Marc Darrow (Physical Medicine and Rehabilitation, Joint Rehabilitation Sports Medical Center, Inc. ) gives expert video advice on: Besides analgesics, what other treatments are there for acute pain? and more...
How is acute pain treated?
If it's a sports injury or if someone fell down, they may be using anti-inflammatory medication to bring down inflammation and reduce the acute pain. There's a typical protocol that is used in Western Medicine for injury; it is the RICE protocol: R-I-C-E, it equals rest, ice, compression, and elevation. So, for example if someone hurts their knee, we might rest that knee; tell them not to walk around on it for a while, we might put ice around it and use some compression with an Ace bandage, and then elevate it. The reason we use elevation typically above the heart level is so that any fluid that's occurred as a result of inflammation and accumulated in the oedema in the joint, or around the area, will then be drawn back into the heart, and re-circulated through the body. This will relieve the area from the excess fluid and the excess acute pain that takes place from the injury.
What is an "analgesic"?
Analgesic just means "away from pain"; "a" or "an" in Latin means "away from". So, what we're doing is we're using something to take pain away. That is what an analgesic is. There are many types of analgesics. One can be simple cold, using ice around the area. Another can be heat. It depends. Typically, with a new injury or what we call an acute injury, for the first three days we use cold and then we'll start using heat after that. We use the heat to help mobilise more motion to the area to get more fluid going, and to have the blood rushing around the area to get the white blood cells actually chewing up and removing the debris from the injury. The first part, called ice therapy or cryotherapy, will be used to actually stop the inflammation of the area, and to close down the blood vessels so there's less leaking of the blood vessels to produce inflammation.
How does a doctor determine the right type of analgesic?
Analgesics, as a whole, are considered to be medications, but analgesia is just the process of taking pain away. So, if we're referring to analgesics as medications and there's an acute injury, doctors will often jump to using NSAIDs, which are non-steroidal anti-inflammatory medications; things like ibuprofen that can be taken orally. They will help reduce inflammation and oedema, and in doing so help take the acute pain away.
Besides analgesics, what other treatments are there for acute pain?
By getting rid of the inflammation that takes place from an injury or from arthritis or things of that nature we're not allowing a good healing to take place. Inflammation brings the immune system cells to the area, like fibroblast, or inside a joint, chondroblast that grow cartilages. And if we slow that process down we may feel good temporarily but then we lose the war of not getting a real good healing taking place by allowing the inflammation to take place. So, in my practice, what I do is I actually, instead of using cold we use heat. And, instead of resting on a joint in the area I use mobilization in getting it moving to keep the juices flowing through that area to move the toxins and bring the cells that actually create the healing to the area.