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How is Chronic Pain Treated?

Treatment of chronic pain usually requires several approaches combined into a pain management program designed just for you. Both drug treatment and non-drug treatment approaches are usually included.

Healthcare providers will try to address your pain based on your diagnosis, and try to provide the best therapy for your type of pain.  Following is a basic overview. We have much more advanced and specific information on the website.

Herbal therapy

Many chronic pain patients have become their own advocate and taken over their own care with exercise, herbal therapy, food supplements and good diet. Some of the more common herbal supplements that are used include ginseng to help fight fatigue and to raise the pain threshold, and devil’s claw as an anti-inflammatory. There are lots of herbal supplements, diet strategies and food supplements that can help.  Again, I’m not going to do detail at this point– there are significant amounts of articles and videos available on our website to review on all of these specific topics.

Medications

Medications might be used for your pain. Often one medication or a combination of medicines may be used. Sometimes you will be on a medication to raise your threshold to pain. You may be placed on a long acting medication that will reduce or blunt your overall pain. You might get a medication that reduces one type of pain, like an anti-nerve pain drug or anti-spasm medication. You will often need a rescue medicine. This is a medicine that takes the pain away when it breaks through from a lower-level. Rescue drugs are usually non-steroidal anti-inflammatory drugs like ibuprofen or short-acting narcotics.

There are many drugs other than narcotics that are used to treat mild to moderate pain. Among these are acetaminophen, aspirin, and non-steroidal anti-inflammatory drugs like ibuprofen or naproxen. These drugs are not addictive, however they usually have significant side effects like upset stomach, ulcers, bleeding problems, kidney damage or even confusion. Side effects vary from one person to another and from one drug class to another and even from each drug in each class. They are also dependent on your health condition and diagnoses and depend on your age.
There are many types of drugs that are used for chronic pain sufferers other than non-steroidal anti-inflammatory drugs and narcotics. They are usually termed adjunctive therapy. Medications like these can include anti-seizure drugs, steroids, sedatives, anti-nerve pain drugs antidepressants, etc.

Narcotics

Narcotics get most of the press 0n chronic pain therapy. Narcotics are medicines like hydrocodone (Lortabs,) oxycodone (oxycontins), morphine, dilaudid, and fentanyl. These are strong drugs used to relieve moderate to severe pain. These drugs are often used to manage chronic pain but only after trying other medicines and exhausting other nondrug treatments.

Narcotics are almost always used in conjunction with other pain management techniques. Sometimes Narcotics can be used as a rescue medication and not for daily use. For example let’s say you’re on an anti-nerve pain drug and also use anti-seizure medicine. On most days, this medication controls your nerve pain. Some days though, when you’re under a lot of stress, such as during cold weather or as night-time approaches, your pain becomes so severe and you can’t sleep. This is when you might use a narcotic medication is a rescue drug.

Narcotics are dangerous. You can become dependent on them and have to be weaned off of them. Narcotics can be addicting. However healthcare providers using them appropriately usually do not get their patients into trouble. Unfortunately many healthcare providers do not have the training to utilize pain medications correctly and are in too big of a hurry to work with the patients effectively. So be very careful if you’re getting any pain therapy and especially narcotic therapy from a physician or healthcare provider, make sure they are well-trained and have experience utilizing these medications.

Narcotic drugs can be given several in different forms; by shot, pill, liquid, suppository or skin patch. These drugs have a wide range of side effects- many that can be severe. These side effects include:

• nausea
• drowsiness
• constipation
• confusion
• breathing problems
• psychological effects
• hallucinations
• insomnia
• anxiety
• irritability
• depression.
• sleep apnea

Side effects are very dependent on the drug you are using, the dose and your tolerance.

Non-drug therapies

Chronic pain is never controlled by medication alone. Here is a list of some of the other approaches we utilize that are non-drug therapies. Non-drug therapies are some of the major things we talk about in our videos and webinars and we also have specialists like physical therapists, occupational therapists and exercise specialist discuss their field as it relates to chronic pain.

Here is a list of non-drug therapies which, while not exhaustive, will give you an idea some of the topics:

• surgery
• interventional techniques like injecting nerves or spines
• heat
• cold
• exercise program which might include walking or aerobics
• physical therapy
• devices like TENS units which electrically stimulate nerves
• water therapy/hydrotherapy which uses swimming pools, hot tubs, or whirlpools
• hypnosis
• acupuncture or acupressure
• massage therapy
• counselling
• biofeedback, especially for headache patients
• relaxation methods, imagery, music and meditation
• healthy diets
• social activities

Treatment of chronic pain is difficult; it is difficult for you, your support group and your healthcare providers. Keep trying, keep persevering and gain all the knowledge you can so you improve your care and become your own effective advocate. We hope to help you transform your life with the information and insight we provide.

Have a good day, take care, and may today be a better day than yesterday.

Dr. Kent

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