What are conventional medical treatments for pain?
Pain management is complex. The treatment given depends upon the type of pain, any underlying cause, the severity and so on.
Treating acute pain
Generally for mild to moderate pain, an acetaminophen (e.g. Tylenol) or a non-steroidal anti-inflammatory drug (NSAID) is prescribed. Some people can’t take NSAIDs because of various reactions and risk factors. If these don’t work, medications such as an acetaminophen/opioid combination are usually given. Potent opioids are usually given for severe acute pain. But they can cause addiction issues even when given short-term, so caution has to be exercised. All unused medications must be disposed of properly.
Treating chronic pain
There are a diverse range of treatments available, and sometimes a combination of treatments is required. Treatment options include:
- Physical therapy techniques, along with employing stretching, strengthening, and pain-relieving techniques can help improve movement and function impaired by an injury or disability and reduce pain.
- Exercise can help, as too much rest may actually increase pain and put you at greater risk of injury when you again attempt movement. Research has shown that regular exercise can diminish pain in the long term. It also causes a release of endorphins, the body's natural painkillers. But the type of exercise has to be appropriate to the person’s condition.
- Psychological treatment can help you to cope with the emotional side effects of experiencing chronic pain. It can also help reduce pain directly as high levels of physiological stress often aggravate pain.
- Over-the-counter pain medications such as Tylenol (acetaminophen) or NSAIDs such as aspirin, ibuprofen, and naproxen. These are said to relieve pain caused by muscle aches and stiffness, and additionally NSAIDs reduce inflammation (swelling and irritation). Pain relieving creams, lotions, or sprays can also be applied to the skin to relieve pain and inflammation from sore muscles and arthritis.
- Prescribed pain medications such as muscle relaxants, anti-anxiety medications such Valium, antidepressants such as Cymbalta for musculoskeletal pain, prescription NSAIDs, or a short course of stronger painkillers. Sometimes, steroids injected at the site of a joint problem can reduce swelling and inflammation. Sometimes, patients are given a device so they can self-administer a premeasured dose of pain medicine intravenously (into a vein), subcutaneously (just under the skin), or into the spinal area. Generally, this is in a hospital setting. Sometimes, a local nerve-numbing medication can be injected into a group of nerves that causes pain to a specific organ or body. But sometimes this can be dangerous, or not the best treatment for the problem. Another method for muscle pain is to inject sterile salt water or local anesthetic with or without a steroid into a trigger point (knots of muscle that form when muscles do not relax). Sometimes this method is also used for fibromyalgia, tension headaches, and myofascial pain syndrome. For chronic migraine headaches, Botox can also be injected to alleviate as it blocks signals from the nerves to the muscles. In severe cases, pain control devices can also be surgically implanted.
- TENS - Transcutaneous Electrical Nerve Stimulation Therapy uses low-voltage electrical stimulation to diminish pain. It "scrambles" the brain’s normal pain signals. It can be helpful for diabetic neuropathy, however, it isn’t effective for chronic low back pain.
- Bioelectric therapy is effective in providing temporary pain control by blocking pain messages to the brain and prompting the body to produce pleasure chemicals called endorphins. It can sometimes help people to halve the amount of pain medications they need to take.
Note: Medications can cause side effects. For example, Celebrex, an anti-inflammatory drug, has the potential to cause heart attacks, strokes, and stomach ulcer bleeding. Even over-the-counter anti-inflammatory drugs (except for aspirin) have the potential to cause stomach ulcer bleeding.
What are alternative treatments for pain?
- Massages can help reduce stress and relieve tension by enhancing blood flow. Neuromuscular therapy aims to treat underlying causes of chronic pain by addressing trigger points (tender muscles points), circulation, nerve compression, postural issues, and biomechanical problems that can be caused by repetitive movement injuries. Deep tissue massages can help relieve painful, stiff "trouble spots" and chronic patterns of tension and help with muscle injuries, such as back sprain. Studies have shown the effectiveness of massage therapy for back pain. In fact, one study showed it reduced the need for painkillers by 36%. Another study showed that people with knee osteoarthritis who received a one-hour massage either one or two times a week had improvements in pain, stiffness, and function.
- Mind/body techniques such as relaxation techniques, meditation, guided imagery, biofeedback, and hypnosis can also help. Studies have shown that meditation or yoga can reduce stress-related pain when they are practiced regularly.
- Acupuncture is thought to decrease pain by increasing the release of endorphins – chemicals that block pain. Many of the acupuncture points are located near nerves. When the needles stimulate the muscles, they send a message to the central nervous system (the brain and spinal cord), causing the release of endorphins that block the message of pain from being delivered to the brain.
- Chiropractic treatment has been shown to cause improvements in some trials; however, it hasn’t been shown effective in treating chronic back and neck pain. Further studies are currently assessing its effectiveness in pain management.
- Nutritional supplements, such as the natural compounds glucosamine sulfate and chondroitin sulfate, have been shown to give some pain relief to knee osteoarthritis and to increase mobility of the knee. Fish oils and SAMe have also been shown to be of benefit, although more research is needed.
- Herbal remedies such as white willow bark, devil’s claw, cat’s claw, ginger, and turmeric that have some evidence supporting their use for pain relief. However, if you are going to use them, you should tell your doctor, in case they cause interactions with other medications you are receiving.
Of course, essential oils traditionally have also been used for pain. For more information, see the Useful Essential Oils tab.