Pain comes in all shapes and sizes, with a corresponding variety of treatments. The trick is finding the right antidote to your problem, says Caroline White

Pain can have a devastating effect on our lives: it is the main symptom in eight out of 10 medical consultations and an estimated 7 per cent of the UK population suffers from chronic pain.

However, pain is also personal: we all suffer it, but none of us experiences it in the same way. How we feel it depends on a complex cocktail of upbringing and experience, state of mind, gender and genes. The same is true of our responses to treatment.

There are three different types of pain. Somatic pain is activated by pain receptors in the skin or deep tissues, and is usually confined to a particular area. Visceral pain comes from pressure deep inside the body, such as internal bruising, abnormal growths, or even trapped wind. Often spread over a wide area of the body, it can be felt in sites far from the original problem. This is known as referred pain. Finally, neuropathic pain occurs when nerves are damaged, inflamed, or trapped. Frequently burning and searing in quality, it is difficult to treat with standard painkillers. It is further characterised by how long it lasts. Acute pain comes on suddenly, lasting from seconds to weeks. Chronic pain can be constant or recurrent and lasts for months or years.

Pain is usually treated with analgesics, a term for pain-relievers or painkillers, many of which can be bought over the counter. Soluble preparations are absorbed more quickly into the bloodstream than tablets, which makes them ideally suited for the treatment of migraines. The most popular analgesics are: paracetamol, aspirin and ibuprofen (which are both anti-inflammatories) and codeine.

Paracetamol works well for acute pain and fever. Be careful not to exceed the recommended dose or take several preparations containing the drug - many cold and flu remedies contain paracetamol. High doses can damage the liver.

Non-steroidal anti-inflammatory drugs (NSAIDs) reduce fever and the swelling caused by injury or inflammatory diseases such as arthritis or tendonitis (inflammation of the tendons). Aspirin was the first NSAID to be developed. Side effects of NSAIDs include heartburn and indigestion, with 10 to 50 per cent of people affected. Aspirin is the worst offender. Taking the drugs during or after food or using antacids will help minimise this side effect.

You should also check with your doctor first if you are: asthmatic, on a course of blood thinning drugs (anticoagulants), taking cortisones such as prednisone, six or more months pregnant or breastfeeding. You should also consult you GP if you have ever had a bleeding ulcer.

Ibuprofen also contains aspirin. Although less of a stomach irritant, it’s a weaker anti-inflammatory. Good for period pains and migraine, it is also the key ingredient in many creams and gels used to soothe muscle strains and sprains. Don’t apply it to broken skin.

Creams containing capsaicin, a substance found in chilli peppers, can work well for shingles, osteoarthritis, and complex regional pain syndrome, in which severe pain remains after the injury has healed. Avoid applying just before or after bathing.

Many other types of drug are used to combat pain. Inflammatory diseases, such as rheumatoid arthritis, can be treated with corticosteroids injected directly into an inflamed joint, or taken in tablet form.

Codeine is an opioid painkiller, related to morphine. Opioids are prescribed for severe pain, such as terminal cancer, or after major surgery. Side effects include constipation, drowsiness, and nausea.

Antispasmodics, to relax muscle contractions, are used to relieve gut pain in irritable bowel syndrome (IBS) and diverticulitis. Some sprays and solutions containing anaesthetic are also used to numb skin and throat pain, or injected as nerve blocks in neuropathic pain.

There is strong evidence to show that pain intensity is linked to mood, and many chronic pain sufferers are also depressed, so antidepressants and other medicines that work on brain chemicals - neuroactive drugs - can be prescribed. Beyond drugs, behavioural therapies such as cognitive behavioural therapy, which alters negative thought patterns, and biofeedback have been successful in treating chronic pain and IBS, respectively.

Music and exercise help chronic pain sufferers by stimulating the release of endorphins, the body’s natural mood enhancers, although the amount produced varies from person to person. You may also want to try acupuncture, massage, and aromatherapy.

Some people, particularly those with musculo-skeletal problems, such as repetitive strain injury (RSI) or torn ligaments, gain relief from mechanical stimulation, such as ultrasound, which provides deep heat, or transcutaneous electrical nerve stimulation, which pulses a gentle electrical current through the nerve endings in the skin.

Pain is the focus of intensive research. And issues such as phantom pain, why women respond to pain and process painkillers differently from men, how pain is ‘learned’ and the role of gene therapy, offer great hope for future treatments.

For more information on pain, details of support groups, and useful website links, access www.painsupport.co.uk