Busy physicians lack time, and sometimes training, to help complex pain problems. This can lead to frustrating encounters at the primary-care level, especially if your doctor is rushed. Most practices are forced to see a certain number of patients in a limited amount of time. Unfortunately, pain treatment is not as simple as five minutes, a few questions, and prescribing a pill. When pain is discussed, medications are often brought forth as the primary means of management. Because of its complexity, pain treatment has emerged as a separate, multidisciplinary specialty.
There is a source you can identify with a simple pain condition, such as banging your finger. There is also a clear course of action that resolves the pain. Pain experienced with long-term medical conditions is different and is not as easily resolved. To deal with the pain, the cause of the pain may not always be addressed, but rather the ways the body expresses the pain, such as inflammation.
Explain the way your pain impacts your life when you’re talking to your doctor. Don’t be intimidated. Stand your ground, calmly. Be persistent about your issues in a way that is constructive to get across to the physician that this is something real. Listen to what the doctor has to say first, but if you’re not satisfied, press harder. Remember you want to create a relationship with your doctor in which you’re a team, both looking for the best way to alleviate your pain. After he or she has assessed your needs, you can consider seeing a pain specialist.
There are various types of injections for pain treatment. Your doctor will decide which medicine is best. Injections deliver medicine directly where needed in your body. Local anesthetics numb the nerve or muscle. Steroids ease inflammation, which lowers pain. Steroids and local anesthetics are often used in conjunction.
- Targeting the nerves along the spine that lead to pain in other areas, such as the arms or legs is what nerve blocks are used for.
- Epidural steroid injections go in the outer part of your spinal column.
- Trigger point injections focus on tight spots in muscles. These areas can be so tight they squeeze nerves and lead to pain in other places.
Radiofrequency Ablation (RFA)
Radiofrequency ablation can relieve pain for 8 months to a year. Nerves send pain signals to your brain, and the RFA is used to inhibit this. A needle with a heated tip is placed very close to the nerve. The heat effects the nerve so that it can’t send the pain signal. This pain treatment assists with many types of pain, including arthritis and neuropathy. Research indicates RFA can also ease lower back and hip pain as well as pain in the knee and neck. And, research is being conducted to see if a cooling type of RFA would be more effective than the heated form.
Opioids are substances, both natural and synthetic, that act on opioid receptors in the body. They are primarily used for pain relief, including for anesthesia. While effective for severe pain, they also have numerous side effects. Further complicating matters, it’s not clear if opioids are helpful after a few months. And the most dangerous issue with opioids is that addiction is common among people who take them long-term.
Alternative and Complementary Therapies
Even though there may not be any increase at a pain site, with chronic pain, nerves may fire continuously. If some of the pain messages are interrupted, or if the brain can actually send out different chemicals such as endorphins, you may feel less pain and interrupt the chronic pain cycle.
There are techniques for using your thoughts to have an impact on your body—and body therapies that target how the use of the body can have an impact on your emotions. Generally, you can learn these and then do them yourself. Here are a few suggestions:
- Abdominal breathing is done by taking deep breaths, initiating from the abdominals, holding the breath for a moment, and then releasing. It’s calming, opens the lungs, and gets more oxygen into the body.
- Relaxation training involves learning how to relax the muscles of the body by letting go of tension in the muscle groups of the body.
- Guided imagery involves the process of mentally imaging a calming, relaxing experience which can include releasing pain from the body.
- Self-hypnosis is giving yourself some kind of signal to release the pain, allowing your body to relax more.
- Meditation was developed to deal with all kinds of pain: emotional pain, the pain of dealing with life, the need to find some kind of peace and calm. Physical pain is often connected to emotional pain. Many people find that meditation can help calm their mind in response to pain.
- Biofeedback is done using equipment to give you feedback, that helps tell you what’s going on in your body. Relaxation techniques are then used to help the body relax.
- Acupuncture involves placing tiny needles in the skin at certain points on the body. Many studies show it can ease low-back pain and may also help for arthritis joint pain.
If you try a therapy and it’s doesn’t work for you, that’s fine. It’s important to be patient and work on finding the combination that provides you with the greatest relief. Be sure to share with your physician the techniques you’ve tried and how effective they were for you—this may help him or her determine future treatments for you.