Pain management treatments
The goal of pain management is to minimize pain, rather than eliminate it. This is because quite often it is not possible to completely eliminate pain. Two other goals are to improve function and increase quality of life. The goals of treating chronic pain are to:
Chronic pain therapy will be tailored to specific needs and circumstances. Due to rapid advances in medicine, a wide variety of medications and treatments are available for acute and chronic pain. In fact, doctors will most likely prescribe medications before other forms of therapy. However, some medicines are more effective when combined with other methods of treatment.
Non-drug pain treatments can help treat both local and general pain. Chronic pain may be relieved by immersion in activities that deeply engage a person diagnosed with pain, such as a hobby. Other alternatives for pain relief include:
Acupuncture - This practice uses very thin needles inserted at specific points on the skin to treat disease and pain.
Electrical stimulation - Transcutaneous electrical nerve stimulation (TENS) is the most common form of electrical stimulation used in pain management. TENS unit treatment can diminish pain by stimulating nerve fibers through the skin.
Hypnosis – Hypnotherapy can significantly reduce pain associated with surgical procedures. Hypnosis might also help stabilize bleeding, decrease the need for narcotic pain drugs, and shorten procedure time.
Manipulation – Joint manipulation may produce immediate pain relief. Chiropractic might also help decrease pain sensitivity of the skin in related areas or reduce joint and muscle tenderness.
Relaxation techniques –Pain increases as anxiety increases; using methods or exercises to decrease anxiety may help reduce pain or the perception of pain.
Treatment of chronic pain usually involves medicines and therapy. Drug treatments for mild to moderate pain usually focus on non-prescription pain relievers. And different types of medicines help people who have different types of pain. For examples, long-acting medicines are prescribed for constant pain. Short-acting medicines treat pain that comes and goes. Other drugs that have been effective in treating chronic pain include:
Anethestics - Local and topical anesthetics can numb the pain in a specific area.
Antidepressants – Antidepressants been shown to have certain types of pain-relieving properties to certain pain. Available only by prescription, they often are used to help you sleep better at night.
Anti-inflammatory drugs - Anti-inflammatory drugs are used to relieve pain, inflammation and fever. Aspirin, non-steroidal anti-inflammatory drugs and steroidal drugs (available only by prescription) are used to treat inflammatory conditions. These types of drugs are non-addictive, but can have side effects that range from upset stomach to kidney and liver damage. Therefore, doctors may suggest applying creams that contain NSAIDs locally on joints to avoid digestion and the possible side effects.
Anti-seizure medicines - Anticonvulsants are frequently used to treat chronic pain associated with nerve damage. These medications are used to relieve what some patients describe as "shooting" pain by decreasing abnormal painful sensations caused by damaged nerves.
Common pain relievers - Nonaspirin pain relievers such as acetaminophen can relieve headaches and minor pain but do not reduce swelling. They are sometimes used in combination with other drugs to provide greater pain relief.
Injection treatments - Local anesthetics with or without cortisone-like medicines can be injected around nerve roots and into muscles or joints. These medicines reduce swelling, irritation, muscle spasms and abnormal nerve activity that can cause pain.
Opioid pain medications - More severe pain may be treated by narcotic drugs called opoids, such as codeine, oxycodone, and morphine. However, narcotics may have no effect on some forms of chronic pain where changes in the spinal cord have altered the normal nerve pathways. Narcotics are addictive drugs and are only used if other medications have not been effective.
Other medicines - Your doctor may also prescribe other types of medication specific to certain pain. Medications that counteract the side effects of opioids or treat the anxiety and depression associated with pain may also be prescribed.
Pain treatment clinic
If chronic pain persists and interferes with your daily life despite treatment, you may want to seek help at a pain management clinic. You will both receive treatment and learn to cope with chronic pain. Treatment is usually provided by a team who works together to address all the possible causes of chronic pain.
A physiatrist or physical therapist can suggest an exercise program tailored for you to increase your daily functioning and decrease pain. Other treatments may include whirlpool therapy, ultrasound and deep-muscle massage.
Many people diagnosed with chronic pain feel emotional effects of the condition. These may include feelings of anger, sadness, hopelessness or despair. In addition, pain can alter one's personality, disrupt sleep, interfere with work and relationships and often have a profound effect on family members. Support and counseling from a psychiatrist or psychologist, combined with a comprehensive pain treatment program, may be needed. Psychotherapists might also specialise in relaxation training or biofeedback to relieve pain, lessen muscle spasms and reduce stress.
Surgical procedures are only used when all other treatment methods have failed and there is a reasonable belief that the procedure will be successful in stopping or reducing pain. Chronic pain that has a definite cause can be relieved by correcting the condition that is causing the pain.
Decompression surgery - This includes decompression surgeries, such as those used to repair a herniated disk or to treat carpal tunnel syndrome.
Drug delivery implants – Doctors can implant drug delivery systems under the skin to deliver pain-relieving drugs directly into the bloodstream or central nervous system (the brain and spinal cord).
Electrode implants - One form of surgical treatment involves implanting electrodes under the skin to stimulate peripheral nerves and relieve pain.
Nerve blocks - Often a group of nerves that causes pain to a specific organ or body region can be blocked with local anesthetics. A nerve block (neurolysis) may be used to destroy a portion of a peripheral nerve. If successful, another solution that numbs the nerves can then be injected.
Nerve surgery - In rare cases when severe pain has not responded to other treatments and procedures, doctors perform surgery on certain nerves to create relief and allow people to resume near-normal activities. In very few cases, pain is relieved by actually cutting the nerves that are causing the pain.
Organ removal surgery - In cases when organic processes cause chronic pain (chronic pancreatitis or pancreatic cysts), doctors may recommend surgery to remove part of the pancreas that is inflamed.
Watchful waiting is a period of time during which you and your health professional observe your symptoms or condition without using medical treatment. If you are able to control occasional, mild to moderate pain with exercise, healthy eating, massage, and pain relievers-such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin-you may not need further treatment from a health professional.