Advanced pain management techniques may be recommended for severe chronic pain.
What is chronic pain?
Pain may be temporary or persistent. Pain which lasts several months is called chronic pain.
Some conditions causing chronic pain include:
- Lower back pain
- Nerve damage
- Multiple sclerosis
Pain Management Interventions
Pain is usually managed by:
- Drugs: These include over-the-counter analgesic and anti-inflammatory medications (NSAIDs), corticosteroids, opioids, muscle relaxants, antidepressant, and anticonvulsant medications.
- Physical therapy: Including specific exercises for pain relief and improved function and physical modalities such as heat and cold application, electric current, and manual therapy
- Alternative therapies: Including acupuncture, massage, and chiropractic treatments.
Advanced Pain Management Interventions
To treat severe chronic pain your doctor may recommend advanced interventions such as:
This technique is useful for patients recovering from surgery. A computerized pump is activated by the patient at the press of a button when increased pain is felt and delivers analgesics through an IV line.
A nerve or group of nerves transmitting pain impulses are blocked by drugs or radiation.
Trigger point injections
In certain conditions, muscles do not relax properly forming “knots” and may be associated with pain. Your doctor injects the site of the muscle knot to relieve pain. Trigger point injections are useful for muscle pain in the arms, legs, and back associated with conditions such as fibromyalgia and myofascial pain syndrome.
An implant may be surgically placed to provide pain management. Commonly used implants include:
- Intrathecal pumps: They are implanted in the skin and deliver pain medication to the intrathecal space in the spine to control pain
- Spinal Cord Stimulation: This implant delivers electric signals to block pain impulses travelling through the spine to the brain. You can start and stop and control the intensity of the electrical impulses through a remote-control device.
- Transcutaneous Electric Nerve Stimulation (TENS): Low-voltage electric current is delivered to the site of pain through electrodes on the skin. This stimulates nerves in the area to send impulses other than pain impulses which results in diminished pain.
- Bioelectric Therapy: Bioelectric therapy involves the application of electrodes to the skin through which electric currents are delivered, preventing the transmission of pain impulses. It is also believed to stimulate the production of endorphins in your body which naturally relieves pain.
- Psychological Therapy: When pain is associated with a psychological illness such as feelings of increased sadness, hopelessness and anger, your doctor may suggest various forms of psychological therapy to help you manage your pain. You will be taught various life skills and how to tackle difficult situations.
Multimodal Pain Management
The American Pain Society (APS) has proposed the use of multimodal pain management strategies to treat chronic pain and overcome the dangers of opioid addiction.
This strategy of pain management is reported to be successful in many patients particularly during or after orthopaedic surgery and has minimal side effects.
Multimodal analgesic techniques target various pain pathways by the administration of two or more analgesic agents along with other nonpharmacologic pain management techniques.
Advantage of Multimodal Pain Management
Medications used to treat pain are often associated with side effects such as decreased energy level, impaired mobility, memory loss, etc. During multimodal pain management, the medications are combined to retain the analgesic effect and minimize their side effects.