Pain management

Overview 

Pain management involves using medications, procedures, exercises, and therapy to help regulate and alleviate pain. Specialists may recommend a combination of these approaches to prevent, reduce, or relieve discomfort. Treatment can take place in various settings, including pain clinics, healthcare offices, or hospitals.

Pain, a complex and individualized experience, can arise from injuries, conditions, or treatments. It can be acute, lasting only a short time and resolving as the body heals, or chronic, persisting for months or years. Invisible conditions that cause pain add to the challenge of seeking help, but it’s crucial to address pain rather than endure it alone. Everyone’s pain is different, and getting the right support is essential.

While it may not always be possible to eliminate pain entirely, effective pain management aims to improve overall quality of life. By focusing on restoring functionality and helping people return to their daily activities, work, or school, healthcare providers continuously adjust treatment plans to help patients feel better and more in control of their pain.

Types  

Approaches to pain management 

Pain management may involve treating the underlying cause of pain and/or managing pain as a symptom. There is no single “right” approach for everyone, as effectiveness varies from person to person. Providers often begin with minimally invasive or conservative therapies before exploring riskier options. 

• At-home pain management: For muscle and soft tissue injuries, at-home remedies like the RICE method (Rest, Ice, Compression, Elevation) and heat/cold therapy may be effective. Lifestyle changes, such as maintaining a healthy weight, eating nutritious foods, staying hydrated, getting quality sleep, and managing stress, can also help reduce pain. Physical activity, including walking, swimming, and strength training, can improve posture, balance, and overall body function, while also benefiting mental health. Always consult your provider before starting a new exercise routine. 
• Physical and occupational therapy 
  • Physical therapy: Helps improve physical movements, either as part of a general pain management plan or to treat specific injuries or conditions. 
  • Occupational therapy: Focuses on improving the ability to perform daily tasks, teaching you how to move through your environment or use tools to minimize pain. 
• Psychotherapy for pain management 
  • Psychotherapy (talk therapy): Helps identify and change unhealthy emotions, thoughts, and behaviors. It’s particularly useful for managing chronic pain, which can lead to depression and anxiety. 
  • Cognitive behavioral therapy (CBT): Teaches skills to cope with the emotional impact of chronic pain and associated mental health issues, including strategies like relaxation techniques and mindfulness. 

• Complementary therapies: These treatments are often used alongside traditional Western medicine to help manage pain: 
  • Massage therapy 
  • Chiropractic adjustments 
  • Acupuncture 
  • Biofeedback 
  • Meditation 
  • Breathwork 
  • Yoga 
  • Reflexology 
  • Aromatherapy 
  • Dietary supplements and herbal remedies 

• Medical procedures and devices: Various medical procedures may assist in pain management, including: 
  • Electrical stimulation therapies like TENS, peripheral nerve stimulation, and spinal cord stimulation. 
  • Procedures such as radiofrequency ablation, steroid injections, nerve blocks, and Botox® injections. 
  • Devices like patient-controlled analgesia (PCA) pumps or baclofen pumps. 
  • Surgery to address underlying causes, such as spine surgery. 

• Medications for pain management: Your provider may recommend prescription or OTC medications depending on the type of pain. Options include: 
  • NSAIDs (e.g., aspirin, ibuprofen) 
  • Acetaminophen 
  • Topical analgesics (e.g., lidocaine, capsaicin cream) 
  • Antiseizure medications (e.g., gabapentin, pregabalin) 
  • Antidepressants (e.g., tricyclic antidepressants, SNRIs) 
  • Muscle relaxers 
  • Corticosteroids 
  • Opioids (used sparingly due to addiction risks) 

Reasons for undergoing the procedure  

Anyone experiencing pain, whether acute or chronic, can benefit from a pain management plan. Such a plan is designed to address pain that may last for a few days, such as post-injury or post-surgery, as well as long-term pain associated with various health conditions. Pain can arise from a wide array of causes, including:  

• Arthritis and muscle or joint injuries.  
• Autoimmune diseases, such as Crohn’s disease, lupus, and fibromyalgia.  
• Burns.  
• Cancer.  
• Neuropathic pain, including pinched nerves, peripheral neuropathy, and trigeminal neuralgia.  
• Chronic pain disorders, like complex regional pain syndrome (CRPS) and central pain syndrome.  
• Circulatory issues, such as peripheral artery disease.  
• Endometriosis.  
• Headaches and migraines.  
• Conditions or injuries related to the spine or spinal cord.  

Risk  

Different type of pain management comes with their own risks, side effects, and potential complications, which can vary depending on your overall health and other medications you may be taking. For example, excessive use of acetaminophen is a leading cause of acute liver failure, while prescription opioids carry a risk of developing opioid use disorder. More invasive procedures, such as surgeries, also have specific risks, including infection and potential nerve damage.

It’s important to discuss the risks and benefits of each pain management option with your healthcare provider before starting any treatment. Don’t hesitate to ask questions; your provider is there to support you and ensure you receive the best care.  

Procedure  

Consult your primary healthcare provider first if you’re not sure what’s causing your pain. If necessary, they can start the diagnostic procedure and direct you to a clinic or pain management team. If you already have a diagnosis, talk about putting in place a thorough pain management plan with the healthcare provider overseeing that diagnosis.

To better understand your pain and its underlying cause, your healthcare team may recommend several tests and assessments, including:  

• Physical examination: A thorough evaluation of your physical condition.  
• Neurological examination: An assessment of your nervous system function.  
• Laboratory tests: Blood, urine, and cerebrospinal fluid tests to check for abnormalities.  
• Imaging tests: Magnetic resonance imaging (MRI) and computed tomography (CT) scans to visualize internal structures.  
• Electrodiagnostic studies: Nerve conduction studies and electromyography (EMG) to assess nerve and muscle function.  
• Functional assessments: Evaluations of how pain impacts your mood, daily activities, relationships, and work life.  

Outcome  

Chronic pain is a complex condition that can affect your brain and nervous system, often evolving over time. The most effective way to manage it is usually through a comprehensive approach led by specialists. Although complete pain relief may not always be attainable, many people experience significant pain reduction or learn new strategies to cope with it. 

A well-structured pain management plan can greatly enhance both your physical and mental well-being. Research shows that current treatments for chronic pain can reduce pain levels by approximately 30%. However, finding the right approach may take time and involve trying different therapies. For instance, fewer than half of those with neuropathic pain experience adequate relief from a single treatment.

Your pain might not disappear entirely, but working closely with your healthcare provider or team and adjusting your plan as needed can enhance its effectiveness.

Contact your healthcare provider if:  

• Your discomfort is preventing you from enjoying your usual activities.  
• Your pain does not improve, worsens, or recurs after treatment.  
• You experience anxiety or depression related to your pain.  
• You have difficulty sleeping due to pain.