6 Ways to Combat Chronic Pain

Today, there are 100 million Americans who suffer from chronic pain, which is a major cause of long-term disability. Chronic pain symptoms may include headaches and pain from cancer, arthritis and other ailments, says the American Academy of Pain Medicine. But you don't have to take pain lying down.

1. Physical Activity for Pain

It may seem counter-intuitive if you're hurting, but according to the American Chronic Pain Association (ACPA), physical activity can really help with pain and help ease discomfort. They include:

• Range-of-motion exercises, which help extend how far you move joints in different directions. A physical therapist is ideally suited to help you with this by developing a personalized plan to help you move and restore function.
• Stretching improves flexibility and range of motion, which decreases chances of further injury.
• Strength training is meant to build and retain muscle mass for better support of your body.
• Cardiovascular conditioning strengthens your heart with aerobic exercises like jogging or swimming

2. Psychosocial Help for Chronic Pain

When you think of a psychologist, mental health is probably what comes to mind. But your thoughts and feelings can have a big influence on how your body deals with physical pain. A psychologist can help you cope with feelings of anger, hopelessness, sadness and anxiety associated with chronic pain.

One way is with cognitive-behavioral therapy. This is a form of talk therapy that teaches you how to develop skills to change negative thoughts and behaviors, which can lessen your awareness of pain, even if you still have the same pain.

3. Pain Relief Medications

The ACPA recommends these four classes of medications for chronic pain:

1. Non-opioids, which include aspirin, NSAIDs (non-steroidal, anti-inflammatory drugs) and acetaminophen.
2. Opioids, including morphine, codeine, and oxycodone. Because of their highly addictive nature, these should be used with caution and only under a doctor’s care.
3. Adjuvant analgesics, like anticonvulsants and antidepressants, weren’t originally designed to help pain but can be used for this purpose. Antidepressants can change the way pain is perceived from the spinal cord to the brain. Anticonvulsants (which are meant to control seizures) can decrease pain by not allowing certain types of nerves to send signals to your brain.
4. Additional medications like corticosteroids and muscle relaxants weren't developed to treat pain, but to treat certain symptoms associated with pain like insomnia, mood disorders, and muscle spasms.

4. Alternative Choices for Chronic Pain

The National Center for Complementary and Integrative Health says the approaches outlined below have proven useful in varying degrees in treating pain.

• Acupuncture: A thin needle penetrates the skin and simulates various points on the body.
• Spinal manipulation: Hands or a device deliver pressure or a controlled force to a joint of the spine, usually by a chiropractor, although other healthcare professionals may provide this service.
• Massage therapy: Muscles and other soft tissues are manipulated by a massage therapist.
• Relaxation techniques:
  • Progressive muscle relaxation (PMR): A method where you focus on a group of muscles, then repeatedly tense and relax them, which is meant to increase awareness of your body and learn to consciously relax.
  • Guided imagery: With help from a professional, guided imagery is used to focus on positive, soothing mental images to take pain out of the front of your mind and into the background, so it becomes more tolerable.
  • Biofeedback: Using a biofeedback machine, a patient is hooked up with sensors that measure breathing, heart rate and blood pressure. These measurements help you learn to control your reactions, like stress, which usually occur involuntarily and can increase pain.
  • Deep breathing: Also called abdominal or diaphragmatic breathing is a technique in which you expand your abdomen and not just the top of your lungs to inhale more air and pump more oxygen through your body.
  • Meditation: The goal of meditation is to be present in your mind and body so you’re more relaxed and can “listen” to what your body is telling you.
  • Tai chi and Qigong: These types of “meditation in motion” require focus, concentrated breathing, and relaxation. They also improve balance and can help lower blood pressure.
  • Yoga: Specific postures and breathing characterize this mind-body practice that improves flexibility and strength. It can be practiced at varying levels.

5. Neuromodulation for Pain

With neuromodulation, electronic signals from a device stimulate the nervous system to bring relief and increased movement.

• Transcutaneous electrical stimulation (TENS): Safe, low-voltage electrical currents are applied to the skin with electrodes from a battery-operated unit. This is the most common, neuromodulation system. You can even buy one yourself.
• Additional stimulation: More complex systems with implantable devices use a lead — wires with an electrode at the tip — along with a neurostimulator implanted under the skin for:
  • Spinal Cord Stimulation (SCS)
  • Deep Brain Stimulation (DBS)
  • Peripheral Nerve Stimulation (PNS)

6. Mildly Invasive Choices for Pain

• Epidurals: This involves injection of a steroid into the epidural space of the spine. The ACPA notes they rarely provide a long-term benefit.
• Nerve and facet blocks: An injection of a local anesthetic blocks nerves that transmit pain.
• Radiofrequency ablation: A probe that destroys the nerve to the facet joint.

Many of the treatments listed here are paid for partially or in full by most health insurance plans. Talk to your doctor about which course of treatment is right for you and check your benefits to understand what’s covered.

Sources:

https://painmed.org/patient-education-resources
https://theacpa.org/
https://nccih.nih.gov/health/pain/chronic.htm#hed5
https://www.frontiersin.org/articles/10.3389/fneur.2017.00285/full
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4745638/
http://onlinelibrary.wiley.com/doi/10.1002/psb.1542/pdf
http://www.merckmanuals.com/professional/neurologic-disorders/pain/treatment-of-pain
http://www.apa.org/helpcenter/pain-management.aspx