Pain Management

When it comes to managing pain, patients have many options available to them—and suffering through the pain doesn't have to be one of them. Dr. Oz talks to pain specialist Dr. Paul Christo from the Johns Hopkins School of Medicine about different types of pain and how to treat them.

There are a variety of different levels of pain, Dr. Christo says. Acute pain, he explains, is believed to be a protective mechanism that helps our bodies. For example, it causes you to withdraw your hand when you touch a hot stove. Chronic pain, on the other hand, develops somewhere between three to six months of having persistent pain. Neuropathic pain relates to pain that persists for months even after the injury heals, he says. This pain is derived from the nerves and spinal cord, and most likely the brain, and is described as a burning, numbing or gnawing sensation.

Although chronic and neuropathic pain can be very difficult to treat, Dr. Christo says it's important that patients seek treatment before the pain worsens. He stresses the importance of accessing a pain specialist for diagnosis and treatment.

Back pain: A lot of back pain is acute, Dr. Christo says. If someone strains their back, he recommends they see their primary care physician first. Dr. Christo suggests an analgesic or an anti-inflammatory agent for acute back pain states.

If the back pain persists for more than three to six months, seek counsel from a pain specialist, Dr. Christo says. Also, back pain in conjunction with shooting leg pain should be evaluated very quickly. Dr. Christo says patients should seek restorative physical therapy techniques to stretch and strengthen their lower back, as well as to learn how to properly position their back as they move. Analgesics can also provide relief, he says.

For all types of back pain, Dr. Christo says acupuncture can be quite effective in relieving pain. When acupuncture needles are placed into the skin, endorphins, naturally occurring opioids, are released in the spinal fluid. In addition, a couple of other neurochemicals are released in the central nervous system, he says. Biofeedback, guided imagery techniques and relaxation techniques can also be very effective in terms of a human being's control over their own pain, Dr. Christo says.

Headaches (tension or migraines): Dr. Christo recommends relaxation and biofeedback techniques, acupuncture, as well as analgesics and anti-inflammatory agents.

Joint pains (sprains): Dr. Christo says heat therapy, analgesics and anti-inflammatory agents help relieve pain. Limit use of the injured ligament at first, but maintain function to prevent disuse and atrophy.

Belly pain, stomach aches: Dr. Christo cautions against medication as a first line of treatment, as it can mask the cause of the pain, which is typically harder to self-diagnose. Seek professional help.

Shingles: A little known fact is that the lifetime risk of developing shingles is about 20 percent, and those who reach 85 have a 50 percent chance of developing this painful disease. Dr. Christo says there are numerous treatments for postherpetic neuralgia (pain that persists after the shingles rash has healed), related to a class of medicines called tricyclic antidepressants, which are administered at low doses. Opioids or anticonvulsants can also be used for treatment.