Are there protocols for how doctors manage pain?

[ADuckNamedSplash]

For anyone with medical knowledge - how do doctors determine what pain relief to administer / prescribe? Are there protocols based on the cause? E.g. if the cause is X, pain relief options are A, B and C?

The reason I ask is that I've been suffering from gallstones for nearly 5 months now - since the birth of my DD (pregnancy was the trigger). The attacks are excrutiating and have landed me in hospital 3 times (twice via A&E, once emergency admission via GP). On each occasion, the doctors have tried to offer me cocodamol as pain relief, and seemed quite surprised when I told them that the cocktail I'd already taken of 32mg codeine, paracetamol, ibruprofen and buscopan had little effect, so cocodamol (with it's mere 8mg of codeine) sure as hell wouldn't do anything.

Anyone who has suffered gallstone attacks will tell you the same thing - a quick Google reveals hundreds of people desperately seeking relief. Yet the medical profession seems clueless as to how bad the pain is, and I just want to know why! Is there some guideline or protocol somewhere? Where have they got this idea that such weak painkillers are a solution and why don't they listen when patients tell them otherwise?

I'm waiting for gallbladder removal surgery, which will hopefully end my suffering soon, but I feel strongly enough about this to campaign for change. I just don't know exactly where the issue is occurring to know how to tackle it. Can anyone advise?

The thing about pain is its such an individual experience, so has to be dealt with on an individual basis. What works for one might not work for another, and how one patient perceives the pain from a particular illness / accident / surgery could be very different to the perception of another.
Having said all of that they tend to be on the cautious side with painkillers as a lot of them can be addictive, and patients can build up tolerance to the drug and it stops being so effective.

Cholecystitis pain is a well known shocker of a pain so you absolutely have my sympathy. Your biggest issue is the wait for the surgery, they need to crack on with a date for you.