-inflammatory effects. A popular example of it is Paracetamol which is used in fever. It reduces mild to moderate pain and has anti-inflammatory effects. Mefenamic Acid is also a popular analgesic that is used for toothaches and headaches. Paracetamol and Mefenamic Acid capsules are over-the-counter (OTC) drugs and are widely used as home remedies. Ketorolac and Tramadol are often prescribed for severe pain and are often used as post-operative treatments of pain. These are given through intravenous for faster effect. NSAIDS can be purchased over the counter but also have severe side effects when frequency and dosage are abused. It can cause ulcer so it should be taken with food. It can also cause constipation in some patients. Kidney failure is an adverse effect that is irreversible. Many dialysis patients have history of NSAIDs intake.

Why Non-pharmacological Treatment of Pain is Popular Nowadays?

Non-pharmacological approaches are being used to treat pain because of studies showing adverse effects of pain medications. A lot of people have become aware and want to take fewer medications as much as possible because of the side-effects. Many people also want to improve their pain tolerance because they are dealing with chronic pain. A lot of health care workers and patients have proven better management of pain because of using pharmacologic and non-pharmacologic, hand in hand.


Types of Non-Pharmacologic Treatment Modalities

deep breathing during meditationDeep Breathing Exercises – It helps in relaxing the patient and poses many other benefits. Reiki and meditation enthusiasts have mastered breathing exercises. The person may feel more comfortable physically as anxiety and tension decrease. It also helps in decreasing muscle tension and helps in the better delivery of oxygen to the body.

Guided Imagery – This works well for pediatric patients but can also do well in adults. The mind can be very powerful and imagining beautiful sceneries such as beaches and other happy places can help relax the patient and keep a positive outlook in life.

Distraction Techniques – This coincides with the Gate-Control Theory of pain.

Massage/Touch Therapy – A geriatric patient who suffers emotional pain and feeling of isolation wants to be touched. A simple back rub can make him feel important and loved. A painful intravenous injection may be relieved with simple soft massage after the IV-push.

Aromatherapy – This aids to relaxation and a lot of people can set a good mood with this.

Music Therapy – Even a non-music enthusiast can enjoy music and this can serve also as a distraction technique.

cold compressHeat/Cold Application – A painful, swollen jaw after tooth extraction can be relieved by alternate hot and cold compresses to the affected site


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