Pain is a natural part of many diseases, conditions and injuries. It can last a short time and stop when you heal (acute pain) or it can continue for months or years and interfere with your daily life (chronic pain).
Your provider may recommend different approaches to regulate your pain through medications, procedures and exercise. These treatments can be done at a pain clinic, your provider’s office or hospital.
Non-medication and non-opioid options
In the United States, a large number of people suffer from chronic pain. Medications are used to control this pain but they can be difficult to use because of side effects.
Opioids increase the risk of addiction and overdose. They also have limited efficacy for long-term treatment of chronic pain. There is an urgent need for more effective, safer, non-opioid therapies to manage this pain.
There are many options available for treating pain without medication. These include over-the-counter medications such as NSAIDs, acetaminophen and topical pain relievers; antidepressants, benzodiazepines, and other drugs that modulate pain such as triptans for migraine headaches or gabapentin (Neurontin) and pregabalin (Lyrica). Peripheral nerve blocks including occipital nerve blocks and trigger point injections may be helpful in managing neuropathic pain, but need further research to support their effectiveness.
In addition to non-pharmacological modalities, cognitive behavioral therapy can help change negative thinking patterns about pain that can actually amplify it. Mind-body techniques like deep breathing and meditation can also help manage pain.
Interventional pain treatments
The pain blocking techniques used in interventional pain management can make everyday activities more manageable and help patients regain their quality of life. These procedures may include injections, nerve blocks, spinal cord stimulation, and ablations.
For those who struggle with chronic and acute pain, finding relief can seem impossible. It is important not to give up! Although medications can temporarily relieve pain, they do not address the underlying causes of your pain. Injections and nerve blocks, on the other hand, can provide lasting pain relief without the long recovery times associated with surgeries and other healing solutions.
Those who have a persistent pain condition that does not respond to over-the-counter medications, physician-prescribed narcotics, or physical therapy should consider seeing an interventional specialist right away. The most common procedure includes epidural steroid injections (ESI) that target the space around the spinal cord and can relieve herniated discs, spinal stenosis, and sciatica. Other treatments may include facet joint injections and trigger point injections.
Cognitive behavioral therapy
Cognitive behavioral therapy is a short-term talk therapy that has been found to reduce negative emotions and behaviors including pain. It teaches individuals how to control their own thoughts and emotions to help reduce the intensity of their pain and increase overall functioning.
CBT includes learning to recognize unhelpful thinking patterns and identifying situations that trigger them. It can also include teaching and practicing relaxation techniques such as deep breathing, progressive muscle relaxation training, and guided imagery to decrease stress levels which can exacerbate pain.
CBT can also include goal setting, activity pacing, and promoting social support to improve motivation and confidence in managing pain. The best way to find a qualified therapist to conduct cognitive behavioral therapy is to speak with your primary care provider. They may be able to recommend someone or can point you in the right direction online. Self-help versions of cognitive behavioral therapy are also available and have been shown to be just as effective as one-on-one sessions.
Physical therapy
In addition to pain medications, physical therapy can be a powerful tool in managing pain. Unlike pain medication that masks the sensation, a physical therapy regimen targets the source of the pain to provide lasting relief and reduce inflammation.
Physiotherapy techniques include therapeutic exercises, electrical stimulation, cold and hot therapy, and dry needling (in which an electrode without medication is inserted into muscle tissue to release or inactivate trigger points). Often, a physician can refer patients to a physical therapist or the patient may seek one out themselves.
A strong relationship between a patient and their physical therapist can improve outcomes and lead to better management of chronic pain. Creating an open dialogue about treatment goals and the impact of the clinician’s language, beliefs, and attitudes can help to set a positive tone for engagement throughout the course of care.
