Pain Science Part 5: Controlling Pain- With Help.
- Jen Hassaj
- Sep 6, 2023
- 5 min read
Updated: Oct 12, 2024
Your experience of pain is influenced by a complex set of factors that are unique to you including your genes, biology, past experiences, emotions and environment. Your pain management depends on the kind of pain that you are experiencing and the cause of that pain. It often involves a combination of formal treatments which are covered in this part of the series, as well as some self-care or home treatments that will be covered in part 6.
Treat pain with Medication:
There are numerous varieties of both prescription as well as over the counter medications that can be taken to assist with pain. Discuss any option that you are considering with your doctor and/or pharmacist to be sure that it is appropriate for you, as well as safe for you to consume with other medications that you may be taking.
The classic form of medication is in pill form. Pain killers provide relief from pain, the two oldest are aspirin, which is derived from willow bark, and morphine, which is derived from opium poppies. In modern times aspirin is mostly replaced by ibuprofen if there is inflammation, or paracetamol if there is no inflammation. Morphine is an opioid and variants of it are still widely used, but can have associated problems like developing a tolerance to it as well as addiction.
Other pain killers include different types of anti-inflammatory style drugs, anti-depressants and anti-convulsants (anti-seizure).
Pain medication can also be in the form of topical applications. These vary from local anesthetics, to analgesics to counter-irritant products.
Other classes of medication that may be beneficial based on your individual signs and symptoms include medications to assist with the emotional symptoms of depression and anxiety, sleep medication, and muscle spasm medication.
All medications have risks and benefits and should not be taken without clear understanding of these as well as the possible complications associated with them.
Specialists and Rehabilitation:
Some additional common treatments for pain include cognitive-behavioral therapy, physical therapy, injections and/or surgery. Most effective therapies combine each of these treatments.
With psychotherapy, there are different approaches to helping with pain, the mainstream approach is to help people cope with the pain and reduce the suffering using cognitive-behavioral therapy, behavior therapy, and acceptance and commitment therapy. Psychotherapy can also assist with pain be caring for other mental health problems that can affect pain themselves. These include anxiety, depression, addiction, insomnia as well as helping with repressed emotions that cause pain.
Massage Therapy assists with reduction of tension and stress, it uses physical and sensory inputs that also are helping with emotional and psychological release.
Physical Therapy and Occupational Therapy improve function and reduce pain, instilling confidence in your ability to function in daily life. This is accomplished through rebuilding your strength and endurance with individualized exercise programs and performing the specific daily tasks that is causing difficulty.
Concerning sensitization; ‘Re-calibration’ is teaching the pain system what a normal stimulus is. This is thought to be achieved through both avoidance and exposure. In avoidance we avoid pain, minimize aggravation and we are as gentle and protective of the body part as possible to give it the chance to calm down. Exposure means to gently and cautiously expose yourself to the pain, challenging the body mostly with activity and exercise. The idea is to get used to stimulation and to repeatedly demonstrate to your nervous system that nothing terrible happens with those motions, etc. A sensible approach is to include both aspects- begin with avoidance then gradually shift to exposure. My description here is very broad as this is an extremely personal and psychological process. Of course there are no guarantees, and I would suggest finding a professional to guide and help you through this process.
Complementary and Alternative Medicine (CAM):
There are numerous treatments that fall in this category, the following list I have provided has been noted to have encouraging evidence in studies showing it to be beneficial with the 6 top chronic pain diagnoses:
1. Fibromyalgia: Tai Chi, Qi Gong, Yoga, Acupuncture, Mindfulness, Biofeedback, pharmacologic therapies, exercise, muscle strength training, Cognitive-behavioral therapy, movement-body awareness practice, Massage therapy, Balneotherapy.
2. Headaches & Migraines: Acupuncture, Massage therapy, Yoga, Biofeedback, Meditation, Relaxation training, Hypnotherapy, Spinal manipulation, Hydrotherapy, Tai Chi, Cognitive-behavioral therapy.
3. Low Back Pain: Exercise, Physical Therapy, Acupuncture, Mindfulness-based Stress Reduction, Tai Chi, Yoga, Motor control exercise, Progressive relaxation, Biofeedback, Laser therapy, Operant therapy, Cognitive-behavioral therapy, Spinal manipulation, Massage therapy.
4. Neck Pain: Acupuncture, Manual therapy, Massage therapy, exercise, Laser therapy, Alexander Technique.
5. Osteoarthritis: Aerobic exercise, Muscle strength training, Pharmacologic therapies, Tai Chi, Yoga, Acupuncture, Massage therapy, Physical Therapy-Ultrasound therapy, Manual therapy.
6. Rheumatoid Arthritis: Relaxation training, Mindfulness meditation, Tai Chi, Yoga, Acupuncture, Biofeedback.
A more extensive list is below with a link to learn additional information about each CAM type:
*Active Release Technique *Acupuncture *Acupressure / Deep Tissue Release
*Aromatherapy *Art Therapy *Aura Imaging *Bach Flowers *Biofeedback
*Breath Work *Chakra Alignment *Chiropractic Work *Colonics *Color Therapy
*Craniosacral Massage *Crystal Therapy *Dance Therapy *Dietary Changes
*Exercise *Energy Body Work *Feldenkrais *Feng Shui *Guided Imagery
*Heat Therapy *Healing Touch *Herb and Mineral Use *Hot Mineral Springs
*Hypnosis *Laser Therapy *Light Therapy *Magnets *Massage Therapy
*Meditation, Mindfulness and Relaxation Techniques *Messages from the Body work
*Music Therapy *Pulsed Electromagnetic Field Therapy *Reflexology *Reiki
*Spiritual Release Therapy *Steam Room *St. John Neuromuscular Therapy
*Tai Chi Chih *Visualization Therapy *Water Therapy *Yoga
Some factors to keep in mind- Care for chronic pain of all kinds needs to soothe and normalize the nervous system- not challenge it with vigorous manipulations. If an individual is treated too intensely by a specialist (PT, Chiropractor, Massage therapist, etc.) then the body’s alarm system may be triggered which could potentially make the problem worse. Factors like poor sleep quality may drive up sensitization and thus are more of a cause of pain than anything going on inside the tissues. Also, sensitization is probably the cause for pain ‘spreading’ beyond the joints in arthritic pain patients.
Thank you for joining me with this comprehensive list of formal treatment options for pain. I purposely did not go into a lot of detail of each, as that is a conversation for you and your doctor to have to ensure the best options for your individual situation. The next Part will give you numerous and various treatment and management options that you can do for yourself beginning in just 2 weeks!
Resources:
Brice B.K. PhD and Harrison T.E. MD. (2013) Mayo Clinic Guide to Pain Relief, Second Edition. Mayo Clinic.
https://uspainfoundation.org/ GOOD RESOURCE TO LOOK AT FOR CAM
Next time:
Stay tuned for my next blog in 2 weeks with Pain Science Part 6: 13 Things you can do to help yourself, plus 10 tips to maintain your gains!
Related Post Links:
Pain Science Part 1:
Pain Science Part 2:
Pain Science Part 3:
Pain Science Part 4:
Pain Science Part 6:
Author: Jen Hassaj | 9-6-23
Comments