An estimated 70 million Americans suffer from chronic pain. Chronic pain is a major medical condition distinctly different and more complex than acute pain. While acute pain is a normal sensation triggered in the nervous system to alert one to possible injury, chronic pain is a state in which pain persists for many months or years, beyond the normal course required by healing. The economic and personal losses associated with chronic pain can be significant, including costly medical expenses, lost income and productivity; lost mobility, anxiety or depression.
The causes of chronic pain are not always clear. Past traumatic injuries, congenital conditions, cancer, arthritis or other disorders may seem to be obvious culprits, but in many cases the source of chronic pain is complex. This makes it difficult to treat, and pain management usually involves a multidisciplinary focus designed to help the patient reach the highest possible level of function and independence.
Pain management specialists are medical professionals well-trained in the diagnosis and treatment of acute, sub-acute and chronic muscle and nerve pain. Board-certified in this specialty and utilizing the most advanced treatment techniques, pain management physicians work one-on-one with patients who suffer from chronic pain to determine the best treatment plan to relieve symptoms and allow resumption and enjoyment of everyday activities.
Causes of Chronic Pain
Chronic pain may develop as a result of several different conditions. Back pain is an extremely common form of chronic pain and may result from many causes, including herniated discs, stenosis, scoliosis, compression fractures and sciatica. Back pain may be radicular, meaning it travels down the arms or legs. Other causes of chronic pain that may require serious pain management include:
- Reflex sympathetic dystrophy (RSD)
- Diabetic neuropathy
- Trigeminal Neuralgia
- Osteo, psoriatic or rheumatoid arthritis
- Inflammatory bowel disease
- Depression or other psychiatric disorders
Any chronic pain should be diagnosed by qualified physicians so that it can be appropriately treated.
Pain Management Treatments
Treatments for chronic pain may focus on relieving symptoms or treating underlying conditions, and vary depending on the cause and severity of the condition, as well as the patient's overall health and medical history. The most successful pain management programs are those that are specifically tailored for each individual patient so that they can remain actively involved in their own recovery. Some of the most common treatments for chronic pain include:
Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) are often the first treatment utilized to relieve chronic pain. Corticosteroids and stronger prescription medications, often opioids are used when NSAIDs are ineffective. These medications include: codeine, oxycodone, percodan and morphine. Because these medications have some serious side effects, doctors usually try to minimize pharmaceutical treatment by recommending alternative pain management techniques whenever possible. In some cases, antidepressants, such as Cymbalta, may also be prescribed, often to supplement analgesics.
Injections are one of the most effective treatment options for pain management, as they block nerve signals to relieve pain and inflammation. These injections are administered directly into the affected area, along with a local anesthetic to relieve any potential discomfort, and may be composed of corticosteroids, BOTOX®, sclerosing solutions or other substances.
Through a small battery-operated device worn on the body, transcutaneous electrical nerve stimulation can relieve pain by stimulating the nerves that target the affected area of the body. This treatment is not painful and is considered safe for most patients.
For the most severe cases that do not respond to less invasive treatments, surgery may be required to relieve pain and allow patients to resume normal functioning, although movement may be somewhat restricted. Surgery may include joint replacement, cartilage repair or denervation.
Most patients benefit from a combination of treatments in order to achieve successful pain relief and may be treated by a number of different physicians, therapists, chiropractors and other health care providers.
Pain management specialists sometimes function as team coordinators of individualized treatment plans.