Treatment. Chronic pain

Chronic pain is a severe long-term health condition. Various complications can arise from it, including depression, anxiety, and sleep problems. In addition, chronic pain can make it more difficult to perform everyday activities. Therefore, it is crucial to diagnose and treat this condition.

Chronic pain diagnostics

No test is available that can measure how much pain a person is experiencing. Therefore, in most cases of acute as well as chronic pain, health care professionals rely on their patients to describe how pain feels and where it occurs. Your doctor may ask you to use words like this when talking about your pain before examining you. It is part of obtaining your pain history. Knowing when your pain started and what intensifies pain or relieves it also provides important clues about what might be causing it.

In addition to a general physical assessment when diagnosing the cause of chronic pain, doctors often perform a neurological examination during which the physician assesses your:

• Reflexes
• Balance
• Coordination
• Feeling and sensation
• Movement

There are ways to find out the cause of the pain or rule out conditions that are not present and, therefore, cannot result in the discomfort. Some of these tests include:

• X-rays
• Electromyography (this test looks for abnormal muscle activity)
• Nerve conduction studies (these tests can monitor how fast electrical signals travel through nerves)
• Magnetic resonance imaging (MRI)

Chronic pain syndrome treatment

Chronic pain treatment usually focuses on improving daily functioning, so the individual can work, go to school, or participate in their usual daily activities. Although there are several available options in chronic pain management, including medications, therapies, and surgery, some are more helpful than others. Whatever plan you use in the treatment of pain, remember that pain is controllable.

Medications for chronic pain

Analgesics. Pain pills, pain relievers, or pain killers refer to drugs used to control pain. Some analgesics are available over-the-counter or without a doctor’s prescription, and others require a prescription from a physician. Examples of non-prescription pain pills include:

• Acetaminophen
• Aspirin
• Naproxen (this is also available in prescription-strength)
• Ibuprofen (this is also available in prescription-strength)

Prescription analgesics include opioids. Examples of these are narcotics like morphine and codeine. These medications cause sedation and provide relief from pain, and in some patients, they can be physically addicting. Additional side effects may include vomiting, nausea, and constipation.

Antidepressants. Certain types of chronic pain can be relieved by antidepressants such as amitriptyline, venlafaxine, or duloxetine.

Anticonvulsants. These medications help treat seizure disorders, but they are also effective in relieving certain types of pain. Examples of these drugs include carbamazepine, gabapentin, and pregabalin.

Triptans. They help treat migraine headaches, but some people have severe side effects. Examples of triptans include:

• Zolmitriptan
• Sumatriptan
• Naratriptan

Therapies for chronic pain

Acupuncture. This procedure is an ancient type of Chinese medicine that involves the insertion of tiny needles to specific points on the body to relieve pain.

Chiropractic.  This treatment method often helps manage chronic pain caused by musculoskeletal disorders. An adjustment of the relationship of the body’s structures is accomplished using spinal manipulations.

Counseling. There are various forms of counseling available to provide support to individuals with chronic pain. Counseling sometimes includes cognitive-behavioral therapy to teach chronic pain patients relaxation and coping skills to help them manage their symptoms more effectively.

Transcutaneous electrical stimulation (TENS). This method involves using tiny electrical impulses to relieve pain by blocking the transmission of pain messages.  

Biofeedback. Its most common application involves the treatment of chronic pain due to back problems or headaches. It uses an electronic device that signals the patient when specific bodily responses, like increased muscle tension, occur. Using the biofeedback method, patients with chronic pain can learn to change their physical reactions to pain. Eventually, the response becomes automatic, so pain decreases.

Exercise. Many types of chronic pain respond well to even small amounts of exertion, like swimming or walking. Such activities increase the circulation of blood and bring oxygen to the muscles. Exercise also promotes good sleep and enhances the mood. 

Hypnosis. Researchers haven’t discovered exactly how this method of pain relief works. It may work as a treatment for pain by slowing impulses in the nervous system or making people who have pain more responsive to suggestions to relax. As a result, the therapy helps control the amount of pain a person can tolerate.

Nerve blocks. In this type of pain treatment, the relay of pain signals is interrupted as they are transmitted between the painful area and the brain. Methods used to interrupt the messages vary and can include chemical agents, drugs, or surgical procedures. Examples of types of nerve blocks include: 

• rhizotomy
• cordotomy
• sympathetic blockade

Surgery for chronic pain

Sometimes the treatment of chronic pain syndrome requires operative procedures. It is often the case when other treatments have not been successful. Surgeries for chronic back pain can include:

• Discectomy
• Laminectomy
• Spinal fusion

How you can prevent chronic pain

Chronic pain isn’t always preventable, but there are some ways to help cope with it. These same methods may also help prevent chronic pain.

• When health problems develop, seek treatment early. Don’t put off seeing your doctor—complications of even simple problems can lead to chronic pain.
• Get some form of activity during the day and alternate rest with activity. Get adequate sleep at night.
• Eat a healthy, well-balanced diet.
• Learn and practice healthy stress-relieving techniques.

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