John Bell - Pharmacist


John Bell is in community pharmacy practice in Sydney’s eastern suburbs – a practice which also provides medication management and clinical services to hospitals and aged care facilities. John is also a Specialist Practitioner/Teacher in Primary Health Care at the Graduate School of Health, University of Technology, Sydney and an advisor to the Pharmaceutical Society’s Self Care Program.

Why we get pain and how to tackle it

The 2017 Global Pain Index has revealed that the level of knowledge about pain medications is low in Australia. Only one person in four is aware of medication ingredients (21%), interactions with other medications (27%) and how their medication compares with others (27%).[1] 

What is pain?

Pain is an unpleasant sensation that has a vital protective function. It acts as an early warning signal to alert you that something is not right with your body. If the body tissues are damaged, the affected area becomes more sensitive than normal to pain sensations in a process called inflammation. 

Why do we experience pain?

If we couldn’t feel pain, we would be unable to avoid repeated injury or permanent damage to our bodies. Pain alerts us to protect ourselves from further harm and allow healing to take place. 

What causes pain?

Pain can either be acute or chronic. Acute pain is often caused by an injury (cut, burn, broken bone) or illness (cold, flu, earache etc.). Chronic pain is continued or recurrent pain extending beyond normal healing time. It’s generally described as persistent pain for a period of three months or more in the past six months. Chronic pain doesn’t always have an easily identifiable physical cause. Some examples include repeated migraines, nerve pain, low back pain or pain associated with other conditions such as cancer or arthritis.  Acute pain can sometimes develop into chronic pain.

How is pain managed?

The best way to manage pain and stop it coming back is to tackle the root cause. Strategies could include good posture control, stress management or hydration maintenance.  

Non-prescription or so-called over the counter (OTC) medications, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs,) can help relieve milder forms of pain. For relief of more severe pain, a doctor may prescribe muscle relaxants, stronger NSAIDs, opioid medicines or steroid treatments.

 

References


[1] Q25. Thinking about the pain medication you take most often (this can be either over the counter medication or prescription medication), how knowledgeable are you about the following areas? [NET Not very knowledgeable] [NET very knowledgeable] // Base: All respondents DATA REF: AUSTRALIA TABLES 

Close accordion

Effective pain management is about understanding your pain

All too often the approach to every day pain management is about reaching for pain medication, such as paracetamol or topical analgesic or anti-inflammatory rubs, which can be highly effective for short-term relief. However, medication is only one part of an effective pain management strategy, first you need to identify and understand the root cause of your pain.

Keep active

Pain can often be caused by weak muscles, poor flexibility or bad posture. Keeping fit and active and your muscles strong can help protect your body and limit the likelihood of pain. Activities such as yoga and pilates are great for flexibility and core strength. Remember, it’s always best to see a professional, such as a physiotherapist or personal trainer, if you need further advice.

Keep well hydrated

Dehydration can cause pain; especially headaches and muscular pain. The recommended daily intake of water for adults is between two and three litres.[1] But beware of too much alcohol or caffeinated drinks.

Speak to someone

Pain isn’t necessarily just physical but also psychological. If pain gets you down, speak to someone about it. Your pharmacist and GP can help and a counsellor can help you get back to feeling like yourself again.

Meditate

It’s been scientifically proven that meditation, relaxation techniques and other forms of stress management can help with pain relief.[2]

 

References


[1] National Health and Medicines Research Council. Nutrient Reference Values https://www.nrv.gov.au/nutrients/water [last accessed May 2017]

[2] Zeidan F et al. The effects of brief mindfulness meditation training on experimentally induced pain. J Pain. 2010 Mar;11(3):199-209.

 

Close accordion

The rise of self-diagnosis

 The rise of self-diagnosis

In Australia, according to the 2017 Global Pain Index, nearly all body pain sufferers and most head pain sufferers say they know the cause of their pain.[1],[2] However, of these, 42% of body pain sufferers and 66% of people with head pain said they self-diagnosed the cause.[3],[4]

 Given the trend towards self-diagnosis it is surprising to find the level of knowledge about pain medications is low in Australia. Only one person in four is aware of medication ingredients (21%), interactions with other medications (27%) and how their medication compares with others (27%).[5] 

It’s important to consult a healthcare professional

Pain caused by different trigger factors will often need different pain management strategies. Your pharmacist or your doctor will be able to advise on the most appropriate option. This may include medication and non-medication treatments such as diet, exercise, cold/heat packs, massage or physiotherapy.

Dr. Google is not a substitute for the real thing

Internet-based advice, at best, is only general in nature and does not take into account individual circumstances. Health diagnosis advice from some websites is not evidence-based and can be dangerous. When choosing a pain reliever it is also necessary to consider what other medical conditions you have or what other medicines you are taking. Your doctor or pharmacist can ensure you get the most benefit from your pain management strategy with the least risk of an interaction or adverse event.

Don’t suffer in silence

There is often a reluctance for pain sufferers to seek early advice and treatment, relying instead on self-diagnosis and self-treatment. However, inappropriately treated or unresolved pain can lead unnecessarily to anxiety, sleep disturbance and generally poor quality of life. People who self-diagnose and self-treat the most have been shown to have the least understanding of their medicines. This can more easily lead to medication misadventure and less than ideal treatment outcomes.                  

Your pharmacist can offer quick advice

Head pain, such as tension headache or migraine, is usually of a shorter duration compared with body pain. Non-prescription therapy (frequently self-selected) is often effective. Body pain, such as muscle or joint pain, may be of longer duration and can be perceived to be possibly more serious. 

Up to twice as many people would visit a doctor over a pharmacist when new pain strikes (73% vs 40% for body pain) .[6] But pharmacists are well trained and have the expertise to offer advice on pain management strategies and to refer to the doctor when necessary.

References


[1] Q8. What is the main cause of the body pain you experience most regularly/chronically? // Base: Those with body pain DATA REF: AUSTRALIA TABLES

[2] Q14. What is the main cause of the head pain you experience most regularly/chronically? // Base: Those with head pain DATA REF: AUSTRALIA TABLES

[3] Q9. How do you know what is causing your body pain? // Base: Those with body pain DATA REF: AUSTRALIA TABLES

[4] Q15. How do you know what is causing your head pain? // Base: Those with head pain DATA REF: AUSTRALIA TABLES

[5] Q25. Thinking about the pain medication you take most often (this can be either over the counter medication or prescription medication), how knowledgeable are you about the following areas? [NET Not very knowledgeable] [NET very knowledgeable] // Base: All respondents DATA REF: AUSTRALIA TABLES

[6] Q47. Thinking about when you have suffered from the following types of body pain as described below, which of the following have you done? // Base: All respondents excluding those who have never suffered from a new type of body pain DATA REF: AUSTRALIA TABLES

Close accordion