The Guide to Pain Management

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Pain management is a process that can address complex or simple causes of pain. The goal is to hopefully end the pain or alleviate the pain to the point an individual can work or enjoy life activities in general. In the following sections is a review of what patients can expect when choosing pain management.

What is Pain Management?

People experience pain for many reasons and different types of pain. It could be something like pain due to spinal disc degeneration, shooting pain down the leg due to a compressed nerve in the back or neck pain. Pain may be due to disease, like rheumatoid arthritis, or aging, injury, or an inherited condition.

Pain can be acute or chronic, and it is the ongoing severity of pain that usually drives people to seek relief. Even acute pain, by definition, can last up to six months. Half a year is a long time to be in pain.

Pain management is a set of techniques and strategies designed to target the specific type of pain experienced. The first focus is on obtaining a diagnosis and then developing a plan that deals with the cause of the pain, as much as possible, in order to ease the pain.

The ultimate goal is to reduce pain feelings and increase the quality of life. Each patient’s situation is unique, so there is no one set approach. The physician at a pain management clinic will collaborate with the patient to develop the best approach.

Types of Pain Management

The general types of pain management approaches are grouped into four major therapy categories.

  • Physical

This category includes physician-directed treatments, like a sacroiliac joint injection or nerve stimulation, physical therapy, massage, biofeedback, occupational or vocational therapy, etc.

  • Behavioral

Changing some behaviors is often recommended, especially if it is believed they contribute to painful feelings. This category includes things like learning to exercise regularly, not smoking, following a nutritious, well-balanced diet, managing stress through the practice of relaxation techniques, learning to move differently. etc.

  • Psychological

Cognitive pain therapies include learning and practicing mindfulness, learning to control thoughts of pain, and adopting mental and emotional coping skills.

  • Medications

Medications are frequently recommended. They are typically over-the-counter anti-inflammatories, like NSAIDs, or prescription pain medications.

In most cases, the pain treatment plan includes a mix of therapies, like cognitive-behavioral therapy or physical therapy and medications. It may be the treatment plan includes all four types of therapies.

Relationship of the Cause of Pain to Pain Management

What does pain management mean? Pain control management does not guarantee the pain will be fully alleviated. There are causes of pain that are not curable, but they are manageable.

For example, there is no cure for fibromyalgia, but the associated pain may be manageable. Sometimes, there is no clear explanation as to why a person experiences back pain. In fact, a lot of pain is unexplained, but it can still be managed with a treatment plan.

Treatment Options

A pain management clinic specializes in pain and understands the complexity of pain. Often, a team of doctors is assembled or a pain specialist has access to numerous resources. These resources include physical therapists, neurologists, psychologists, surgeons, pain counselors, nutritionists, and occupational or vocational therapists.

The interdisciplinary approach to pain control is one of the best strategies because it ensures the patient is treated holistically. It does not mean a patient will have to personally consult with each type of health professional. It only means the pain management specialist is ensuring all options for pain control are considered in the context of the patient’s specific situation.

Treatment options include:

  • Medications – nonsteroidal anti-inflammatory drugs, antidepressants, anticonvulsants, muscle relaxants, opioids, etc.
  • Physical therapy or occupational/vocational therapy
  • Injections – epidural steroid injectionsfacet joint injections, lumbar sympathetic block, stellate ganglion block, trigger point injections, etc.
  • Diet – consulting with a dietician to develop a healthy meal plan
  • Exercise plan – exercise to strengthen muscles, ligaments and tendons
  • Cognitive-behavioral therapy – learning new behaviors and new ways of thinking to interrupt pain signals

Some physicians may suggest trying acupuncture or Transcutaneous Electro-Nerve Stimulators (TENS). It is seldom one treatment option that eases pain. It is a combination of treatment options.

Knowing the Path to Pain Management

Knowing how to manage pain can mean the difference between enjoying or not enjoying life. The one thing people should not do is assume they must live with the pain. New technologies and a greater understanding of pain signals are leading to increasingly more effective treatment plans.

Originally appeared at Sapnamed.com blog

The Guide to Pain Management 1Majid Ghauri, MD Interventional Pain Management Specialist. Medical Director and Founder of Spine and Pain Clinics of North America