What are the treatments for chronic pain?

Treatments for chronic pain can be as varied as their causes. There are many approaches, from over-the-counter or prescription drugs to mind/body exercises to acupuncture. No one technique will guarantee complete relief when it comes to chronic pain. Combining treatment options can provide relief.

Nonprescription and prescription drugs

Aspirin, ibuprofen, and naproxen are all nonsteroidal antiinflammatory drugs that can relieve milder pain. Acetaminophen (acetaminophen) and NSAIDs can ease muscle aches, stiffness, and pain. NSAIDs also reduce inflammation and swelling. Topical pain relief such as lotions, creams, or sprays can be applied directly to the skin to reduce pain and inflammation caused by sore muscles and osteoarthritis.

If the over-the-counter drugs don't work, your doctor might prescribe a more vital medication, like muscle relaxants, antianxiety drugs (like diazepam, [Valium]), and antidepressants (like duloxetine, [Cymbalta]) prescription NSAIDs, celecoxib, or a course of more potent painkillers, (such as codeine and fentanyl (Duragesic and Actiq), oxycodone, The injection of a small number of steroid at the site of an inflammatory joint condition can help reduce swelling. For lower back pain or spinal stenosis, an epidural may be prescribed.

The FDA requested that prescription and nonprescription NSAIDs increase their warning labels in July 2015 to include the potential risk for strokes and heart attacks. As the dose of these drugs increases, so does the danger. There is also a possibility of bleeding stomach ulcers.

Local medication can sometimes block a grouping of nerves that cause pain in a particular organ or area. A nerve block is the injection of a substance that numbs nerves. Even though there are many types of nerve blocks, they cannot be used in all cases. Sometimes, nerve blocks are either not possible or too dangerous. Or they are not the most effective treatment. Your doctor can tell you if this treatment is proper for you.

PCA is another way to control pain. The patient can self-administer opioid-infused pain medication by pressing a button on the computerized pump. The pump is attached to a tube that injects the medicine subcutaneously, intravenously, or spinally. The pump is used to treat post-traumatic and post-surgical pain and pain from terminal cancer.

Trigger Point Injections

A trigger point injection treats painful muscle areas that contain triggers or knots that form when muscles are not relaxed. A healthcare professional injects a local anesthetic, which may include a steroid, into the trigger point using a tiny needle. Sometimes, salt water or sterile water is also injected. The injection renders the trigger point inactive and relieves the pain. A short course of treatment usually results in lasting relief.

Trigger point injections treat muscle pain, especially in the neck, arms, legs, and lower back. This approach also treats fibromyalgia (chronic pain involving tissue surrounding muscles), tension headaches, and myofascial syndrome.

Onabotulinumtoxina, or Botox, is a toxin that blocks nerve signals to muscles. The toxin can be injected for chronic headaches. Multiple injections are given around the neck and head every 12 weeks. This procedure may relieve pain for three months.

Surgical Implants

If standard pain medications and physical therapy do not provide adequate relief, you could be a good candidate for a surgical device to control your pain. There are two types of implants to manage pain when they are used.

  • Intrathecal drug delivery. They are also known as infusion pain pumps or spinal drug distribution systems. The surgeon creates a pocket large enough for a medication pump. The pump usually measures about three inches in width and one inch in thickness. The surgeon inserts a tube that carries the pain medication from the pump into the intrathecal area around the spinal cord. The implants deliver medicines like morphine and muscle relaxants directly to the spinal cord, where pain signals are sent. Intrathecal drug delivery can relieve pain with only a fraction of the dosage required by pills. The system also has fewer side effects than oral medication because it is less needed to control the pain.
  • Spinal Cord Implants. In Spinal Cord stimulation, low-level electrical impulses are sent to the spinal cord or specific nerves to block pain signals reaching the brain. This technique is used to treat back and leg pain. In this procedure, an electrical device is implanted surgically in the body. The patient uses a remote control to turn on and off the current or adjust the intensity. Some devices produce a pleasant tingling feeling, while others don't.
  • There are two types of spinal cord stimulation systems. There are two types of units: partial and fully implanted. Fully implanted units are the most common. The antenna and transmitter of the latter approach are carried externally while the receiver is embedded within the body.

TENS

Transcutaneous electrical neurostimulation therapy (TENS) is a form of electrical stimulation that reduces pain. Low-voltage electrical currents are delivered to the skin through electrodes near the pain source. The electrodes send signals to the brain, which "scrambles" the standard pain signals. TENS may mask diabetic neuropathy pain, as it is not painful. The American Academy of Neurology (AAN) says TENS is not recommended for chronic low-back pain.

Bioelectric Therapy

Bioelectric therapy reduces or eliminates painful sensations by blocking pain signals to the brain. Exercise and bioelectric therapy both cause the body to release endorphins, which reduce or eliminate pain by blocking messages of pain to the brain.

Bioelectric therapy treats many chronic and acute conditions, including back pain, migraines, muscle pain and headaches, TMJ disorder, and diabetic neuropathy.

Bioelectric therapy can temporarily pain relief but should be part of an overall pain management program. Bioelectric treatment can be used with other pain relief medications to allow patients to reduce their dosage by as much as 50%.

Physical Therapy

Physical therapy relieves pain through special techniques to improve movement and function impaired by injury or disability. A physical therapist can use TENS in addition to stretching, strengthening, and pain relief techniques.

Exercise

Resting too long can increase your pain. It may also put you at risk of injury when you try to move again. Regular exercise has been shown to reduce pain over time by improving strength, flexibility, and muscle tone. Exercise can also release endorphins which are the body's painkillers. Specific activities are more accessible to do for chronic pain sufferers than others. Try swimming, cycling, walking, rowing, and Yoga.