The practical reality for those of us on the receiving end is that pain hurts. For the time it affects us, we don’t really care about the niceties of definition. But, for researchers, some labeling and classification is required so we can all know what we are talking about.
The main distinction is all about time. For the lucky, the injury will respond to treatment. There will be a cure and, over time, the pain will disappear, and life will return to normal. Pain that lasts for no more than a month or so is labeled “acute”. This has nothing to do with the severity of the pain. Similarly, when the pain persists and shows no immediate sign of disappearing, it’s labeled “chronic”.
This points to a more general problem with the science. When studying something, it’s usually possible to define it with some precision. Talk about influenza and the scientists can wheel out petrie dishes full of all the most common viruses responsible.
With the aid of electron microscopes, we can eyeball these pesky nuisances and show them how tough we are. But there’s nothing to identify when it comes to pain. It’s more subjective than objective and, in most cases, the only way in which you can get people to assess how much pain they feel is to ask them on a scale of 1 to 10, how bad it is. Obviously, what is a 5 to one person may be a 10 to others. It all comes down to attitude.
Worse, for a number of reasons, people have motives to lie about how much pain they feel. This may simply be to escape social obligations or to inflate a legal claim for damages. As it stands, there are few ways to prove how real pain is. Worse, because doctors rely on self-reporting, it often leads to them diagnosing lower rather than higher levels.
Over the centuries, there has been a continuous search for painkillers. Whether it was actually beneficial, there were early discoveries of natural substances that produced numbness. The downside was the addictive qualities, more often than not causing more long-term damage than benefit. Yet, until this century, there were no real alternatives.
Now we have developed drugs which relieve pain with a significantly lower risk of dependence. Second, there are now extended and slow release systems that allow dosages to be delivered over a set period of time. This overcomes the scattergun approach in which you dump drugs into the bloodstream and wait for the liver and kidneys to filter them out.
Ultram now comes in a range of doses so that, for acute injuries, you can build up a high concentration in the bloodstream and then taper it down. This gives you immediate relief and then allows you to balance the amount of drug as you heal. For chronic injuries, the extended release version gives you a stable concentration of drug and keeps the pain under better control. This is particularly useful when looking for a way of sleeping through the night. In this respect, Ultram has proved the most useful and flexible of painkillers.