When was the last time you experienced pain? For some, it was the last time they stood up, and others (likely younger), it may have been some time. The sensation of pain is a complex phenomenon, involving many specific processes and numerous individual structures. Naturally, several kinds of pain have been recognized, with everyone experiencing pain a little differently. There is much we do not know about this important sensation, with millions of Americans living with pain on a daily basis.

Pain occurs when specific, specialized nerves detect tissue damage. Stepping on a tack causes the nerve receptor there to transmit this information through the leg, sending this to the spinal cord and, subsequently, a different nerve brings this data to the brain. In contrast, a reflex is where the signal goes to the spinal cord and then comes right back, stimulating the muscle directly. Like touching a hot surface, which elicits an immediate contraction of the appropriate arm muscles.

Pain is not a simple thing and involves social and emotional components as well as physical. It is a much more interactive process than previously thought. One genetic variation causes rare individuals to be unable to experience pain. Interestingly, some of these people are unable to feel anxiety. We know there is some relation between emotions and pain, yet the specific association remains unknown. But be certain: the brain makes pain. It is not a sensation existing outside your mind.

Most of us can relate to the sudden onset of pain when you stub your toe or suffer a debilitating paper cut. These are both examples of acute pain, a predictable and logical sensation. It makes sense to people: injure the body and some pain should be immediately noted, in some way proportionate to the degree of damage. Chronic pain is different and not nearly so logical. It’s volatile, hard to predict, affected by numerous unknowable systemic variables.

Chronic pain affects more than 50 million Americans, about 20% of the population, and leads to almost $300 billion in annual healthcare costs. Definitions vary, primarily on how long someone must experience some discomfort before it can be termed ‘chronic.’ Three months is often mentioned, but six is as well, for some persistent pain, one that carries on despite treatment. Neuropathic pain is another animal entirely.

Ideally, healing occurs after some injury or surgery……but not always. We don’t really understand all the factors lending some painful problem to become a chronic one, and no longer proceeding through the appropriate stages of repair and recovery. But chronic pain serves no purpose, and its course is unknown.

It is in the treatment of pain that our science and medicine have failed to provide better options. We have little to offer the American consumer other than the few standard choices, acetaminophen, an anti-inflammatory, or an opioid. When it comes to over-the-counter medications, there are only the first two mentioned, both of which are in widespread use. The packaging may vary, but most OTC pain-relieving products contain one of the two (or ibuprofen’s sibling, naproxen).

Ibuprofen is the most frequently prescribed of the NSAID’s, the nonsteroidal anti-inflammatory drugs, and they are the most consumed medication worldwide. Three out of every five Americans with chronic pain take one of these meds. These drugs are not addictive and effective for many with acute pain, that which resolves in a timely fashion. Unfortunately, these drugs are often taken on a chronic basis and complications can ensue including stomach ulcers, kidney failure, and a heart attack.

The use of NSAIDs will likely be increasing since the prescribing of opioids is receiving increasing scrutiny, and then there’s our aging population. But the research has clearly demonstrated a greater risk of developing chronic pain from a problem which was initially an acute one. These findings should cause us to question current practices of pain relief. Normal recovery and repair involves inflammation: blocking that inflammation with drugs seems to result in pain that is harder to treat.

Many options for pain go largely unused in the US. Compounding is rarely prescribed. This long-practiced technique entails the administration of various medications topically (to the skin) via a specialized cream into which the drugs are mixed. Complications are rare since miniscule amounts get into the bloodstream. And benefits can be significant since a variety of agents can be mixed into one cream.

Although uncommon in the states, the use of powered, pulsing magnetic fields (PEMF therapy) is gaining popularity. Although newer versions require shorter treatment times, older devices demand long exposure to the magnetic field to have any benefits. Although small portable units are available, sufficient study has not yet been performed on this technology to convince many in healthcare.

Chronic pain is a serious condition, affecting millions, altering the lives and livelihoods of so many Americans. Too many are taking these household drugs which have real complications. And there are natural alternatives to ibuprofen and the NSAIDs, like arnica and curcumin.

Although we have only hints of the complexity of acute pain and its transition to chronic, we know it is challenging. And also that chronic pain is a function of both the body and the mind. Treating it requires the use of differing approaches, varying therapies, employed congruently. This is a serious issue in modern medicine: we need to develop either better meds, or healthier alternatives to the health crisis that is chronic pain.