Almost without exception, the animal kingdom survives because pain shapes its understanding of threats and dangers in the environment. Animals run away or hide when they see a source of danger approaching. If possible, they fight when attacked. Humans are no different. Babies learn it is painful when they fall or knock into furniture, and this knowledge stays until death finally removes pain.
If you had to pick the single most important survival characteristic, it would probably be pain because, over time, it programs humans to avoid danger and seek help when injured. But there is a problem. When there is an injury, the central nervous system is alerted and sends out pain messages. Unfortunately, there is no way of switching the message off. The injury has to heal or other medical treatment has to remove the source of the pain. While waiting for the healing to end or the treatment to succeed, the only option used to be patience. Now we have analgesics, pain killers designed to ease the pain or, in some cases, make it go away altogether. Modern science can sometimes seem like magic. Except, there is sometimes a price to be paid for some of the tricks.
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The most powerful of the pain killers, the opiates, can eliminate awareness of all but the most severe pain. But these drugs are highly addictive and can only be used for very short periods of time. Even tramadol is habit-forming if used at too high a dosage for too long. If you do become addicted, there are withdrawal symptoms to endure while weaning yourself off the drug.
So all doctors advise you use pain killers in low doses over as short a period of time as possible. When you have been involved in an accident or are recovering from surgery, you know the pain will slowly go as you heal. This means you will be using tramadol as intended over a short time. But when the injuries are going to leave you with pain, or you have a disease or disorder that will cause chronic pain, you have a choice to make.
When you know the pain is going to last, you could give up the battle before you start, pick up the bottle of pills and leave it to the pharmaceutical industry to keep you reasonably free of pain. If the drug was free, this would be a rational decision but, given the cost of medications, paying for pain relief for the rest of your life is going to be a financial drain.
It is better to learn to live with the disability, moving in a way that gives you the most freedom for the least pain. If the pain does grow more severe, you can use tramadol for a short time to bring it back under control, but you should be looking to self-help to give yourself maximum mobility and the greatest quality of life. Running to tramadol every time you have pain is the quickest way to grow poor and become an invalid.
For these purposes, we need to start off with a basic definition. Pain is nothing more than a message sent by the affected part of your body to the brain saying you are injured. It's useful when it first alerts you to an injury or disease. It's a problem in its own right when it will not shut down and let you get on with your life.
Doctors distinguish between two types of pain: acute pain is where an injury or illness can be cured so the pain will slowly fade as the treatment of the cause takes effect, and chronic pain where the injury or disorder will continue to cause you pain over a long period of time. It's not so hard to remain optimistic and positive when the pain is acute. You know you will get better.
It's a different psychological battle when the pain is chronic. This is life-changing and many people react by feeling some degree of depression.
In an ideal world, everyone suffering from chronic pain would be given personal attention. Specialists from all the different areas of medicine would form a team to investigate your condition and then prescribe the best set of responses. Unfortunately, this is not possible. The career path for physicians assumes the best will become specialists and rise through the ranks to lead a team of specialists. Status will be decided by the number of people in the team or department the doctor ends up running.
For pain management to work effectively, this structure of separate kingdoms has to be dismantled and everyone works together in teams centered on individual patient needs. No more empire building and politics. Doctors supply the most effective treatments based on a diagnosis of the underlying cause of the pain. Take back pain as an example.
If the hospital works together, the relevant tests can be performed. Let's assume the cause is found to be a herniated disk. The recommended treatment is a steroid injection and physical therapy. A caring hospital might also throw in some counseling and support to encourage the patient to make the best possible recovery. In this model, diagnosis drives the choice of treatment. In the world now, the doctors first choice of action is a painkiller to relieve your suffering. No doubt this could be seen as caring. In reality, it's the most cost-effective way of persuading the patient to go home and allows the hospital to claim the maximum amount from the health insurance company. A separate pain management department in a hospital is labor intensive and less profitable. They do exist but only in a few cities.
This leaves pain management in the hands of the pharmaceutical industry. Fortunately, the research and development teams have come up with a world's best painkiller. It's called tramadol - one of the so-called opiates which gives you good pain relief without many of the adverse side effects from a full opiate. A vast amount of practical experience proves this drug gives effective relief from moderate to severe pain. If you are facing chronic pain, buy tramadol and find an improvement to your life.
But always remember you should not become dependent on any drug. Ignoring the expense of buying these pills for the rest of your life, there are physical costs in using drugs over long periods of time. There are better ways of managing your pain without drugs.
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