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On a Scale From 1 to 10: Most Painful Medical Conditions

Discussion in 'Anesthesia' started by Hadeel Abdelkariem, Jun 11, 2018.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

    Apr 1, 2018
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    The worst type of pain? It's whatever pain you personally suffer from. But experts and patients agree: Certain medical conditions are especially excruciating. When health care providers ask patients to rate their pain on a scale from 1 to 10, these conditions – whether acute or chronic – can have some of them responding "11." If pain can't always be cured, proper treatment can at least help scale it back.


    Kidney stones

    Trying to pass a kidney stone stuck in the urinary tract can bring people to their knees and straight to the emergency room. Usually made of calcium, these hard pellets block the flow of urine, making the kidney swell and causing waves of sharp pain at the mid-back, abdomen or sides and for men, pain at the end of their penis. Nausea, vomiting, fever and blood in the urine are common. Once a kidney stone is confirmed, treatment with IV fluid and medication allows the stone and the pain to pass. Stubborn small kidney stones may require shock wave therapy, or lithotripsy, to break them up. Larger or recurring stones may call for more complex methods.


    For some women, intense pain in the lower back is an unforgettable aspect of childbirth. Often called back labor, the pain peaks during contractions and lingers in between, making it more difficult for women to push. It's sometimes caused by the baby's head position, with the back of the head pressing into the mother's tailbone, but that's not always the case. Non-medication methods to ease the mother's pain include moving away from a back-lying position, walking and applying counter pressure, for instance with a tennis ball or warm compresses, to the back. If these aren't enough, relief options include pain medication or an epidural nerve block using local anesthesia to numb the area.


    With a gunshot wound or other trauma, sudden, severe pain can strike a healthy person to a degree they've never experienced, says Dr. Asokumar Buvanendran, an anesthesiologist specializing in pain medicine with Rush University Medical Center in Chicago. Acute pain provokes a variety of bodily signs, says Buvanendran, also the president of the American Society of Regional Anesthesia and Pain Medicine, or ASRA. Rising blood pressure, a racing pulse and cues from the patient's physique, movements and posture all tell the story of intense pain. But clinicians must rely on patients to gauge exactly how much pain they're in – thus those requests to "Rate your pain on a scale from 1 to 10."


    Older adults who suffer from shingles may wish they'd been vaccinated against herpes zoster, the virus that causes chickenpox in kids and shingles in seniors. Besides rashes, blisters and scabbing, shingles patients suffer intense pain. This occurs in parts of the body along a nerve pattern, called the dermatome, where the virus resides – often across the trunk. Unfortunately, some patients go on to develop a chronic condition called post-herpetic neuralgia, with symptoms including deep or burning pain, extreme sensitivity to touch and numbness in the affected area, which can last for years if not addressed promptly. Early treatment for shingles can help prevent the transition from acute to chronic pain, Buvanendran says.

    Sickle cell disease

    Although it's classified as a rare disorder, sickle cell disease is well-known for the pain it causes. The inherited condition affects red blood cell formation. In sickle cell crisis, normally flexible and disc-shaped blood cells become stiff and crescent-shaped. Blood can't flow smoothly, which reduces delivery of needed oxygen to the body's cells. Pain management is an ongoing challenge for people with sickle cell disease, some of whom encounter acute pain during crises along with ongoing day-to-day discomfort.

    After-surgery agony

    No surprise here: Recovering from surgery can be painful. But some procedures cause more postoperative pain than others. Knee replacement surgery would rank near the top of the list, Buvanendran says, because of all the cutting through bone. However, he says, for whatever reason, the aftermath of hip replacement doesn't seem to hurt as much. But with every breath, lung surgery brings postoperative pain to the involved muscles, he adds.

    Spinal headaches

    Spinal headaches can result from an accidental tear or puncture made during a spinal tap procedure. Leaking of fluid from around the spinal cord can cause a severe spinal headache, Buvanendran explains. In some cases, he says, lifting heavy objects (like a fish tank for one patient) can cause a vulnerable spot to tear. Nausea, dizziness, light sensitivity and neck stiffness are symptoms. Doctors sometimes treat spinal headaches with blood patches from the patient's own blood to plug the leakage site.

    Back injury

    As a source of agonizing back pain, an acute disc herniation – possibly caused by heavy lifting – is all too common. "Your disc protrudes and bulges and pushes on the nerve," Buvanendran says. "You have severe pain going down your legs." Many other people suffer from less dramatic but still-debilitating chronic back pain. The ASRA website offers a gamut of pain treatment options.


    They're not as sudden and sharp as spinal headaches. Even so, migraines can knock people out for days, notes Penney Cowan, founder and CEO of the American Chronic Pain Association. For this and other pain conditions, she says a balanced approach using a variety of therapies – which will depend on the condition and patient – is best. ACPA provides an A-to-Z rundown of treatments, including over-the-counter and prescription medications, acupuncture, complementary and alternative medicine, and cognitive behavioral therapy. With each individual, Cowan says, the goal is "to reduce their sense of suffering and improve the quality of their life and function."

    Chronic pain conditions

    Lyme disease, fibromyalgia and arthritis are among dozens of chronic conditions addressed by the ACPA. "Pain is so isolating," Cowan says. "It makes you withdraw from everything and everybody." Pain management programs, offered by medical centers such as Cleveland Clinic, Johns Hopkins and Mayo Clinic, can make a big difference, she says. However, she adds, many people don't have access to these programs or can't afford them. With the current spotlight on opioid addiction risks, Cowan says, many chronic pain patients who have functioned well on these drugs for years are now being denied by doctors. See the ACPA site for in-depth information and options for chronic pain management.

    Read Also:

    Everything About Herniated Disc and Back Pain

    Risk Factors, Causes, Diagnosis, Treatment And Prevention Of Sciatica


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