Tuesday, July 16, 2013

5 Methods For Treating Chronic Pain

A common scenario - A guy goes to his doctor and tells him he’s experiencing pain all over his body. His doctor asks him to be more specific, so with his index finger, the man points out the painful areas. His knee. (Ouch!) His back. (Doh!) His stomach. Even his earlobe hurts when he touches it. The doctor pauses, then deadpans, “Your finger’s broken.” 

OK, sure, it’s a goofy joke, but when you live with chronic pain from an old injury or a degenerative condition like osteoarthritis, getting the right treatment—and lasting relief of the noncomic variety—can be difficult. All joking aside, many Americans are in this same boat. 

According to a recent report from the Institute of Medicine, 116 million of us—more than all the people with heart disease, cancer and diabetes combined—suffer from chronic pain. While pain management is starting to get the national attention it deserves, you need relief now. We’ll help you make informed decisions about dealing with your chronic pain by understanding treatment from all angles, from physical approaches to behavioral techniques.

Pain Medications
Over-the-counter medications like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) can provide a first line of defense against chronic pain, but regular takers should exercise care, says Perry Fine, M.D., president of the American Academy of Pain Medicine. “Even with mild analgesics [painkillers], you need to proceed with care because these can cause damage to the body if taken in excess,” Fine says. These side effects include ulcers, gastrointestinal bleeding, liver and kidney damage and addiction. Fine says he also cautions against prescription-strength pain relievers for most chronic pain sufferers. For acute injury with severe pain, high-dose pain medications can help mobilize a person and allow the body to heal. “This isn’t the case for most people experiencing prolonged chronic pain,” Fine says, “and is only advised for a small, select group of individuals for whom there are no better or safer solutions.”

Complimentary and Alternative Medicines
When you’re serious about solving your pain problems, don’t rule out any treatments. Alternative therapies can complement traditional treatments, says Loren Fishman, M.D., co-author of Yoga for Arthritis: The Complete Guide and Yoga and Multiple Sclerosis: A Journey to Health and Healing. “By using two, three or even four methods, I’m often able to increase a patient’s relief,” Fishman says. "Maybe it’s acupuncture and injections and then yoga to improve posture and psychotherapy to help with the coping.” Fishman, who teaches yoga, is also an advocate of meditation. He includes five to 10 minutes of it at the end of his yoga classes. “Meditation gives people a place they can rest and leave all their troubles at the door,” he says. “They know those troubles will be there waiting for them when they emerge, but in the meantime, they are trouble-free, and this gives them comfort and hope.”

Exercise and Nutrition
It’s the last thing you may want to do when you’re hurting, but exercise is a proven pain reliever, and for many chronic pain sufferers. Before you begin an exercise regimen, your doctor may prescribe physical therapy. Therapists teach exercises and proper body mechanics as well as offer real-world tips to help minimize pain as you go about your daily life. This might include using a foam roller—or even just a tennis ball in a sock—to work out troublesome spots. Fine also recommends a balanced diet (no surprise) and a daily combination of aerobic, stretching and strengthening exercises like walking, yoga and swimming.

Interventional Procedures
When conservative methods aren’t enough, interventional therapies may be needed to complement other treatments. Interventional therapies like injections and nerve blocks are treatments that directly interact with the areas of the body involved in the pain. Trigger-point injections—injecting a local anesthetic into trigger points in the musculature around the back— can be helpful for people with chronic lower-back pain and neck pain. But because interventional therapies can be overused, practitioners must exercise restraint. “The real key is to find someone you trust, who’s well trained and is going to be thoughtful about how much and how often, and what the balance of benefits and burdens are,” Fine says.

Cognitive Behavioral Therapy
Just like physical therapy helps your body, cognitive behavioral exercises can help you learn to change the way you think and feel about your pain. “It’s similar to psychological treatment for people with phobias and anxiety. And it’s probably the most empowering thing you can do, but it does take time,” Fine says. And doing behavioral exercises certainly doesn’t mean saying no to other options. “If something’s treatable we want to treat it, but if it’s chronic and can’t be completely cured, the real role of a chronic pain physician is helping you make the best of your situation and optimize your overall health,” Fine says.

Manage Your Pain Close to Home
Help is closer than you think. Gwinnett Medical Center–Lawrenceville’s Pain Management program is committed to maximizing patient comfort, using every tool at the team’s disposal to ease pain. “Pain is unique to each patient we treat,” says Richard Reisman, M.D., director of GMC’s Pain Management program, “so every patient receives an individualized treatment plan to meet his or her goals.” To learn more about our pain management program, call
678-312-5200. The program strives to:
  • Determine the cause of pain
  • Assess surgical options
  • Assess levels of pain, depression, anxiety, fatigue and function
  • Discuss treatment plans
  • Discuss whether your condition will get completely better or if you will always have pain 
  • Set goals for pain levels and function
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