Pain Management: A Treatment Guide

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Pain is defined as an unpleasant physical and emotional response to noxious stimuli. What most people don’t understand is that pain, ideally, is a good thing. It alerts us of possible injury to our tissues. When that happens we respond by stopping the injury. For example, when you touch a hot surface and you feel pain naturally you will be quick to withdraw your hand, right? Imagine that you do not feel pain and hence you leave your hand on the hot surface. What will happen? This is what makes pain “a good thing.”

However, pain can be complicated when it lasts for more than three months. This kind of pain is referred to as chronic pain. Such pain may occur with or without the presence of noxious stimuli. For example, amputees may experience phantom limb pain. In this case, they feel severe pain on the limb that was amputated.

Chronic pain, depending on the origin, can be difficult to manage. When not adequately managed, chronic pain may lead to limited mobility, reduced productivity, lost earnings, poor self-esteem, depression, substance abuse, and even death.

Treatment modalities for chronic pain are as diverse as the causes and types of chronic pain. Each modality is designed to alleviate a certain kind of pain. In this guide, we shall be looking at 10 different treatment modalities for the management of chronic pain. This includes over-the-counter drugs to mind and body techniques such as acupuncture.

1.   Over the Counter Pain Medication

Mild to moderate pain can be treated using over the counter medications. Pain caused by inflammation can be treated with non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen. Acetaminophen (Tylenol) is used to treat pain that is not inflammatory. Topical pain creams can be applied on the skin to relieve sore muscle and joint pain.

2.   Prescription Pain Medication

Prescription pain medication is given to relieve severe pain that is not responding to over the counter pain medications. A combination of drugs may be given to address the different components of the pain. This includes using opioids (morphine, fentanyl), muscle relaxants (diazepam), and antidepressants (duloxetine).

3.   Trigger Point Injections

Trigger point injections are usually administered on muscles that have localized severe pain. A local anesthetic such as codeine is injected into the surrounding tissue to numb the area and in the process alleviate the pain. This has been used to treat pain conditions such as fibromyalgia, fascial pain syndrome, and tension headaches. Botox has also been used to offer sustained relief for migraine pain.

4.   Surgical Implants to Manage Pain

When chronic pain is not responding to conventional treatment, a surgical implant may be considered. There are two main types of surgical implants that can be used to relieve pain: intrathecal drug delivery and spinal cord stimulation implants.

In intrathecal drug delivery (infusion pain pumps), a pocket is created under the skin and a catheter is inserted to deliver pain medication to the intrathecal space of the spinal cord. Prescription medications such as opioids and muscle relaxants are delivered to the spina cord through which pain signals travel. This technique is usually effective and causes fewer side effects because less medication is used.

In spinal cord stimulation implants, low-voltage electrical signals are transmitted to the spinal cord to stop pain signals from reaching the brain. This is usually used to manage severe back pain.

5.   Transcutaneous electrical nerve stimulation (TENS) pain therapy

TENS, involves the use of low-voltage electrical current to stop pain. The current is delivered through the skin near the source of pain to the brain to “scramble” pain signals. This has been effective in the management of diabetic neuropathy pain.

6.   Bioelectric Therapy

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This is a drug free pain therapy that involves the use of a bioelectric device to block pain signals from being transmitted to the brain. In the process, endorphins are released and prevent pain sensation. Usually, bioelectric therapy is combined with conventional pain medication and may reduce the dose needed for effective relief by about 50%.

7.   Physical Exercise to Manage Pain

Physical therapy may be offered by a physiotherapist to reduce pain after an injury and also to promote healing. The physiotherapist starts the patient on pain relieving techniques alongside the use of conventional pain medications. Physiotherapy also helps to prevent long-term disability.

8.   Psychotherapy

Pain, especially the chronic type, has an emotional and psychological aspect. A person experiencing chronic pain may experience anxiety, sadness, depression, and despair. In such a case, medical management alone may not suffice. A psychotherapist may help the patient to deal with the psychological aspect of the pain.

9.   Acupuncture for Pain Management

In acupuncture, fine needles are inserted at specific points in the skin that coincide with nerve endings. The stimulated nerves cause a dull ache in the affected muscles thereby numbing pain. Acupuncture is often used to treat back aches, menstrual cramps, osteoarthritis, and carpal tunnel syndrome among others.

10.  Chiropractic Treatment and Massage

Chiropractic is a form of therapy that focuses on the structure of the spine. It involves manipulating the spine alignment to offer pain relief and improve mobility. It is often used in the management of chronic back and neck pain. This is often combined with massage therapy and heat compresses. Patients with chronic back pain who have not found relief from conventional medication may benefit from this form of therapy.

In massage, a professional therapist works on painful regions of the body such as muscles, tendons, and joints. They apply pressure in these regions to cause relaxation and stress relief. Massage is believed to “close the pain gate” and prevent transmission of painful stimuli. A 2014 study that was published in the Annals of Family Medicine demonstrated that 60 minutes massage sessions twice or three times a week for a period of four weeks can help to relieve neck pain.

Can Medical Marijuana Offer Pain Relief?

Pain relief is one of the many medical marijuana health benefits. Cannabidiol (CBD) is one of the numerous phytocannabinoids that are found in cannabis. Several researches have looked at the pain relieving properties of CBD. One animal model study that was published in the European Journal of Pain demonstrated the pain-relieving effects of CBD. A different study demonstrated CBD’s ability to fight inflammation and neuropathic pain. CBD for pain management is a great area of interest for researchers.

CBD interacts with the endocannabinoid system (ECS) through endocannabinoid receptors. This system regulates different vital functions in the body, including the perception of pain.

In case you are suffering from chronic pain, you can try CBD for pain. However, it is important to first consult with your primary care doctor before you start any alternative treatment for managing chronic pain.

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