Chronic Pain Treatment

Chronic pain treatment may include the use of pain medications, surgically implanted pain control devices, physical therapy, and/or counseling.

It’s important to treat chronic pain as early as possible. The longer the pain persists without treatment, the more difficult treatment may become. This is thought to be because the brain “learns” pain, and the pathways for pain are strengthened the longer the pain persists. Therefore, if you have had pain lasting for three months, you should discuss it with your doctor and formulate a plan for treatment as soon as possible.

Unfortunately, complete elimination of pain is not always possible. The goal will be to reduce your pain to a manageable level, and to allow you to function in your daily life despite any remaining pain you may have.

If the cause of your pain is known, then your treatment will include treating the underlying cause. However, this isn’t always possible, and even if it is, there may be a need to treat the pain itself while the other treatment is ongoing. Some treatments that may help patients with chronic pain include:

• Oral or topical pain medications
• Injections
• Implanted pain control systems
• Physical therapy
• Counseling

Certain medications can help with chronic pain. Most people are familiar with the over-the-counter pain relievers, such as ibuprofen (Advil/Motrin) and acetaminophen (Tylenol). These medications should not be used for a long period of time without a doctor’s supervision, because they can have side effects.

Depending on the type of pain you have, your doctor may prescribe a number of other prescription pain relievers to help you with your chronic pain. Many of these are taken by mouth, but there are also topical pain relievers that can help with the pain of certain conditions, such as arthritis. Don’t wait to take your medication until the pain is unbearable; taking the pain reliever earlier, while the pain is still not too bad, could help prevent it from becoming difficult to manage.

Although opiate pain relievers (such as Vicodin, Oxycontin, and Percocet) are often prescribed for chronic pain, the available evidence suggests that they don’t help with chronic pain. Furthermore, they have a strong tendency to be addictive and can cause many side effects. These medications are usually used for treatment of the pain from an injury or illness soon after it happens, but not for chronic pain, unless everything else has been tried first.

In some cases, medications can be injected directly into the part of the body that’s experiencing chronic pain. For example, steroids may be injected into painful joints. Epidural injections (into the area around the spinal cord) may be used for back or neck pain.

When other treatments have not worked, surgeons may implant a device into the body to treat chronic pain. The implanted device may use pain medications, electrical currents, or other methods to help control pain.

In certain cases of chronic pain, physical therapy or chiropractic care may be useful. This involves manipulating the region of the body that has pain, along with using exercises to improve strength and flexibility in that area. This can be used along with heat or cold therapy, or electrical stimulation of the area.

Chronic pain can be caused by anxiety or depression, and anxiety or depression can also be caused by chronic pain. A therapist can help you to manage these emotions and learn coping strategies to deal with your pain. Counseling can improve your quality of life and may also reduce the amount of your pain. Other complementary therapies, such as meditation, biofeedback, acupuncture, and hypnotherapy, may also help people with chronic pain; discuss your use of these treatments with your doctor.

References

National Institutes of Health. “Chronic Pain: Symptoms, Diagnosis, & Treatment.” NIH Medline Plus 6, no. 1 (Spring 2011): 5-6. http://www.nlm.nih.gov/medlineplus/magazine/issues/spring11/articles/spring11pg5-6.html

Ballantyne, Jane. “Managing Pain with and Without Opioids in the Primary Care Setting.” CDC’s Primary Care and Public Health Initiative (2012). http://www.cdc.gov/primarycare/materials/opoidabuse/docs/managingpain-508.pdf

National Cancer Institute. “Pain.” (2015) http://www.cancer.gov/about-cancer/treatment/side-effects/pain

American Academy of Pain Medicine. “AAPM Facts and Figures on Pain.” http://www.painmed.org/patientcenter/facts_on_pain.aspx

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