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Pain

Introduction
 
Pain is defined by the International Association for the Study of Pain (IASP) as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’. 
 
Pain is there to tell us that something is wrong. When pain is experienced it may make the person stop what they are doing (if this is making their pain worse) or seek help if it is being experienced regularly. Pain is experienced for a reason and therefore should not be ignored. There are many different types of pain so it is not always easy to know exactly what you are suffering with. Pain may be either acute or chronic.
 
Acute pain
 
Acute pain is short lived and is your body alerting you to an injury that will stop when it is healed. This type of pain can be dealt with using over the counter painkillers (analgesics).
 
Chronic pain
 
Chronic pain lasts for longer periods of time and might be a sign of something more serious. This type of pain may be dealt with using over the counter analgesics but may also need to be treated with stronger prescription medicines.
 
Why does pain happen?
 
Pain happens as a result of your body responding to an injury that has happened. The injury may be internal (within the body) or external (on the outside of the body).
When an injury occurs, pain receptors are triggered and send a signal to the brain. The subconscious part of the brain receives the signal that something is wrong. The conscious part of the brain receives this signal as pain at the site of the injury and decides how serious it is.
Chemicals called prostaglandins are then released at the site of the injury which then causes one or more of the following effects:
  • Inflammation; the area becomes red, swollen and tender
  • Fever; chemicals transported via the blood upset the part of the brain that controls body temperature, causing the temperature to rise
  • Muscle spasm; muscles at the site of the injury may spasm and cause pain
There are different types of pain depending on where the pain is felt in the body.
 
  • Musculoskeletal pain. This pain is felt in the muscles or bones of the body
  • Nociceptive pain. This pain is felt as a result of tissue damage or inflammation in the body
  • Neuropathic pain. This pain is felt when a problem occurs within the nervous system of the body. This could be following such   things as an infection or an amputation or with customers who suffer with diabetes or those with multiple sclerosis (MS)
  • Referred pain. This pain is felt as a result of internal body organ damage. The pain may be felt some distance from the the organ  that is dmaged. For example a pain in the left arm as a result of a heart attack.
 
Pain relief or painkillers. 
 
Chemicals called prostaglandins are responsible for causing pain. In some cases they can also cause an elevated temperature and inflammation. Analgesics work by either reducing the production of prostaglandins at the site of pain or in the brain. Some analgesics work in both of these ways.
 
Analgesics have three possible effects. They can:
  • Provide pain relief (analgesic)
  • Reduce inflammation (antiinflammatory)
  • Reduce body temperature
 
Paracetamol
Paracetamol is thought to work by blocking the spread of the pain signals that come from the brain. It is available to be sold Over The 
Counter ( OTC) as tablets, effervescent tablets, caplets, capsules, suspension, sachets and suppositories, in a variety of strengths. 
 
Effect
  • Two main effects; analgesic and antipyretic
  • Normally takes effect within 30 minutes and lasts for around four hours
The following are the main oral analgesics available for over the counter sale:
  • Paracetamol
  • Non Steroidal Anti-Inflammatory
  • Drugs (NSAIDs)
Dose
  • Adults: maximum daily dose is 4g, taken in 1g doses, a minimum of four hours apart.  Always read labels for correct dosage for Adults and Children and/or ask your local Life Pharmacist for advice. 
 
NSAIDs
 
NSAIDs work by stopping the body from producing prostaglandins. The following are NSAIDs available for over the counter sale:
  • Aspirin
  • Ibuprofen
Aspirin
 
Aspirin is a widely used analgesic that has been around for many years to help with pain relief. It is available to be sold over the counter as tablets, effervescent tablets and entericcoated tablets (a coating which protects the tablet from being broken down until it reaches the small intestine). 
 
Effect
  • Three main effects; analgesic, antiinflammatory and antipyretic
  • Normally takes effect within 30 minutes and lasts for around four hours
Dose
  • Adults: 300-900mg every four to six hours, maximum daily dose is 4 g when used for pain relief, with of after food
  • Children: not recommended for use in children under 16 years old as it is linked to Reyes Syndrome, which is a rare but serious condition which affects the liver and brain
Aspirin can be used to help reduce the incidence of heart disease or deep vein thrombosis (blood clots in the leg) on prolonged journeys as it prevents platelets (a type of cell present in the blood) sticking together to clot the blood. A dose of 75mg daily is sufficient for this purpose but is only available on prescription. Aspirin is a cheap and effective analgesic and can also be used for pain caused by arthritus, period pains and tootache.
 
Aspirin should not be taken by Asthmatics as can cause breathlessness or if you suffer from Ulcers as can interfere with other medications. Should not be taken by diabetics, pregnant or breastfeeding women. Patients on warafin or other blood thinning drugs should not take Please consult with your local Life Pharmacist is you are unsure regarding dosage or suitability of this medication. 
 
Ibuprofen
 
Ibuprofen has also been available for some years. It is available to be sold over the counter as tablets, caplets, capsules, suspension and sachets, in a variety of strengths. 
 
Effect
  • Two main effects; analgesic and antipyretic
  • Normally takes effect within 30 minutes and lasts for around six hours

Dose