There are various chronic treatment/management options available. Chronic pain treatment focuses on treating and managing the root cause and underlying condition that is causing the pain. The physical and psychological aspects of chronic pain need to be balanced in order for a treatment plan to work.

That is why a complete treatment plan can sometimes be necessary to address both the physical and psychological factors generating the pain. Because of this treatment plans often involve different pain specialists working in conjunction with a customized treatment/management plan according to the individual’s needs. This can include a combination of treatment protocols, like:

• Health coaching
• Psychological therapy
• Chiropractic
• Physical therapy
• Medication
• Acupuncture
• Yoga, Pilates

Treatment/Management

The focus of chronic pain treatment is to:

• Lessen pain frequency and intensity
• Help individuals get back to work
• Improve mobility and flexibility
• Maintain quality of life
• Reduce or eliminate reliance on pain meds
• Reduce possible re-injury or new injury
• Reduce mental and emotional symptoms like anxiety and depression

Pain Meds

Non-Opioids

Nonsteroidal anti-inflammatory medications are usually the first treatment for chronic mild to moderate pain. Examples are ibuprofen, aspirin, and naproxen. These medications work by blocking enzymes and reduce prostaglandins throughout the body that cause pain and swelling. Acetaminophen used in Tylenol is similar to these medications but works differently. Instead, these meds block the production of inflammatory chemicals in the brain.

Opioids

Opioids are narcotics and can be extremely powerful pain relievers. These are used to relieve severe pain symptoms temporarily. Narcotics work by blocking the pain signals before they get to the brain. However, these meds are highly addictive and can lead to abuse. Doctors prescribe narcotics when non-opioids and all forms of non-pharmacological treatment/s fail or don’t work in providing sufficient pain relief. Examples include:

• Buprenorphine
• Fentanyl
• Hydrocodone
• Oxycodone
• Hydromorphone
• Methadone
• Morphine
• Tramadol

Anticonvulsants

Anticonvulsants or anti-epileptics are used to treat seizures. They can also help in relieving pain that is associated with nerve injury/damage and fibromyalgia. Examples include:

• Gabapentin
• Pregabalin
• Carbamazepine
• Lamotrigine

Muscle Relaxants

Muscle relaxants can be used for chronic pain but there is division among medical experts as to how effective they are and of their addictiveness. Plus there are few studies supporting their use in individuals with chronic pain.

Corticosteroids

Corticosteroids are hormone-based medications that help reduce inflammation. They are generated naturally in the body while some are synthesized in a laboratory. Injectable steroids can help relieve pain brought on from pinched nerves or joint disorders.

Antirheumatics

Antirheumatic meds are used to control and manage rheumatoid arthritis symptoms. They prevent or inhibit the immune system and help reduce joint damage. Examples include:

• Methotrexate
• Leflunomide
• Hydroxychloroquine
• Sulfasalazine

Antidepressants

Antidepressants are used to treat anxiety disorders and depression disorders but are also used to relieve chronic pain. They are used to treat pain caused by:

• Arthritis
• Migraine
• Nerve damage
• Fibromyalgia

These medications increase the brain’s chemical levels like serotonin, dopamine, and norepinephrine. They can also be used even when an individual has no depression symptoms. Examples include:

• Amitriptyline
• Venlafaxine
• Paroxetine.

Alternative Treatment

Alternative treatment/management can also help with the pain. It’s recommended to discuss any type of alternative treatment with a doctor or medical professional. Doctors encourage alternative treatments along with keeping a journal of how an individual feels after a series of treatment sessions. If the individual feels better, and the treatment is working, then consider continuing for an extended period. Here are some alternative treatments/therapies to think about.

• Acupuncture: Works by releasing endorphins, the natural pain-relieving chemicals, and affects the brain region that controls serotonin, the chemical that regulates mood.
• Massage: Helps relieve pain by keeping muscles, ligaments loose and proper blood flow throughout the body
• Meditation: Has been shown to help improve pain perception and reducing depressive symptoms
• Hypnosis: Has been found to be useful in treating cancer and back pain

Psychological Therapy

Psychotherapy, also known as talking therapy could be part of a chronic pain treatment plan. What it does is to help improve the associated symptoms/conditions which include:

• Depression
• Anxiety
• Fear of pain

Psychotherapy has shown promising results and has various forms. They are:

Acceptance/Commitment Therapy

Acceptance commitment therapy is short-term psychotherapy. There are two approaches to pain perception. One, it teaches the individual to accept things beyond what they control. Second, it encourages the individual to feel things the way they are, work towards relief instead of questioning and being skeptical. It opens an individual’s psychological perspective. It can be used to treat low back, leg, and neck pain.

Cognitive-Behavioral Therapy

This therapy educates individuals on pain, mood, behavior, and how they all relate to each other. It also trains an individual on relaxation strategies. Individuals learn techniques to replace negative thoughts concerning their pain with positive thoughts. Cognitive-behavioral therapy has been shown to be effective in treating pain caused by:

• Spinal cord injury
• Chronic migraines
• Fibromyalgia
• Rheumatoid arthritis
• Irritable bowel syndrome
• Osteoarthritis
• Multiple sclerosis
• HIV/AIDS
• Cancer

Early and aggressive treatment/management of chronic pain can make a significant difference. Knowledge is power so make sure you understand all options before deciding which to take.

Sciatica Specialist

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