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JAMA Patient Page
November 12, 2003

Pain Management

JAMA. 2003;290(18):2504. doi:10.1001/jama.290.18.2399

Every person experiences pain at one time or another. Pain may be related to an injury, a surgical procedure, or a medical problem. Pain can come from an illness or can be the result of a combination of factors. Each person experiences pain in an individual way. Different kinds of pain may cause a variety of pain-related problems.

There are many ways to treat pain. Treatment often depends on identifying the cause of the pain. Sometimes simple therapies are not enough to treat persons with a difficult pain problem. For these patients, there are doctors who specialize in treatment of pain. These physicians may have backgrounds in a variety of medical specialties.

The November 12, 2003, issue of JAMA is a theme issue devoted to articles about pain and pain management.


  • Acute—injury, inflammation, surgery, childbirth

  • Chronic—pain problems of long duration

  • Neuropathic—from diseases of the nerves or from injury to nerves

  • Cancer—pain related to malignant disease or tumors and their effects on the body

See your doctor if you experience a pain problem that is unusual for you. Early diagnosis and treatment of pain problems can lessen their effects on the body and the mind. Because pain also has emotional effects, your doctor may suggest ways other than medications to help you manage your pain problem.


  • Rest or exercise

  • Heat or ice

  • Physical therapy

  • Nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen)

  • Opioid (narcotic) medications taken by mouth, injection, or rectal administration

  • Antidepressant medications

  • Stress reduction

  • Nerve block (injection of anesthetic around a nerve)

  • Transdermal (through the skin) medications

  • Epidural (space outside the spinal cord covering) or spinal (space inside the spinal covering) injections

  • Implantation of pumps (for medications) or spinal cord stimulators

  • Psychotherapy (talking with a mental health professional)

Fear of addiction to narcotic medications stops some persons from treating their pain adequately. Narcotic medications, when used properly under the supervision of your doctor, may be useful in treating severe pain, cancer pain, or difficult chronic pain problems.



To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA 's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on managing pain was published in the April 5, 2000, issue; one on coping with back pain was published in the December 6, 2000, issue; and one on low back pain was published in the June 19, 1998, issue.

Sources: American Board of Pain Medicine, American Cancer Society, American Pain Foundation, National Institute of Neurological Disorders and Stroke, American Society of Anesthesiologists

The JAMA Patient Page is a public service of JAMA . The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.