FAQ

Often the cause of pain is obvious, a broken leg, or a bruise. Occasionally it is very difficult to find the exact cause of a person’s pain. Most minor ones are easy to treat; others may be a sign of something more serious. For example the pain of a broken leg will make us rest the leg until it heals. Here the pain is helpful. By contrast chronic pain often serves no useful purpose. Medical assessment and diagnosis does not usually lead to the pain going away and over time it may affect what we can including ability to work and sleep patterns may be interrupted. It can affect mood and relationships with our family and friends too. Pain signals from injury normally travel to the brain via specialized nerve fibers and the spinal cord.. These nerves also process the pain signals. All together they work like a very powerful computer.

It has been known for some years, that some antidepressants may help pain, particularly neuropathic pain. These older antidepressants are called the Tricyclics and examples are amitriptyline , imipramine nortriptyline. They act through complex mechanisms, which may include inhibition of the two nerve transmitters, noradrenaline and 5-HT. There is evidence that some of the newer antidepressants, e.g. duloxetine may also be helpful in some painful conditions. You can also find out more about antidepressant drugs on the Pain Management clinic center website.

This is difficult to answer for an individual. In general, X-rays take a picture of the bones. They are used for diagnosing cancer, tumors, rheumatoid arthritis and osteoporotic collapse. An MRI scan is also a picture of the body and is more useful for examining the soft tissues such as muscles and nerves. However scans and x-rays often do not show the cause of a pain and they may identify changes that are of no relevance so they must be selected, interpreted and explained to patients carefully.

This is pain that results from damage to the nerves – muscles and bones may not be directly affected. For example: Sciatica where a nerve is irritated or compressed in the bottom of the back giving pain down the leg, Shingles where virus damage to a nerve causes extremely painful sensitivity of the area of skin supplied by that nerve. Diabetes and Multiple Sclerosis can damage the nerves at multiple points resulting in more widespread pains.

Epidural steroid injections are one of a number of procedures or injections that may be offered for some types of nerve pain originating in the spine. The doctor offering you the injection should give you detailed information about it if this treatment is being considered.

A pain is referred when somebody gets a pain in one part of their body, but the cause is in another part of their body. Strange but true! Pain in the left arm caused by a heart attack, and sciatica are both examples of referred pains.

There are a number of voluntary organizations that may be able to help with your condition: see our useful addresses section for details. Some areas do have self-help groups, but it is fair to say that there are not that many: again, you can look at our ‘Useful addresses’ section. Your local council or library may also have a list of local organizations. You may also wish to read our Understanding and Managing Pain: information for patients booklet.

The Expert Patients Program (EPP) is a NHS-based, lay-led training program that provides opportunities to people who live with long-term chronic conditions (such as arthritis) to develop new skills to manage their condition better on a day-to-day basis. For further details, including how to find your nearest program, you can visit their website

The type of painkiller required will depend on the cause of the pain. The best way to find the most effective painkiller for you and your pain is to talk to your doctor, pain nurse or pharmacist. They can give you individual and detailed advice. You can view our guide to over-the-counter painkillers.

There is a range of medication that may help you. The best thing to do is to talk to your doctor, nurse or pharmacist. Healthcare professionals can give you individual and detailed advice.