Pain is one of the most common reasons why people visit the hospital. People experience pain due to a lot of reasons. Pain is a way of the body telling us that the body is in distress or danger. Pain is an unpleasant feeling that can take many forms. It could be light pain, or present as discomfort due to arthritis, or a headache. Pain occurs due to a complex interaction between some special nerves, and the central nervous system. The central nervous system consists of the brain and the spinal cord. The most prevalent type of pain is physical; however, it can also be emotional. This article would be focusing on physical pain, and how steroids can be used in treating it. Before going into the interaction between steroids and pain, it’s important to know some basic things about pain.
What Are the Types Of Pain?
Pain can be classified into two types, based on duration. They include the following:
- Acute pain: Acute pain, also known as short term pain is the type of pain that resolves within a short period of time. This mostly occurs when people have an injury, surgery or an illness. Acute pain doesn’t persist for more than 3 months. It can be easily treated with the use of medications such as pain-relievers, steroids and so on.
- Chronic pain: Chronic pain, also known as long term pain is the type of pain that persists for a long time. It usually lasts for more than 3 months and even years in some cases. Chronic pain is considered a health condition by itself.
People affected with acute pain does know where and why they have the pain. As an illustration, a footballer that got kicked in the knee can point to where he’s experiencing pain, and can also explain why he feels pain. Acute pain is caused by tissue damage. We feel pain because that’s the body’s way of alerting us that there is something wrong with that part of the body. It’s also to protect us from further harm. On the other hand, chronic pain can occur without any injury or illness.
What Are the Causes of Pain?
Pain occurs when a nerve ending is stimulated. This might occur as a result of an injury to the body tissues, or if an individual hurt him/herself. Pain can also occur due to the disruption of the nerves. There are also cases when pain occurs for no identifiable reason. Pain can develop in any part of the body. Some of the most common forms of pain are lower back pain, upper back pain, neck pain, headaches, migraine, cancer pain, pain due to nerve damage, and also pain that is related to conditions such as fibromyalgia, sciatica, nerve compression and so on.
Pain That Occurs Due to Tissue Damage
As earlier mentioned, pain is the body’s way of informing us that we’re in danger. Humans perceive pain through their sensory neurons. These are the cells that carry information from the various senses such as touch, sight, hearing, taste, and smell. Tissue damage might occur to injuries such as vehicular accidents, mechanical injuries and so on.
Pain That Is Caused By Nerve Damage
This is the type of pain that is caused by damages to the nerve. This may be damaging to one or more peripheral, spinal nerves. It might occur due to diseases, surgery or infections. These conditions would cause the damaged nerve to abnormally send pain signals, rather than in response to injuries. This form of pain is also known as neuropathic pain. Patients might feel a burning, shooting, numbing or tingling sensation in the affected part of their body. This form of pain is common in patients affected by diabetes mellitus. It’s referred to as the ‘‘pins and needles’’ sensation, which occurs as a complication of diabetes mellitus. Another type of neuropathic pain occurs due to sensitization. This happens when the pain pathways in the peripheral nerves and the spinal cord becomes activated persistently. This process amplifies whatever pain the affected individual might experience. This condition occurs in individuals affected with phantom limb pain.
What Conditions Influence Pain?
Conditions that are extremely painful to some people might just be slightly painful to other persons. This is because people respond to pain differently, and there are several factors that could cause this. Some of these factors include emotional, social and psychological factors. Pain usually passes through the emotional and thinking regions, then the physical sensation region. Below are some of the factors that affect how people respond to pain:
- Genetics: Genetics play an important role in how sensitive the body is to pain signals, and also how one perceives pain. Some people are genetically wired to have a sharp sensitivity to pain. Such people perceive even mild pain as extreme.
- Gender: Studies have shown that women report more frequent and severe pain than men do. The type of pain they experience is also longer-lasting as compared to men. It’s not yet clear if this can be attributed to biological, psychological and social factors.
- Chronic diseases: Studies have shown that chronic diseases such as fibromyalgia, migraine, headaches are associated with pain.
- Social factors: According to studies, it has been shown that people with lower education levels, lower income, tend to have a higher prevalence of pain, as compared to those with higher income and education levels.
- Previous experiences: Previous painful memories can affect current experiences. As an illustration, people that have had a bad experience with the dentist, tend to get nervous about it. Something as small as a minor probe can elicit a strong pain response from them.
- Psychological factors: Studies have shown that people with psychological problems such as depression, anxiety, and low self-esteem tend to experience pain more, as compared to people without these disorders.
- Individual factors: It has been shown that people’s upbringing and different coping strategies and attitude plays a role in how they interpret pain and how they tolerate it.
What’s the Impact Of Pain?
Everyone feels some pain at some point. This might be due to injuries, acute pain or chronic pain. Most people tend to ignore acute pain, especially when it’s just mild. Severe or chronic pain can interfere with the ability of people to carry out their daily activities. It can negatively affect the relationships and interactions of people with others. Severe pain can affect the overall health of the affected individual.
However, there are a lot of options for the treatment of different forms of pain. Other factors that play a role include the lifestyle and the attitude of the individual. Steroids are one of the effective ways of treating pain.
What Are Steroids?
Steroids are one of the ways of treating pain. Corticosteroids can be applied to the inflamed area to improve the pain and swelling. In addition, steroids also help to reduce the activity of the immune system. Steroids are mainly used when other conservative methods of treating pain have failed. Corticosteroids are usually considered before surgery is done. They can be taken in various forms, through injections, orally, and so on. It’s important to consult your physician if you’d be needing steroids and the route of administration. The type of pain a patient has would determine the route of administering steroid. As an illustration, individuals with back pain would require steroidal injection for treatment.
How Do Steroids Work?
Steroid work by blocking and reversing the effects of inflammation. It’s important to know that they only reverse the damaging effects. The mechanism behind this is that they inhibit the production of prostaglandin and other mediators. They do this by stimulating cortisol from cholesterol. The immune system, which is responsible for protecting the body against diseases, infections and foreign substances get stimulated when one is injured. The causes the release of some special chemicals into the injured area of the body. These chemicals mediate the damage and also hastens the healing process. When an individual is injured, the chemicals released into the body by the immune system causes inflammation and also allows the body to heal. However, the inflammatory process can sometimes get out of hand. This can cause more injuries to the body, even more than the initial injury. This is why physicians recommend steroids to people affected by injuries. As earlier mentioned, steroids have anti-inflammatory features. Other features of steroids include the suppression of the immune system and so on.
What Conditions Can Be Treated with Steroids?
Steroids are used for the treatment of a number of conditions associated with pain. Some of these conditions include the following:
- Spinal stenosis
- Rheumatoid arthritis
- Sjorgren’s syndrome
- Systemic vasculitis
- Sciatica: This is a condition in which pain spreads along the path of the sciatic nerve. The sciatic nerve branches from the lower back, through the hips and buttocks, and down each leg. This condition typically affects one side of the body. Sciatica usually starts suddenly, especially after engaging in activities such as the heavy lifting of materials. It can also develop over time. Studies have shown that about 90% of sciatica cases are due to spinal disc herniation. Other conditions that could lead to sciatica include spinal stenosis, piriformis syndrome, pelvic tumors, pregnancy and so on. Physicians diagnose this condition by carrying out the straight-leg-raising test. They might also make use of imaging test such as X-ray, MRI, CT-scan, although these tests might not be needed. The initial treatment of this condition involves the use of pain medications. Steroids are effective in the treatment of pain associated with sciatica. Other medications used in treating this condition include gabapentin, pregabalin and so on. Alternative medicine can also be helpful in treating this condition. Examples of this include acupuncture, and spinal manipulation.
What Are the Signs and Symptoms of Sciatica?
Persons affected with sciatica do experience the radiation of pain from their lower back to their buttocks, and down to their leg. This is the classic presenting features of sciatica. Patients might also feel some pain along the nerve pathway.
In addition, patients might experience sharp pain, burning sensation or severe pain that might feel like an electric shock. These symptoms tend to worsen when the patient coughs or sneezes. As earlier mentioned, only one side of the body is affected. Some patients may present with strange sensations in their legs, such as numbness and muscle weakness.
When Is It Important to See A Physician?
Mild cases of sciatica usually don’t require any form of treatment. However, it’s important to seek medical help when the signs and symptoms don’t subside, especially after one week. Below are some of the reasons why you should get urgent medical help:
- If you develop pain, after an accident, or a serious
- If you have difficulties controlling your bowels and bladder.
- If you develop a sudden and severe pain in parts of your body such as the lower back, leg.
What Are the Causes of Sciatica?
This condition occurs when the sciatic nerve is compressed or pinched. This can be due to various reasons. However, the most common cause is disc herniation or the overgrowth of bone on the vertebrae. Also, the nerve can also be compressed by a tumor or other conditions such as diabetes mellitus and so on.
What Are The Risk Factors Of Sciatica?
These are conditions that increase the risk of developing sciatica. They include the following:
- Age: Studies have shown that this condition occurs more in old adults. This can be attributed to the changes in the spine such as herniated discs, and bone spurs as one age.
- Obesity: Individuals that are overweight or obese tend to develop sciatica. This is because their excess weight puts stress on the vertebrae and other joints of the body.
- Occupation: Persons that do jobs which require them to sit down for duration are prone to developing sciatica.
Diagnosis Of Sciatica
Physicians diagnose sciatica by taking the medical and family history of the patient. Physical and neurological examination of the patient is also carried. Patients might be asked to walk on their toes or rise from a squatting position. An individual affected with sciatica would find it difficult doing this and might experience worse symptoms. Physicians do make use of imaging tests when diagnosing their patients. Some of the tests that might be carried out include the following:
- X-ray: The X-ray may show an overgrowth of bone, that may be compressing a nerve.
- MRI: This is done to produce more vivid images of the back. The MRI produces pictures of the bone and soft tissues in the affected part of the body. The MRI is capable of showing the herniated discs.
- CT scan: This is done to get a clearer image of the spine. Contrast dye is usually injected into the spinal canal before the X-rays are taken.
How Is Sciatica Treated?
Mild cases of sciatica don’t require medical intervention. However, patients that don’t experience any improvement in their condition usually benefit from a combination of medications and physical therapy.
- Medications: Some of the medications used in the treatment of sciatica include the following:
- Steroids: Steroids are one of the most effective medications used for the treatment of sciatica. They are effective because of their anti-inflammatory properties.
- Muscle relaxants
- Physical therapy: Patients might need the services of a physical therapist to help create a treatment plan to prevent the occurrence of future injuries.
This is a common form of arthritis. It’s an inflammatory condition that affects the joint. The affected joints usually become red, tender, hot and swollen. This condition occurs due to the high level of uric acid in the blood. Other conditions that contribute to the development of gout in the body include genetics, diet, and other health problems. The high amount of uric acid leads to the crystallization of the uric acid in some parts of the body, such as in the joints, tendons, and the surrounding tissues. Gout occurs more in people that consume foods such as seafood, meat, beer on a regular basis. This condition is also common for overweight people. Physicians diagnose this condition by checking for the presence of crystals in the joint fluid, or outside the joint. This condition is treated with steroid medications, nonsteroidal anti-inflammatory drugs and so on.
What Are The Signs And Symptoms Of Gout?
Below are some of the signs and symptoms presented by people affected with gout:
- Joint pain: One of the earliest symptoms of gout is that patients affected with the condition present with intense pain in their joints. This can affect any of the joints. Examples of the joints that are affected by gout include the ankles, knees, wrists, and However, the pain gets severe within the first 4 to 12 hours after it starts.
- Inflammation: The affected joint also becomes swollen, tender, warm and red.
- Restricted range of motion: Persons affected with this condition may find it difficult to move their joints normally.
When Is It Important To Consult A Physician?
It’s important to seek the help of a physician if you present with any of the following:
- Patients that experience sudden and severe pain in their joints should seek the help of a physician.
- If the joint pain is associated with fever or any signs of infection.
What Are The Causes Of Gout?
Gout occurs when there is a high level of uric acid in the blood, and they crystalize due to some reasons. This causes inflammation and pain. Some of the causes of gout include the following:
- Heredity: A percentage of all gout cases is as a result of genetics. Some genes have been identified to be closely connected to the development of gout. These defected genes cause hypouricemia, by decreasing the absorption of urate, and not opposing urate secretion. There are some diseases that are often complicated by gout; some of the diseases include Lesch-Nyhan syndrome, familial juvenile hyperuricemic nephropathy.
- Lifestyle: Studies have shown that diet is responsible for about 12% of gout cases. This includes the consumption of food such as alcohol, meat, seafood, sweetened drinks and so on. These foods are rich in purines which yield uric acid. Food sources that help in reducing the risk of developing gout include coffee, vitamin C, and so on.
- Drugs: Some medications have been implicated as causes of gout. This drugs possibly increases the crystallization process of uric acid, or increase the amount of uric acid in the blood. Some of the drugs that are associated with the development of gout include hydrochlorothiazide, Angiotensin-converting enzyme inhibitors, beta blockers and so on.
Diagnosis Of Gout
Gout is diagnosed through several means. Some of the tests used by physicians include the following:
- Joint fluid test: The physician may take a fluid sample from the affected joint. Uric acid crystals would be visible when the sample is examined under a microscope.
- Blood test: Blood test might also be done, and this would show the level of uric acid and creatinine in the blood. However, a blood test can sometimes be misleading. There are cases of people that have a high level of uric acid but don’t have gout, and vice versa. This is why it’s important to confirm the diagnosis with other diagnostic tests.
Physicians treat gout by making use of medications. Examples of these medications include the following:
- Corticosteroids: Corticosteroids are effective for the treatment of gout. They help to control inflammation and also improve pain. They can be taken in pill form, and also through injections.
- Nonsteroidal anti-inflammatory drugs: Examples of these medications include ibuprofen, aspirin and so on.
- Colchicine: This medication is meant for those that react to NSAID.
- Other drugs: Other drugs that can be used to treat this disease include interleukin-1 inhibitors. An example of this group of the drug is the Canakinumab.
Why Are Steroids Injected?
Physicians inject steroids into areas of the body affected with inflammation or pain, to deliver a high dose of steroids. On the other hand, physicians can’t guarantee that steroids administered through the mouth or IV would get to the affected area. Also, the side effects of oral and IV steroids are quite high, when compared to injected steroids.
What Are the Side Effects Of Steroid Injections?
Steroid injections are useful in the treatment of conditions such as gout, rheumatoid arthritis and so on. However, they have some side effects. Below are some of them:
- Infection: Although, this is rare. There have been situations where patients got infected through steroid injections.
- Skin discoloration: Patients might also present with an abnormal change in skin color.
- The bones, ligaments, and tendons of the patient might become weakened.
- Patients might present with bleeding into the joint.
It’s important to know that these side effects rarely occur.
Jenssen, I. and Johannessen, K. (2015). Aggression and body image concerns among anabolic-androgenic steroid users, contemplators, and controls in Norway. Body Image, 12, pp.6-13.
Pates, R. (2002). Body-building, Drugs, and Risk. Addiction, 97(8), pp.1077-1077.
Sustainability mindset key to future: building industry body. (2012). ECOS.
Becker, M. (2011). Treatment of the hyperuricemia of gout in the United States. GOUT AND NUCLEIC ACID METABOLISM, 35(2), p.214.
Fuchs, E. (2012). The Impact of Cell Culture on Stem Cell Research. Cell Stem Cell, 10(6), pp.640-641.
Journal search results – Cite This For Me. (2018). .
Khanna, D. (2013). American College of Rheumatology guidelines for management of gout. GOUT AND NUCLEIC ACID METABOLISM, 37(2), p.139.
Scadden, D. and Srivastava, A. (2012). Advancing Stem Cell Biology toward Stem Cell Therapeutics. Cell Stem Cell, 10(2), pp.149-150.