Ouch, it hurts. Do I really need a pain doctor?
‘Ouch!’ is the instinctive reaction we give when pain occurs.
The positive thing about pain is that it works as an alarm, to alert us that something has gone wrong and signal us to get help or medical attention to address the injury. However, constantly living with pain is a whole different ball game.
Ms Lim is a 24-year-old piano teacher who woke up one day with a painful neck. Thinking it was a mild sprain, she ignored it but after a week, the situation exacerbated as not only did the pain not stop, her right thumb started to feel numb and she felt weakness in her shoulder.
Mr Lim Zhi Ming, a 72-year-old retiree, lived with pain in his teeth for years. He extracted four teeth but the pain did not subside. After six months, he had two more extracted but it was futile. He consulted a TCM which eased the pain somewhat, but did not provide enough pain relief.
Each person’s story with pain is unique. Some seek treatment for pain early, others ‘live’ with it for years. Is every pain bad and call for immediate attention? And if pain persists, is it time to see the pain doctors or pain specialist?
Here, we ask Dr. Bernard Lee, the pain expert from Singapore Paincare Holdings and Mr. Daryl Li, the principal physiotherapist of Readyfit Physiotherapy to share their opinions on pain management.
Good vs bad pain
First, we recognise that there is in fact “good pain” and “bad pain”.
Daryl Li from Readyfit Physiotherapy commented that the most common type of good pain is clinically referred to as delayed onset muscle soreness; this occurs as the result of challenging a muscle or muscle group with exercise. One to two days after exercising, a tender soreness will be felt in the belly of the muscles and this tends to be spread out over a large area. With some rest, this pain will dissipate gradually.
“Bad pain” can come in different forms. The most common type would be joint pain. When pain occurs in a joint, such as the knee, rather than in thigh muscle, it is the body trying to tell us that something is not right. Do not try to work through joint pain while exercising ” warned Daryl.
“Bad pain is increasing pain caused by worsening structural damage such as fracture, nerve compression/ injury, worsening infection and instability pain. Bad pain should not be engaged or worked through on your own as it may cause further damage and complications,” explained Dr. Bernard Lee.
Another common type of bad pain that should be brought to the attention of a doctor is radiating pain, or pain that shoots from one area to another. Daryl explained: “This type of pain is caused by pressure or compression of nerve roots as they branch out from the spinal cord and can shoot down your arm or leg and may originate from the spine.”
Acute vs chronic pain
Pain may be categorised into acute and chronic.
Acute pain comes on suddenly and is usually caused by a specific incident. Some examples are broken bones, burns, cuts, surgery or labour. It doesn’t normally last longer than three months. Chronic pain, however, persists beyond that. There is a multitude of causes to chronic pain, including a pinched nerve, inflammation of the spinal disc and fibromyalgia. Some chronic pain needs active engagement and rehabilitation, while other conditions require one to be immobilised and rested to get better.
Knowing about chronic pain
The World Health Organisation estimates that about 22 per cent of the world’s population are struggling with chronic pain. With the number of ageing Singaporeans, the patients that report chronic pain are also steadily increasing. Singapore General Hospital reported that patients with complaints of chronic pain have risen about 10 per cent annually. Singapore Paincare Center reported that their pain management clinic sessions have increased dramatically over the past few years. The ageing population is one contributing factor to the increase.
Chronic pain lies on a broad spectrum, and the causes of pain vary according to age. As one ages, the causes of pain may stem from degeneration. Common types of pain associated with older people are at the back or neck, and caused by the complications associated with degeneration of the spine. Hip or knee pain is also commonplace, and there is also cancer and nerve pain. Nerve pain is a silent culprit and it can manifest as facial or dental pain, or shooting pulses in an arm or leg.
When to see a pain doctor?
The key is to be ready and proactive to seek treatment when necessary instead of waiting until it is too late. As a general rule of thumb, it is advisable to seek consultations with a pain doctor or specialist when
- your pain persisted for more than 6 weeks
- there is a loss of functions because of pain (e.g. the inability to stand or move due to pain
- there are weaknesses, numbness and tingling on your limbs
- pain affects or disrupts your sleep continuously over a period of time
By taking a proactive step to detect and intervene your chronic pain condition as soon as possible, you will be able to detect potential risk factors and receive treatment early, thus resulting in a higher rate of remission, and potentially cure.
What’s stopping us from seeing the pain doctor?
Many older people accept pain as ‘fate’ and a part of ageing, so they may give up trying after attempting to resolve the issue after once or twice. They believe that it can be accepted as a part and parcel of growing older.
Resistance to taking medicine is another reason why pain sufferers avoid treatment. They believe that they will just be prescribed painkillers and are skeptical of doctors getting to the root of the problem. In fact, that is hardly true. Professional pain specialists seek to understand the cause of the pain and aim to tackle the problem at its root, and do not simply provide pain relief options.
Dr Bernard Lee, the pain expert from Singapore Paincare Holdings explained: “We treat chronic pain conditions by first carefully evaluating where the real source of pain comes from. What may seem like the obvious cause may not always be the true pain generator.”
“Through our understanding of pain mechanism and our unique diagnostic evaluation process to target pain source, we are able to eliminate and/or manage difficult as well as persistent and recurring painful conditions,” explains Dr. Lee.
Why you shouldn’t live with chronic pain
The impact of chronic pain is far-reaching. It does not just affect one physically, but also functionally, emotionally, psychologically and socially. People with chronic pain are at higher risk of developing depression, poor sleep, poor appetite and poor self-esteem.
Physically, it may not be restricted to the source. There can be physical effects that are stressful on other parts of the body. For example, the body avoids movement patterns that cause pain, which might not be efficient, as it can lead to other complications or dysfunctions in other parts of our body. For instance, if sitting with our back straight gives us pain, we might slouch for comfort, putting unnecessary pressure on other areas of our lower back.
Most importantly, there is light at the end of the tunnel. Pain doctors are now equipped with state-of-the-art technology and judicious medical knowledge to end the pain for those who never thought they will be rid of their shackles.
Consult a pain doctor today
The longer you live with pain, the more likely it is for pain to make changes to your body, so seeking treatment fast is crucial. If pain has stopped you from living your life fully, it is time to see a pain doctor.
Pain doctors and pain specialist at Singapore Paincare Holdings are trained and certified to be able to perform the pain treatments with great proficiency and accuracy, thereby giving long lasting excellent outcomes for our patients.