Treatment Options for Chronic Pain
Treatment Options
for Chronic Pain
Learn about the treatment
options for chronic pain
Chronic pain treatments are as varied as the causes. There are numerous approaches, ranging from over-the-counter and prescription medications to mind/body treatments and acupuncture. When it comes to chronic pain, however, no single approach can promise comprehensive pain relief. A mix of therapy options may be used to find relief.
Medication – Prescriptions and Over The Counter
Over-the-counter medications like paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naproxen can help with mild pain. NSAIDs and paracetamol both ease discomfort from muscle aches and stiffness, and NSAIDs also reduce inflammation (swelling and irritation).
Topical pain medications, such as creams, lotions, and sprays that are applied to the skin to relieve pain and inflammation caused by tight muscles and arthritis, are also available.
If over-the-counter medications don’t work, your doctor might prescribe stronger medications like muscle relaxants, anti-anxiety drugs (like diazepam [Valium]), antidepressants (like duloxetine [Cymbalta] for musculoskeletal pain), prescription NSAIDs like celecoxib (Celebrex), or a short course of stronger painkillers (like codeine, fentanyl [Duragesic, Actiq], Swelling and inflammation can be reduced with a small number of steroid injections at the site of a joint problem. For spinal stenosis or lower back pain, an epidural may be used.
Local medication can sometimes be used to block a group of nerves that cause pain in a specific organ or body region. A nerve block is the injection of this nerve-numbing chemical. Although there are numerous types of nerve blocks, they are not always effective. Blocks are frequently impossible, too risky, or not the greatest solution to the situation. Your doctor can tell you whether or not this treatment is right for you.
Patient-controlled analgesia (PCA) is another form of pain control. The patient can self-administer a premeasured amount of pain medicine laced with opiates by pressing a button on a computerised pump. The pump is attached to a tiny tube that permits medicine to be injected intravenously (via a vein), subcutaneously (just beneath the skin), or into the spinal area. This is commonly used in hospitals to treat post-traumatic or post-surgical pain, as well as discomfort caused by terminal cancer.
Trigger Point Injections
Trigger point injection is a procedure that is used to treat painful muscles, which are knots that form when muscles do not relax. A healthcare expert injects a local anaesthetic with a steroid into a trigger point with a tiny needle during this treatment (sterile salt water is sometimes injected). The trigger point is rendered inactive and the discomfort is relieved with the injection. A short course of treatment will usually provide long-term relief.
Muscle pain in the arms, legs, lower back, and neck is treated with trigger point injections. This method has also been used to treat fibromyalgia, tension headaches, and myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that has not responded to other treatments.
Botox is a toxin that works by blocking nerve signals from reaching the muscles. Chronic migraine headaches can also be relieved by injecting them. Multiple injections across the head and neck are given every 12 weeks, and the surgery can relieve discomfort for up to three months.
Surgical Implants
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Intrathecal Drug Delivery: Also known as spinal medication delivery devices or infusion pain pumps. A pocket large enough to house a medication pump is created under the skin by the surgeon. The pump is normally three inches in diameter and one inch thick. A catheter is also inserted, which transports pain medication from the pump to the intrathecal region around the spinal cord. The implants deliver painkillers or muscle relaxants directly to the spinal cord, where pain signals are sent. As a result, intrathecal medication delivery can give effective pain relief with a fraction of the dose needed with pills. Furthermore, because less medication is necessary to control pain, the system may have fewer negative effects than oral drugs.
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Spinal Cord Stimulation Implants: Low-level electrical signals are sent to the spinal cord or specific nerves in spinal cord stimulation to prevent pain signals from reaching the brain. This approach is very effective for back and limb discomfort. A device that provides electrical signals is surgically placed in the body during this surgery. The patient uses a remote control to turn the current on and off and to vary the intensity of the signals. While some gadgets produce a nice tingling sensation, others do not. There are two types of spinal cord stimulation systems. Units that are partially or completely implanted. The most often used unit is fully implanted. The antenna and transmitter of the latter technology are carried outside the body, while the receiver is implanted inside.
TENS
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TENS: Transcutaneous electrical nerve stimulation is a pain-relieving technique that involves electrical stimulation. Low-voltage electrical current is supplied through electrodes placed on the skin near the site of discomfort during the treatment. The electrodes stimulate the nerves in the damaged area, which transmit messages to the brain that “scramble” typical pain signals. TENS is a painless therapy that can be used to mask discomfort caused by diabetic neuropathy.
Bioelectric Therapy
Bioelectric therapy works by stopping pain signals from reaching the brain. Bioelectric therapy also causes the body to manufacture chemicals called endorphins (also released by exercise) that reduce or eliminate painful sensations by preventing the pain message from reaching the brain.
Back pain, muscle pain, headaches and migraines, arthritis, TMJ dysfunction, diabetic neuropathy, and scleroderma are just a few of the chronic and acute pain conditions that bioelectric therapy can help with.
Bioelectric therapy can provide temporary pain relief but should be used as part of a comprehensive pain management plan. When used in conjunction with conventional pain-relieving medications, bioelectric treatment can permit pain sufferers to reduce the dose of pain medication by up to 50%.
Physical Therapy
Physical therapy helps to reduce pain by improving movement and function that has been hampered by an accident or handicap. A physical therapist may utilise TENS to help with treatment in addition to stretching, strengthening, and pain-relieving treatments.
Exercise
Although small periods of rest might help relieve pain, too much rest can exacerbate it and put you in danger of harm when you try to move again. Regular exercise has been demonstrated to reduce pain in the long run by improving muscular tone, strength, and flexibility. Endorphins, the body’s natural painkillers, may be released as a result of exercise. Swimming, biking, walking, rowing, and yoga are some of the workouts that are simpler for chronic pain sufferers to do than others.
Psychological Treatment
You may experience rage, grief, hopelessness, and/or despair when you are in pain. Pain can change your personality, interfere with your career and relationships, and affect your sleep. Depression and anxiety, as well as a lack of sleep and stress, can all exacerbate pain. The psychological treatment uses non-drug approaches to manage pain directly by lowering excessive levels of physiological stress, which can increase it. Psychological counselling can also help with the indirect effects of pain by teaching you how to deal with the various issues that come with it.
Education is an important aspect of psychological pain treatment, as it teaches patients how to manage a challenging situation.
Complementary and Alternative Therapies
Complementary and alternative medicine (CAM) is a type of treatment that is not part of conventional medicine.
Acupuncture, homoeopathy, aromatherapy, meditation, and colonic irrigation are among the treatments available.
CAM has no broadly accepted definition.
Although the terms “complementary and alternative” are frequently used interchangeably, it is important to distinguish between them.
This difference is used by the US National Center for Complementary and Integrative Health (NCCIH):
- A non-mainstream practice is deemed “complementary” when it is utilised in conjunction with traditional care.
- Alternative medicine is when a non-mainstream practice is employed instead of standard medicine.
There may be some overlap between these groups.
Aromatherapy, for example, can be utilised as a complementary treatment in some cases and as an alternative treatment in others.
In order to treat or cure a health condition, a variety of complementary and alternative treatments are commonly used.
Some examples are:
Mind-Body Therapies
Mind-body therapies are treatments that aim to improve the mind’s ability to influence the body’s functioning and symptoms. Relaxation techniques, meditation, guided imagery, biofeedback, and hypnosis are all used in mind-body therapy. Chronic pain can be made more bearable by using relaxation techniques.
Another effective pain-relieving strategy is visualisation. Try this: Close your eyes and visualise the pain, giving it form, colour, size, and movement. Now gradually replace this image with one that is more harmonic, pleasant, and smaller.
Another option is to keep a journal of your pain episodes, as well as the factors that caused and corrected them. Regularly review your diary to identify potential areas for improvement. Make an effort to see pain as a component of life rather than the entire experience.
Electromyographic (EMG) biofeedback can help you recognise how muscular tension is contributing to your pain and learn to manage it. Through refocusing techniques, hypnotherapy and self-hypnosis may be able to assist you to block or alter discomfort. Glove anaesthesia is a self-hypnosis technique that involves entering a trance, laying a hand over the painful location, pretending the hand is relaxed, heavy, and numb, and visualising these sensations as replacing other, unpleasant feelings in the affected area.
Regular use of relaxation techniques such as meditation or yoga has been demonstrated to alleviate stress-related discomfort. Yoga’s gentle stretching is particularly beneficial for strengthening muscles without placing the body under additional strain.
Acupuncture
Acupuncture is supposed to reduce pain by increasing the production of endorphins, pain-blocking molecules. Many acupuncture sites are located near nerves. These nerves cause a dull discomfort or a feeling of fullness in the muscle when activated. The activated muscle transmits a message to the central nervous system (brain and spinal cord), which causes the production of endorphins, which inhibit the pain message from reaching the brain.
Many pain-related illnesses, such as headaches, low back pain, menstrual cramps, carpal tunnel syndrome, tennis elbow, fibromyalgia, osteoarthritis (particularly of the knee), and myofascial pain, may benefit from acupuncture as a complementary treatment. Acupuncture could potentially be used as an alternative to or as part of a complete pain management regimen.
Chiropractic Treatment and Massage
The most frequent nonsurgical treatment for back pain is chiropractic treatment. Some studies found that persons who received chiropractic manipulations improved. However, the bulk of scientific research has shown no compelling evidence that the treatment is useful in treating chronic back and neck pain. More research into the effectiveness of chiropractic therapy for pain management is now underway.
Osteopathic doctors, who have the letters “D.O.” following their names, are also trained in bone manipulation techniques comparable to chiropractors.
People in pain are increasingly turning to massage to relieve their symptoms, particularly persistent back and neck discomfort. Massage can help to ease stress and tension by increasing blood flow. This treatment can also help to lower the presence of chemicals that can cause or prolong discomfort. Massage treatment, like chiropractic procedures, appears to have a lot of potential when it comes to treating back pain. However, due to the limitations of current studies, it is impossible to draw definitive conclusions about the usefulness of massage in treating pain.
Therapeutic Touch and Reiki Healing
Therapeutic touch and reiki healing are supposed to aid in the activation of an individual’s self-healing mechanisms, hence reducing pain. Although these so-called “energy-based” therapies do not require direct physical touch, they do require the practitioner and patient to be in close physical proximity.
Several reviews published in the last few years assessed the efficacy of these healing modalities in reducing pain and anxiety and improving health. Although some trials found positive results with no major negative side effects, the limitations of some of these studies make it difficult to draw firm conclusions.
People in pain are increasingly turning to massage to relieve their symptoms, particularly persistent back and neck discomfort. Massage can help to ease stress and tension by increasing blood flow. This treatment can also help to lower the presence of chemicals that can cause or prolong the discomfort. Massage treatment, like chiropractic procedures, appears to have a lot of potentials when it comes to treating back pain. However, due to the limitations of current studies, it is impossible to draw definitive conclusions about the usefulness of massage in treating pain.
Diet & Supplements
Nutritional Supplements
Supplements such as fish oils and SAMe have also been shown to be beneficial, though further research is needed.
Herbal Remedies
It’s been difficult to draw conclusions about the effectiveness of herbs, while there is a handful that has some proof behind them, such as white willow bark, devil’s claw, cat’s claw, ginger, and turmeric. Tell your doctor if you decide to utilise herbal medicines to help you manage your pain better: Some herbs may interact with medications you’re taking for pain or other ailments, causing harm to your health.
Dietary Approaches to Treating Pain
Some people feel that reducing dietary fat intake and/or eating anti-inflammatory plant foods can aid with pain relief by reducing inflammation.
Some persons with fibromyalgia found that eating a primarily raw vegetarian diet helped them, however, the study was not well-designed. A low-fat vegetarian diet was linked to lower pain intensity and duration in a study of women with premenstrual symptoms. People with osteoarthritis can benefit from weight loss achieved through a combination of dietary adjustments and increased physical activity.
However, further research is required to assess the efficacy of dietary changes as a pain treatment.
Pain Clinics
Many patients with chronic pain can achieve some control over their condition by attempting many of the aforementioned treatments on their own. However, some people continue to suffer from terrible pain regardless of which therapy method they use. Pain clinics, which are special care centres dedicated solely to the treatment of intractable pain, may be the answer for them. Some pain clinics are affiliated with hospitals, while others are independent; in either case, inpatient and outpatient care are frequently available.
In general, pain clinics use a multidisciplinary approach that includes physicians, psychologists, and physical therapists. The patient should also participate actively in their own treatment. In many circumstances, the goal is not simply to relieve pain, but also to teach the chronic patient how to cope with pain and function despite it.
According to many studies, chronic pain sufferers can reduce their suffering by up to 50% after attending a pain clinic, and most people learn to manage better and can resume normal activities.
View the benefits of a pain clinic.