The International Association for the Study of Pain defines pain as an “unpleasant sensory and emotional experience.” But for anybody living with any degree of persistent pain, it can be something that seriously impacts quality of life. The goal with most forms of pain management is to reach a point where discomfort is minimized as much as possible. For many people, this goal is achieved with a combination of the following pain management techniques.
Opioids (narcotics) can be effective for pain relief, but only on a short-term basis due to addiction risks. NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen, naproxen, and aspirin are often recommended to control tissue swelling (inflammation) that can contribute to peripheral neuropathy, neuralgia (sharp pain along the path of a nerve), and other forms of nerve-related pain. Other pain management medications may include:
- Muscle relaxants
- Acetaminophen for pain relief
- Anti-seizure medications for pain linked to nerve damage
- Antidepressants to help with sleep
A combination of a powerful anti-inflammatory medication (corticosteroid) and a local anesthetic may be delivered to the affected area with an epidural injection. It’s a direct form of pain management that’s sometimes used for diagnostic purposes to determine if a specific nerve is the source of a patient’s pain. Injections also come in the form of nerve blocks and plasma-rich platelets (PRP). Best known for its use in treating sports-related injuries, PRP is unique in that the patient’s own blood is used.
Mind and Body
Treatments with both mental (mind) and physical (body) benefits often provide relief since multiple sources of pain are addressed at the same time. For instance, yoga is a gentle form of exercise that can strengthen core muscle groups while also promoting overall relaxation. Some patients experience similar results with acupuncture and chiropractic manipulations. Techniques like mindful meditation sometimes help change the perception of pain.
While it may seem counter-productive, exercise can be effective for someone living with persistent pain because it strengthens muscle groups that provide support to bones and joints. Active PT (the kind involving exercise) is based on a patient’s capabilities, and the intensity is often increased as strength and flexibility improve. Less-demanding forms of exercise like water aerobics can produce similar results without the same level of stress on bones, joints, and muscles.
Physical therapy can also be passive in nature (done to the patient without the need to participate). Heat and cold therapy is the most common form of this type of PT. Patients often respond well to alternating applications of heat and cold. Applications should be limited to 15-20 minutes to avoid skin irritation. Temperature-based therapy works by soothing soft tissues and increasing circulation. Passive forms of PT also include:
- Massage therapy
- TENS (transcutaneous electrical nerve stimulation) units and other forms of electrotherapy
- Iontophoresis (steroids delivered through the skin with a mild electric current)
Pain is real and physical even when there’s no clearly identified source. Yet it’s also based on perception, explaining why two people with the same injury can report very different symptoms. Issues like depression and anxiety can make pain seem worse, so it’s equally important to consider multiple factors when determining the approach to pain management that will likely produce meaningful results.