Family Health: Get help for chronic pain

On a scale of one to 10, how bad is your pain today? For some people, that question – and the sad faces on the pain chart – are their everyday companions. These are people with chronic pain. Unlike acute pain, which goes away as the injured area heals, chronic pain can last for months or years.

Most chronic pain doesn’t reach the top of the pain chart, but according to Steve Kemple, a pain specialist at the Advanced Pain and Spine Institute of Montana, its unrelenting nature can make it a life-altering condition. “When you’re in pain every single day, it affects your work, your finances, your family relationships – every aspect of your life,” says Kemple.

According to the National Institutes of Health, more than 100 million people in the U.S. have this type of pain. Arthritis is a typical cause, especially osteoarthritis – the deterioration of joints that comes with age and overuse. Chronic pain can also result from cancer and cancer treatments, conditions of the nervous system, headaches, old injuries and many other conditions. Regardless of the cause, pain that persists longer than six months is classified as chronic.

While chronic pain has a precise definition, it also has a more complex side. For one thing, people with the same medical condition often experience pain very differently. Also, the same person may feel more pain one day and less the next, even though their condition hasn’t changed. These differences are related to your genetic makeup, your life experiences and even your mood on a particular day – the brain systems that interpret physical and emotional pain overlap, so one can intensify the other. And while the source of chronic pain is often obvious, for some people it remains unknown.

While all pain can be treated, chronic pain often can’t be cured. In fact, the objective of treatment usually isn’t reaching zero on the pain scale. According to Kemple, a better approach is to decrease pain as much as possible while maximizing function. “You can avoid pain by being inactive, but that doesn’t alleviate the problem,” he says. Instead, people with chronic pain should work toward being as active as they can safely be.

If you have pain that lasts after an illness or injury has resolved, your first step is to see your doctor. He or she may order tests and ask about your health history to learn more about what is causing your pain and how to treat it. Anti-inflammatory medicines, such as aspirin and ibuprofen, sometimes help with mild to moderate pain.

For pain that doesn’t respond to initial treatment, your best choice may be to see a pain expert. Physicians and other providers at pain clinics diagnose the causes of pain and determine the best treatments. You may have some of these treatments for your pain:

  • Medications. Opioids may be used for hard-to-treat pain. These include medicines such as Vicodin and OxyContin. Antidepressants help relieve pain for some people, and anti-seizure medicines can be effective against some types of chronic pain. All drugs have side effects, though, and using them in combination can be dangerous. Always tell your doctor about everything you are taking, even supplements.
  • Physical therapy. A physical therapist trained in chronic pain management can use manual therapies and show you ways to strengthen specific muscles to help relieve pain. Physical therapy can also involve treatments such as therapeutic ultrasound, low-level laser, heat and ice.
  • Psychological counseling. Psychologists who are trained in chronic pain management can help with therapies such as biofeedback and cognitive behavioral therapy. They can also help you sleep better and minimize feelings of anxiety or depression that often come with chronic pain.
  • Exercise. It’s important to stay as active as possible. Low-impact exercises such as swimming, walking and bicycling are best. However, be careful not to overdo it.
  • Massage. A massage can improve circulation, relax your muscles and reduce stress.
  • Complementary care. Studies show that techniques such as acupuncture and chiropractic therapy can help with some types of chronic pain.
  • Relaxation techniques to relieve stress. You can often minimize pain by using meditation, yoga, tai chi or other methods for reducing stress. And it’s important to spend time with friends and stay involved with hobbies and projects to keep from focusing on your pain.
  • Occupational therapy. If pain limits your movement, occupational therapy can show you easier ways to do ordinary tasks like cooking and cleaning.
  • Surgery. In some cases of pain that doesn’t respond to other therapies, surgery may help. The surgery can involve relieving pressure on nerves or destroying specific nerves by cutting or burning them.
  • Injections. Several types of injections can help reduce pain by blocking nerve impulses or introducing substances such as cortisone or Botox to specific areas. Injections may also be used to find pain’s point of origin – if pain is reduced after the injection, that specific area is presumed to be the problem.
  • Implanted devices. For some people with chronic back or limb pain, doctors can use a minimally invasive procedure to implant a device that delivers electrical stimulation to nerves at the source of the pain. The current interferes with pain signals to the brain. A similar procedure is used to implant a pump that delivers pain medication to the space around the spinal cord.

Living with chronic pain can lead you to withdraw from everyday activities and even avoid your friends. It’s easy to feel depressed when you hurt most or all of the time, especially since others can’t see your pain and may not understand your condition. And depression can make pain worse. You can short-circuit this downward spiral by getting help now. Make an appointment with your doctor or visit the American Chronic Pain Association at theacpa.org to learn ways to document your pain and describe it during your doctor visit.