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And what pain isn’t. We asked Master of Pain, Dr Bernard Lee to dish the dirt on the most common myths about pain. He said:

Myth: you just have to live with it

Fact: There are many chronic pain conditions that either come about spontaneously or after an innocuous injury. Some of these chronic pain conditions persist because of wrong diagnosis or misguided instruction. A small fraction of these conditions like ”shingles” pain or “phantom pain” can’t be cured, but people learn how to control their pain so that the pain doesn’t control them.
Other than medication which eases discomfort, cognitive and behaviour changes are important aspects of good treatment outcomes. Physical therapy, biofeedback, relaxation strategies and exercises can also help patients manage their pain and improve their quality of life.1
Uncontrolled pain is associated with adverse consequences in terms of daily functioning, mood, sleep, overall quality of life, energy level, the ability to work and marital relationships. Persistent pain can also cause changes in the brain and spinal cord that begets more pain.2
Standard painkillers may not be effective for certain types of pain eg. Nerve type pain. Even giving strong painkillers such as morphine may be ineffective for conditions such as nerve compression or nerve injury pain. In these situations, adjunctive medications such as anti-convulsants and anti-depressants in low doses are helpful in stabilising the excitable nerve and hence reducing the pain.

Myth: it’s all in the head

Fact: This is only partly true as pain has both a physical and emotional component. Emotions, such as feeling anxious, stressed or depressed, can worsen pain and decrease your ability to cope. Pain perception is usually brought on by a pain generator. The psychological emotions can magnify this intensity of pain.
Anxiety, for example, can actually increase the volume of pain signals and make the discomfort worse.
Many causes of chronic pain are invisible to the naked eye, but this doesn’t mean that it’s not there -- even if a specific reason for it can’t be determined. Scientists say that when people are in pain, brain scanning images or MRIs show the brain is actually involved. In fact, our understanding of chronic pain is growing by the minute. There is so much research now available that point to sources of pain generators that were previously elusive or unknown.

Myth: Treat the underlying cause to cure chronic pain

Fact: Pain might be treatable – one can just remove a splinter to stop the pain. However, the intersection of an underlying cause and pain is more complicated. Some diseases cause chronic pain and it might be hard to control. In other cases, the pain lingers even after the original cause seems to have been resolved.
People who live with chronic pain should seek treatment for the underlying cause (if there is one) and separately seek treatment for the pain itself.3 In some cases, innovations in medication like combined tramadol/paracetamol treatment have now made it possible to address both , e.g. address the inflammation in chronic osteoarthritis that causes the pain even while treating the pain symptoms.

(Endnotes)

  1. Cool, Lisa C. 5 Myths about pain. GoodHouseKeeping.com. Retrieved from
  2. Szalavitz, Maia. Ed. Haynes, Gary. The truth about painkillers. MSN Health. Retrieved from
  3. Ibid.

Myths about pain in sports medicine

As a sports physician, Dr Roger Tian knows that pain can affect your physical performance... in sports. Here are his top myths about pain.

Myth: No pain, no gain

i.e For an exercise/training to be effective, the athlete must experience some pain after the session.  Conversely, the athlete feels compelled to push through the pain threshold.

Myth: More pain = more gain

Myth: Pain will go away with rest

“Pain is temporary, glory is forever”, says Lance Armstrong) - but if the symptom/injury is not heeded or treated, the pain may be forever too.

Myth: The pain always originates from an injured structure

“Pain is temporary, glory is forever”, says Lance Armstrong) - but if the symptom/injury is not heeded or treated, the pain may be forever too.

Consult a trained doctor who will perform a physical examination to elicit the cause of pain; imaging modalities such as XRays, Ultrasound or MRI scans may also be necessary.

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