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How is chronic pain treated? Dealing with chronic pain. Understanding and Managing Chronic Inflammation. Read this next. Medically reviewed by Natalie Olsen, R. Medically reviewed by Stella Bard, MD. Depression and irritability often leads to insomnia and weariness, leading to more irritability, depression, and pain.
This state is called the "terrible triad" of suffering, sleeplessness, and sadness. The urge to stop the pain can make some people drug-dependent, and may drive others to have repeated surgeries, or resort to questionable treatments. The situation can often be as hard on the family as it is on the one suffering with the pain. Chronic pain affects all parts of your life. The most effective treatment includes symptom relief and support. A multidisciplinary approach to pain management is often required to provide the needed interventions to help manage the pain.
Pain management programs are usually done on an outpatient basis. Many skilled professionals are part of the pain management rehabilitation team, including:. A pain management rehab program is designed to meet your needs. The program will depend on the specific type of pain, disease, or condition.
Active involvement by you and your family is vital to the success of the program. The goal of pain management programs is to help you return to the highest level of function and independence possible, while improving the overall quality of life--physically, emotionally and socially. Pain management techniques help reduce your suffering. Prescription pain medicines, including opioids, may be needed to provide stronger pain relief than aspirin. However, these drugs are reserved for more severe types of pain, as they have some potential for abuse and may have unpleasant and potentially very dangerous side effects.
Prescription antidepressants can help some people. These medicines increase the supply of the naturally produced neurotransmitters, serotonin and norepinephrine. Serotonin is an important part of a pain-controlling pathway in the brain. Heat and cold treatments to reduce the stiffness and pain, especially with joint problems such as arthritis. Exercise to reduce spasticity, joint contractures, joint inflammation, spinal alignment problems, or muscle weakening and shrinking to prevent further problems.
Local electrical stimulation involving application s of brief pulses of electricity to nerve endings under the skin to provide pain relief. The philosophy common to all of these varied psychological approaches is the belief that you can do something on your own to control pain.
This includes changing your attitudes, the perception of being a victim, feelings, or behaviors associated with pain, or understanding how unconscious forces and past events have contributed to pain. Surgery may be considered for chronic pain. Risk factors for chronic pain include:. Other risk factors include stress, relationship problems, or a history of physical, sexual, or emotional abuse. Watchful waiting is a period of time during which you and your doctor watch your symptoms without using medical treatment.
During this period of watchful waiting, your doctor may have you try to get more sleep, work on reducing stress, and get more exercise. If you are able to control pain with exercise, massage, and pain relievers, you may not need further treatment.
But watchful waiting is not appropriate if your pain is severe or if it interferes with your life. If you delay treatment, the pain may get worse. If you have mild to moderate pain that keeps coming back and that you can't manage at home on your own, you may need to see one of the following health professionals:. If your chronic pain is moderate to severe and is constant, or if treatment does not control the pain, you may need to see a specialist, such as one or more of the following:.
Often more than one specialist will treat your chronic pain. For example, a primary physician may manage your medicines, and a physical therapist may help you restore function through exercise or other treatments. A professional counselor may help you with coping and depression.
Someone else may help you with acupuncture or yoga. Your doctor will take a detailed medical history, asking you questions about your overall health; past illnesses, surgeries, or injuries; and your pain. He or she may ask you to start keeping a pain diary. In your physical exam, your doctor will look for areas that are tender, weak, or numb. The doctor will also check for health problems that contribute to chronic pain, such as:.
One or more of these tests may help your doctor rule out health problems that can cause chronic pain. Treating chronic pain can be challenging. And it may take several types or combinations of treatments before you find relief. Be sure to seek treatment if your pain lasts longer than 2 to 3 months. Early treatment may prevent the pain from getting worse. The goals of treatment are to reduce your pain and increase your ability to function. This includes improving your sleep and your coping skills and reducing stress so you can return to your regular activities.
It's important to build a clear treatment plan with your doctor. Part of this plan includes identifying ways for you to manage your pain. Only you know the severity of your pain and how it affects your life. Be sure to ask your doctor if you are not clear about what steps you can take when pain occurs or gets worse. You may be able to control your pain at home by using pain relievers and practicing healthy habits.
For more information, see Home Treatment. If your chronic pain is not relieved after you have tried numerous treatments, you may want to think about going to a pain management clinic. Treatment is provided by a team of doctors who work together to address all the things that may cause your chronic pain.
Chronic pain can't always be prevented. But staying in good physical and mental health may be the best way to prevent it or help you cope with it. Treat medical conditions and mental health concerns early, before they get worse and become harder to treat. Untreated health conditions such as shingles or mental health problems such as depression or anxiety can make chronic pain harder to treat. Get regular aerobic exercise—such as swimming, stationary cycling, and walking—to build your strength and health.
Water exercise may be especially helpful in reducing pain that gets worse during weight-bearing activities, such as walking. Talk to your doctor before you begin an exercise program. Start slowly and increase your efforts bit by bit. If your joints are stiff, try taking a warm bath or shower first to loosen up. Also, do some stretching exercises each day. Schedule your day so that you are most active when you have the most energy. Learn to move in ways that are less likely to make your pain worse.
Assistive devices , such as walking canes or doorknob extenders, may help you do your daily activities. These devices can help you to be more mobile and independent. With self-massage you can help relax your own back muscles using a tennis ball. If you are a caregiver for a person who has chronic pain, your own stress and worry can also cause you to have symptoms of depression, vague body pains, digestive disorders, or headaches.
Experts say that it is important to take care of yourself, too, and not to feel guilty about it. For more information, see the topic Caregiver Tips.
Medicines can often help control chronic pain. In some cases, it may take several weeks for the medicine to work. Medicine may work best when it's used along with other types of treatment, such as physical therapy and counseling, to address the different causes of chronic pain.
Sometimes a medicine loses some or all of its ability to work when it is used daily over a long period of time. This is because your body develops a tolerance to it. If this happens, you may need to take more of the medicine, change medicines, or add another medicine.
Your doctor can work with you to do this. You will likely start with medicines that cause the fewest side effects such as acetaminophen. The dose will be increased or the medicines will be changed as needed. Be safe with medicines. Read and follow all instructions on the label.
Surgery for chronic pain isn't common. It's usually considered only after other treatments have failed or if it is considered medically necessary. Surgery may provide pain relief, but it also may permanently damage your ability to perceive other sensations, such as light touch and temperature changes.
It can also cause a different pain to occur. Implanted pain control systems involve inserting devices under your skin or elsewhere in your body. The devices use medicine, electric current, heat, or chemicals to numb or block pain. Decompression is a type of surgery used for nerve pain, such as from trigeminal neuralgia. The doctor cuts open your skin and then tries to move away blood vessels or other body structures that are pressing on nerves and causing pain. For back pain, physical therapy , osteopathic care, or chiropractic care usually includes spinal manipulation , which is a kind of manual therapy.
It involves working on the head, shoulders, neck, back, or hips. It can range from massage and slow pressing to a quick thrust. Your care provider may also use hot and cold therapy to relieve pain. You may also learn stretching and range-of-motion exercises to maintain strength, flexibility, and mobility. Transcutaneous electrical nerve stimulation TENS applies brief pulses of electricity to nerve endings in the skin to relieve chronic pain. It's common to respond to chronic pain with feelings of frustration, depression, anxiety, fear, and even anger.
These feelings can make it harder to manage chronic pain, especially if you use alcohol or drugs to deal with your symptoms. A counselor may use treatments such as cognitive-behavioral therapy to help you cope with your pain. A support group is made up of people with similar experiences who can understand your feelings and provide comfort.
They can keep you from feeling isolated and alone. Being around others who share your problem can help you and your family learn how to accept and manage chronic pain. To find a group near you, contact the American Chronic Pain Association at or online at www. Complementary therapies may help you feel better by reducing your pain or stress. These therapies include:.
If you decide to try one or more of these complementary therapies to treat your chronic pain, find a health professional who has special training and, whenever possible, certification in the particular therapy. You may get a referral from someone you trust such as your doctor, family, or friends. Make sure all of your health professionals know every type of treatment you are using to reduce chronic pain.
Author: Healthwise Staff. Medical Review: Anne C. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
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