Recognizing chronic pain as an ongoing problem is the first step to finding treatment. It’s important to talk to your doctor about your symptoms in order to identify the source of the pain and to come up with a successful treatment plan.
Relieving chronic pain requires a comprehensive plan that takes into account your overall health and lifestyle needs. Over-the-counter and prescription medications are often used to manage pain, as well as physical therapy, exercise, acupuncture, relaxation techniques, and psychological counseling. For many people, a combination of treatments is thought to be the most effective in relieving chronic pain.
Micke Brown, BSN, RN, the Director of Communications for the American Pain Foundation, believes that a “multi-modality” treatment is the best approach to managing chronic pain. “Pain and its treatment are complex, and what works best for one may not work for another,” says Micke. “The secret to creating an effective pain treatment plan is adding the right ingredients to find the recipe that works for the individual.”
The most common types of over-the-counter pain-relievers are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxrn. Both acetaminophen and NSAIDs can be used successfully as a means to relieve mild pain caused by muscle aches, but only NSAIDs work to reduce inflammation and swelling.
Topical creams that work to relieve pain associated with arthritis and muscle aches are also widely available.
If pain persists or worsens, your doctor may want to prescribe a stronger medication. The American Chronic Pain Association (ACPA) points to four major classes of medications that are most often used to treat chronic pain.
- Non-opioids: aspirin, NSAIDs and acetaminophen
- Opioids: morphine, codeine, hydrocodone, and oxycodone
- Adjuvant analgesics: including some antidepressants and anticonvulsants.
Medications with no direct pain-relieving properties, such as antidepressants, are often prescribed as part of a pain management plan.
Possible Side Effects
Medications can cause unpleasant side effects. Talk to your doctor if you experience any unusual symptoms. Some of these include:
- edema (Swelling)
- nausea and Vomiting
- diarrhea or constipation
- breathing Difficulties
- abnormal Heartbeat
If chronic pain is not alleviated by prescription medications, your doctor may want to administer a surgical implant, such as an infusion pain pump or spinal cord stimulator.
Trigger Point Injections
Injections of a local anesthetic, which may also include a steroid, can be used to relieve pain in areas where mechanical compression of a nerve leads to intractable pain.
The ACPA states that cognitive, behavioral, and physical therapies often lessen the need for medications and other more invasive procedures. Plus, these forms of treatment allow patients to take a more active role in managing their pain.
“Pain is like the oil light on your body's dashboard telling you that something desperately needs attention,” says Jacob Teitelbaum, MD, the medical director of the Fibromyalgia and Fatigue Centers. “Just as the oil light will go out when you put oil in your car, pain will often go away when you give your body what it needs.”
Regular exercise and physical therapy are usually part of any pain-management treatment plan. Teitelbaum believes exercise is critical in the relief of pain. A very large percentage of pain comes from tight muscles, even if these are triggered by tumors, inflammation, and other problems. Regular exercise is important because it helps to do the following:
- strengthens muscles
- increases joint mobility
- improves sleep
- releases endorphins
- reduces overall pain
Relaxation techniques, such as meditation, massage, and yoga are often recommended as part of a treatment plan, as they help to reduce stress and decrease muscle tension.
Acupuncture and Acupressure
Acupuncture and acupressure are used to relieve pain by inserting small needles into the skin at key points which prompts the body to release endorphins and blocks the message of pain from being delivered to the brain.
Biofeedback is another technique often used in pain management therapy. It works by measuring information about muscle tension, heart rate, brain activity, and skin temperature. The feedback is used to enhance an individual’s awareness to physical changes associated with physical and psychological stress or pain. Using this information, a person can train themselves to manage pain.
Transcutaneous electrical nerve stimulation (TENS) uses a small electric current that is applied to specific nerves. The current interrupts pain signals and triggers the release of endorphins.
Also known as "medical marijuana," several states have laws permitting the use of cannabis for debilitating pain syndromes and painful disease like cancer and multiple sclerosis. Cannabis has been used as a method of pain relief for centuries. Often obscured by controversy and misinformation, recent research has put cannabis back on the map for the plant’s anti-inflammatory and analgesic properties.