Treating chronic pain
Recognizing that chronic pain is a problem is the first step in finding treatment. Start by talking to your doctor about chronic pain symptoms. Together you can identify the source of the pain and come up with a comprehensive treatment plan that takes into account your overall health and lifestyle.
Over-the-counter (OTC) and prescription medications are often used to manage pain. However, for many people, a combination of treatments is most effective.
Medications may be combined with:
- physical therapy
- relaxation techniques
- psychological counseling
Micke Brown, B.S.N., R.N., is the Director of Communications for the American Pain Foundation (APF). Brown 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 Brown. “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 OTC pain relievers are acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs). Types of NSAIDs include:
Both acetaminophen and NSAIDs can be used successfully to relieve mild pain. NSAIDs also reduce inflammation and swelling.
Long-term use of either type of drug can have potentially severe side effects. Talk to your doctor before you use any OTC medicine for chronic pain.
Topical pain relief
Oral medications are not the only type of OTC pain relief. Topical creams are also available. These are often used to relieve pain associated with arthritis and muscle aches.
Some chronic pain can’t be controlled with OTC medication. In these cases, your doctor may want to prescribe something stronger. The American Chronic Pain Association (ACPA) identifies several major classes of medications used to treat chronic pain. These include:
- nonopioids, such as aspirin, NSAIDs, and acetaminophen
- opioids, such as morphine, codeine, hydrocodone, and oxycodone
- adjuvant analgesics, such as certain antidepressants and anticonvulsants
Antidepressants affect the way the brain processes pain. They can be very effective at treating certain types of pain. They can also improve depression and anxiety, which may indirectly improve chronic pain symptoms by helping with your coping skills.
Possible side effects
Medications can cause a variety of unpleasant side effects, ranging from mild to severe. Talk to your doctor if you experience any unusual symptoms. Some of these include:
- edema, or swelling
- nausea and vomiting
- diarrhea or constipation
- breathing difficulties
- abnormal heartbeat
If chronic pain is not alleviated by oral medications, there are other options. Your doctor may want to try a surgical implant.
There are several types of implants used for pain relief. Infusion pain pumps can deliver medication directly where needed, such as to the spinal cord. Spinal cord stimulation can use electricity to alter the pain signals sent to the brain.
Trigger point injections
Trigger points are a special type of tender area within the muscle. Injections of a local anesthetic, which may also include a steroid, can be used to relieve pain in these areas. Not all adults have trigger points.
They are most often found in people with specific conditions such as:
- chronic pelvic pain
- myofascial pain syndrome
The ACPA states that alternative therapies often lessen the need for medications and other more invasive procedures. Alternative therapies include:
- cognitive therapies
- behavioral therapies
- physical therapies
These forms of treatment also allow people to take a more active role in pain management.
“Pain is like the oil light on your body’s dashboard telling you that something desperately needs attention,” says Jacob Teitelbaum, M.D., 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 plan.
Dr. Teitelbaum believes exercise is critical in the relief of pain. A large percentage of pain comes from tight muscles. These may be triggered by overuse, inflammation, or other conditions.
Regular exercise is important for treating chronic pain because it helps:
- strengthen muscles
- increase joint mobility
- improve sleep
- release endorphins
- reduce overall pain
Relaxation techniques are often recommended as part of a treatment plan. They help to reduce stress and decrease muscle tension. Relaxation techniques include:
Yoga also has other benefits for chronic pain. It can help strengthen muscles and improve flexibility.
Acupuncture and acupressure
Acupuncture and acupressure are types of traditional Chinese medicine. They relieve pain by manipulating key points of the body. This prompts the body to release endorphins which can block messages of pain from being delivered to the brain.
Biofeedback is another technique for pain management. It works by measuring information about physical characteristics such as:
- muscle tension
- heart rate
- brain activity
- skin temperature
The feedback is used to enhance an individual’s awareness of physical changes associated with stress or pain. Awareness can help a person train themselves to manage physical and emotional pain.
Transcutaneous electrical nerve stimulation (TENS) applies a small electric current to specific nerves. The current interrupts pain signals, and triggers the release of endorphins.
Several states have laws permitting the use of cannabis, also known as medical marijuana, for pain relief. It is also used to manage the symptoms of other serious illnesses like cancer and multiple sclerosis.
According to the Mayo Clinic, cannabis has been used as a method of pain relief for centuries. There is a great deal of controversy and misinformation about cannabis use. However, recent research has made more people aware of the plant’s medicinal properties. It is now legal for medical use in several U.S. states.
Talk to your doctor before you use cannabis. It is not safe for use in all patients, nor legal for medicinal uses in all states.
There are many different treatment options for chronic pain. Talk to your doctor about your chronic pain symptoms. Your doctor can help you decide on a combination of alternative and medical treatments to manage your symptoms.