Prepared Patient: Responding to Acute Pain

Jan Adams, 66, a retired general practitioner who lives a Minneapolis suburb, has had multiple experiences of acute pain—most of which were managed well but one that was not. While Adams’ post-surgical back pain received excellent care, her most traumatic experience with acute pain came during an emergency gastrointestinal procedure.

Lys Fulda, a 36-year-old sales and marketing professional from Chicago, also had a terrifying experience with acute pain during a root canal in her 20s, which left her with a fear of dentists that took 10 years “and a very patient dentist” to conquer.

Fifty-four-year-old Mike Gaynes, a media consultant, suffered extreme acute pain during an attack of kidney stones. On his way to a hike with his wife, he was suddenly overcome by it. “I’ve never been shot or stabbed, but talking to people who have, that’s the closest thing to it,” he says.

Getting the Right Help for Acute Pain

Whether caused by injury, surgery or a toothache so bad it slams you awake in the middle of the night, acute pain is difficult.. Receiving prompt and helpful treatment can make all the difference in the world. But lack of care or inadequate care means that the acute pain may develop into chronic agony.

Fortunately, acute pain is not always long lasting or overwhelming, such as when you have short severe cramp or multiple bee stings that can be handled with time, over-the-counter medication and other home remedies [See sidebar].

Since individuals’ tolerance for pain varies widely, the question of when pain itself requires urgent medical attention is difficult to answer. Chest pain should prompt a visit to the emergency room, of course—but other types of pain are trickier to call.

“If it hurts like hell, come to the E.R.,” says Dr. Sergey Motov, assistant program director for emergency medicine at Maimonides Medical Center in Brooklyn. “The problem is that it’s so subjective, there’s no really good objective way to tell when [help is required]. If it’s the worst pain you’ve ever experienced, [come].”

Once you seek medical attention, you should be treated promptly and with compassion. “If you don’t treat acute pain properly, it can become chronic,” Motov says. “If someone comes in with acute pain and it’s sub-optimally treated, they go home and come back in three days and it’s sub-optimally treated again and later on they’re in chronic pain, that started with us because we did not address the acute pain properly in the first place.”

So how should extreme acute pain be treated? Jan Adams, a retired general practitioner herself, describes receiving excellent care after she had back surgery following an injury. She was immediately given strong opioid medication because of the intensity of the pain.

“What they did right was allow me to manage how much pain medication I needed for the first few days,” she says. “I needed more at first and what they did right was to allow me to manage the pain, understanding that there’s a big difference between abuse of pain medication and acute pain use of narcotics.”

Mike Gaynes, a media consultant, received similarly caring treatment with opioids when he reached the ER suffering with kidney stones. Although he does not normally have high blood pressure, the pain had made it skyrocket. “This was cork-popping,” he says, “They gave me I.V. morphine and it helped somewhat, then they gave me more and it helped a little more. It took the edge off but did not shut [the pain] down entirely.”