CHAPTER 8: Pain

Contents

CHAPTER 8: Pain

Up to 15% of adolescents will say that they have had pain "most of the time" during the last month. The most common pains they have are headaches, chest pains, and stomach pains. Because these are such common problems, we will use some medical terms that you will be likely to hear.

What Should I Do For Pain?

Many teens have problems with headaches, chest pain, and stomach pains. For most teens the pains will go away quickly. You can try some simple tricks for the common pains that are described below. But if a pain keeps getting worse or you have questions about it, you should contact a nurse or doctor immediately. A lot of pains can be made worse by stress or emotional problems. Be aware of this connection and read the Chapter on Feelings and Problem Solving if you think stress or emotional problems may be related to your pain.

Common Pains: Headaches

For both adults and adolescents, "migraine" (my grain), muscle tightness type, and "mixed" headaches are the most common causes. Migraine (vascular) headaches are often felt in the front and side of the head. They usually get very bad within 60 minutes and may make you feel sick to the stomach or want to avoid light. You often feel a pulsing or throbbing. You may have about a twenty minute warning before your headache begins (for example, flashing spots, sick to the stomach). Alcohol, exercise, some foods (chocolate, preserved meats, and ice cream), changes in the weather, and your menstrual period may cause the headaches. You may find that you can relieve the headache somewhat by pressing on the arteries just above and in front of your ears. Migraine headaches come and go on their own and may last from a few hours to a day.

Muscle Contraction Type headaches usually begin gradually and get worse by the end of the day. The pain feels aching and pulling and is usually worse around the entire head and in the neck. You may feel that your head is being squeezed. These headaches may last for days or weeks. Exercise and hot showers may help a muscle contraction headache but make a migraine headache get worse.

Mixed headaches are a mixture of migraine and muscle contraction headaches.

The first treatment for all types of headaches is to find out if there is something that usually causes them. Then try to avoid it. The next best approach is to use a safe treatment to try to reduce the headache. Aspirin, acetaminophen (Tylenol), ibuprofen, and naproxen are all effective medications that you can get without a prescription. A safe, effective mix of medicines is known as Excedrin (or the same mixture sold as a "generic drug").

Many other prescription medicines are used for treatment of headaches (beta blockers, calcium channel blockers, amitriptyline, ergotamine, methylsergide, sumatriptan, naproxen, imitrex, and cyproheptadine). All medicines have a cost and side effects that could cause harm. Your doctor can talk to you about these choices.

Mixed and muscle contraction headaches are more difficult to treat with medicines alone. Therefore, many health professionals recommend that you try relaxation, music, or imagery for headaches that you can feel coming on.

A simple relaxation approach requires that you turn on soft back- ground music. (Without news or advertisements!) Lay down in bed or a recliner, and let your jaw drop slightly, as though you were starting a small yawn. Keep your tongue quiet and resting on the bottom of your mouth. Let your lips get soft. Breathe slowly and evenly: inhale, exhale, rest. Allow yourself to stop forming words with your lips and thinking in words. Think of pleasant pictures.

S inus headaches are another common headache. Usually it causes pains in the face that get worse when you bend over. You may notice that you have a cold or runny nose when you have a sinus headache. Nasal sprays or sinus/nasal decongestants for a few days (never more than 5 days) can help sinus headaches.

If sinus problems persist and you are a smoker, smoking is usually the cause. You will need to stop smoking. If you are not a smoker, a one month trial of a cortisone spray for several weeks may prove helpful.

Chest Pains

In adolescents, doctors seldom find out the causes of chest pains, but they are almost always not serious. They are usually sharp but of short duration. They are often brought on by exercise or made worse by deep breathing, but sometimes they start for no obvious reason. They can happen a few times a day or once or twice a week. Sometimes they are described as a "stitch." Some teens when under stress can hyper-ventilate (breathe faster than normal). This occurs without the person or anyone around realizing that it is happening. Usually with hyperventilation, there is also some light headedness and pins and needles in the arms or hands that goes along with the chest pains. Relaxing and thinking about breathing slowly or breathing into a paper bag for a few minutes will take away the pain.

The main concern is chest pain with shortness of breath or difficulty getting air into your body. Some persons having asthma attacks can start with chest pain and shortness of breath as a first sign, rather than with coughing or wheezing. (See Breathing Problems). If you have chest pain with shortness of breath, you should get help as soon as possible.

"Stomach" Pains

The commonest cause of pain in the abdomen (belly) area may be due to the irritable bowel syndrome, peptic ulcers or dyspepsia (dis-pep-see- ya), and food problems such as (lactose intolerance). The irritable bowel syndrome often causes discomfort around the belly button area. It can be quite severe at times and changes in bowel pattern may be noticed with it. For a day or two you have diarrhea (lots of loose bowel movements) and then you may feel constipated (can't go). Usually the discomfort lasts for a few days. Other times, change of bowel pattern and discomfort can go on for weeks. Stress makes this condition worse.

Adding fiber each day to your diet and exercising regularly usually works well. Bran is one form of fiber -- but also vegetables, fruits, whole wheat products.

Peptic ulcers are pretty rare in adolescents but dyspepsia is more common. Both problems cause a burning or gnawing ache in the upper middle abdomen just below the chest. Usually the pain is made better by eating meals or antacids. It is made worse by alcohol, aspirin, ibuprofen, and smoking.

"Lactose intolerance" may be a cause of discomfort.

“Food Allergies” may be a cause of discomfort, but are often difficult to prove and relatively rare and easily confused with an irritable bowel syndrome.

True gluten (wheat) allergy can be diagnosed by a blood test. However, many more people claim they feel better when they avoid gluten.

Lactose is a sugar in milk and milk products. About 15% of the white population and as high as 90% of African and Chinese Americans may have bloating, gas, and cramps when they have lactose. They can either avoid eating lactose or try lactase pills. However, many persons who have a normal ability to digest lactose also have these problems. If you have bloating, gas, and cramps when you eat dairy products you can try to avoid eating lactose or use lactase pills. If the approach works, great!

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.

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