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A National Institutes of Health study found that approximately 21% of adults experience chronic pain, and 8% experience high-impact chronic pain. Chronic pain is pain felt nearly every day for three months or longer. High-impact chronic pain is pain that limits a person’s ability to function normally in their personal or work lives.
Acute pain may only last for less than three months, but it can be debilitating for the time it endures. Treatment for pain focuses on reducing the pain experienced while maximizing function to improve the quality of life. Each circumstance is different, so there are various pain management treatments a pain doctor can use to customize a pain treatment plan.
What is Pain Management?
There are five categories of pain management treatments and procedures. A physician determines the best approach based on a medical evaluation of what is causing the pain and what will best control it and improve the patient’s quality of life. Usually, a combination of treatments is included in a pain management plan that the doctor prepares, tailored to the patient’s needs.
1. Medications
Common medications that relieve pain vary in their ability to address pain based on severity. Acetaminophen eases mild pain, and NSAIDs (non-steroidal anti-inflammatory drugs) are used for mild to moderate pain. Opioids are the most potent pain relievers, but they are addictive and may produce serious side effects. Other drug classes include antidepressants that may relieve neuropathic pain, antiepileptics for neuralgia and neuropathic pain, and local anesthetics.
2. Medical interventional procedures
A wide range of medical procedures may relieve pain. The one that is the best fit depends on what is causing the pain. Chronic pain can be due to a standalone or clearly defined diagnosis, like a herniated spinal disc, primary pain syndromes, like fibromyalgia or migraine headaches, visceral pain like irritable bowel syndrome or nonspecific pain, like low back pain. When appropriate, interventional pain management procedures are used to relieve pain.
For example, epidural injections, nerve block or trigger point injections may relieve chronic low back pain from disc herniation. Radiofrequency ablation might treat lower back pain due to issues in the sacroiliac joints.
Surgery is interventional, but it is always a last-resort treatment for relieving pain.
Surgical intervention involves changing body organs and tissues through a manual procedure, including cutting, abrading, suturing, and lasering.
3. Physical therapy
Physical therapy is often used as a first-line treatment option or combined with other pain management modalities. It involves exercises to improve physical functioning and teaching the patient exercises they can do at home. Physical therapy is often an element of a multidisciplinary treatment plan for pain, especially chronic pain. A physical therapist develops an individualized treatment plan that includes manual therapy, therapeutic exercise, and patient education.
A review of 60 clinical controlled trials involving patients with low back found that physical therapy effectively decreases pain and improves function. It is also pain relieving for people with hip and knee osteoarthritis and can improve physical functioning.
4. Psychological support
Pain is complex. It has physical, psychological, and emotional elements. People experiencing pain, especially chronic pain, have thoughts and feelings that influence how they respond to the pain and even pain intensity.
Counseling and cognitive behavioral therapy can help people feel less anxious and better control the physical limitations that may accompany pain. Psychological therapies are also used to help people cope better with their symptoms. Cognitive therapies include mindfulness, relaxation training, behavioral activation, cognitive restructuring, and pacing.
5. Alternative therapies
Alternative therapies for pain management include acupuncture, meditation, yoga, massage, biofeedback, tai chi, etc. These therapies are usually part of a holistic pain treatment plan that includes following a healthy diet, regular exercise, managing stress, and getting quality sleep. There is a growing body of research presenting evidence that some alternative therapies may help patients with chronic pain, low back and neck pain, osteoarthritis, fibromyalgia, and more. If interested in trying alternative therapies as a pain management treatment, working with a physician or pain specialist is crucial.
Improving Pain and Function
Today, pain management treatments focus on reducing pain and increasing physical functioning. Utilizing a mix of medical treatments and other modalities enables a pain specialist to develop a customized treatment plan that empowers patients to live fuller lives. Pain is very personal, with each person experiencing and reacting to it. It is essential to consult a medical professional when pain lasts more than a few days to a week to find the root cause and prevent complications.
Sources
- https://www.nih.gov/news-events/news-releases/nih-study-finds-high-rates-persistent-chronic-pain-among-us-adults
- https://www.ncbi.nlm.nih.gov/books/NBK560692/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC10743062/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4558964/
- https://www.apta.org/contentassets/b9421650038941469c75d06a0a191069/beyond-opioids-white-paper.pdf
- https://www.ncbi.nlm.nih.gov/books/NBK279297/
- https://extension.usu.edu/heart/research/cognitive-behavioral-therapies-for-chronic-pain-management
- https://www.nccih.nih.gov/health/chronic-pain-and-complementary-health-approaches-usefulness-and-safety