Revolutionizing Spine Care…Changing Lives

Do You Have Clean Pain or Dirty Pain?

To find out, read on.

For something so common, pain is amazingly complicated. The International Association for the Study of Pain’s widely used definition states: “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

This unpleasant experience can also motivate a person to withdraw from dangerous or potentially harmful situation, to protect a damaged body part while it heals and to avoid similar experiences in the future. In this sense, pain is extremely valuable, even a life-saver.

“When these nerve signals of pain are sent along the spinal cord and arrive in the brain, lots of other biochemical reactions can occur,” noted Texas Back Institute psychologist Dr. Andrew Block. “Even the level of tension one might be experiencing at the time can exacerbate the pain.”

The Center for Disease Control notes, “Pain is the most common reason for physician consultation in the United States. It is a major symptom in many medical conditions and can significantly interfere with a person’s quality of life and general functioning.”  Since Dr. Block helps hundreds of patients each year manage their pain, he is an excellent source for insights about how psychological factors such as social support, hypnotic suggestion, excitement, or distraction can significantly modulate pain’s intensity or unpleasantness.

What’s the Best Medicine for Pain?

In most cases, someone experiencing pain, whether it is back pain, muscle strains or common headaches, automatically reaches for the most common over-the-counter medication in the world – acetaminophen. This drug is usually known by the brand name of Tylenol.  When taken in moderation, this drug is safe and can usually alleviate most common pain, including lower back pain.  However, Dr. Block warns about too much of a good thing.

“I take Tylenol from time to time and it helps stop most minor pain,” he said. “However, when someone takes this drug for years and years, there is a possibility of liver damage.”

There is even some question about the effectiveness of acetaminophen. A recent Australian study, published in Lancet magazine and reported on CBS News found the drug, sold as Tylenol and Paracetamol, was no more effective than placebos for relieving back pain. This study also highlighted the effect of a patient’s psychological state in their ability to effectively deal with back pain.

“No one would suggest a person experiencing chronic back pain is ‘imagining’ this pain,” said Dr. Block. “However, it’s important to refrain from over-reacting.  Give the condition time to resolve itself. If after three to seven days the back pain has not stopped, it could be severe and the result of injury or disease. If there is numbness, muscle tingling or the loss of bowel of bladder control, the person should see a back specialist,” he said.

The Difference Between Clean and Dirty Pain

While most pain ends when the damaging stimulus is removed and the tissue has healed, in some cases the pain persists despite removal of the stimulus and apparent healing of the body. In many cases, pain arises in the absence of any detectable stimulus, damage or disease.

“I use the terms ‘clean’ and ‘dirty’ pain,” Dr. Block notes. “’Clean’ pain is the result of tissue damage or bodily aches and pains resulting from physical stress or overuse. ‘Dirty’ pain is that which results from psychological, emotional or cognitive stress someone might be experiencing at the time.”

“While it is entirely possible, even probable, to have clean and dirty pain simultaneously,” he notes. “The unpleasantness and severity of this situation can be lessened by understanding and dealing with these two types of pain.”

“Using anti-inflammatory drugs, physical therapy, stretching, exercise and weight-loss can help minor ‘clean’ pain,” he said. “Hypnosis, biofeedback and stress-reduction techniques such as meditation can often help lessen the effect of ‘dirty’ pain.”

“There are several approaches to pain management that are dangerous and should be avoided,” Dr. Block noted. “Self-medication by consuming alcoholic beverages or unsupervised drugs and anti-depressants is always a bad idea. While they might offer temporary relief, they can result in permanent damage to the body.”

“Often understanding the reasons for pain can enable a person to keep it from taking over their life,” he noted.

If you are experiencing chronic back pain which is affecting your work, family and life, contact Texas Back Institute for a consultation and examination. Understanding the cause is the first step in alleviating the pain.

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