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Pain management, not pain elimination – what does that really mean? Who wants to manage pain, anyway? With an estimated 86 million Americans suffering with chronic pain, it seems there’s a whole lot of pain going around. Why not just pop a pill and be done with it?

Wait, that pill’s effects wear off and you find yourself taking another one, maybe even before you should. If one pill doesn’t work like you want, get another prescription for something stronger. XYZ brand did wonders for your neighbor who has severe arthritis, so maybe it will make your back pain go away. After a while, the pill bottles line your medicine cabinets or kitchen counters. You may even forget which pill you’re supposed to take for what and when. Did you take your anti-inflammatory and your pain pill this morning? Can’t remember? Why not take them now, just in case. Besides, you think you feel a sharp pain near the base of your spine.

Hold on a minute. No one likes to be in pain, it’s true. And while it would be wonderful if scientists could discover a cure for pain that would be a simple, one-time procedure, pill, or injection, such a scenario isn’t ever likely to happen. Pain isn’t something for which there’s a single remedy that works for everyone. Some people can tolerate a lot of pain or significantly more pain than others. Some rush to medicate at the first twinge of discomfort. But what about those who suffer intractable pain, the kind of pain that’s without respite, agonizing and debilitating pain? Aren’t these people supposed to find relief through whatever kind of prescription medication is available? Sure, they might become addicted, but isn’t that a small price to pay to alleviate pain?

And then there are the others, patients who pop painkillers long after the medical condition for which the medication was prescribed is gone. Too much reliance on opioids (painkillers) can result in tolerance. The person needs to take more of the medication more frequently in order to get the desired effect – complete relief from pain.

But it doesn’t stop there. Continued abuse of painkillers may result in dependence. The person worries that if they stop taking the pain medication that their pain will return and will be unbearable. Dashing off concerns that pain medication use is becoming abuse, the person continues to take the medication in larger doses and more often. Then, in what may be only a short period of time, addiction may result. The person cannot stop taking the painkiller without suffering withdrawal symptoms ranging from mild to moderate to severe – or even life-threatening.

Such are the dangers of taking pain medication inappropriately or too long. It’s also the danger of taking pain medication to completely eliminate pain. That’s not what pain medication is designed for in the first place.

Pain Management versus Pain Elimination

Think of pain management and pain elimination as being on a continuum. At one end of the scale is zero pain. This could result from the condition causing the pain having been cured or healed or overcome or it could result from taking drugs that obliterate the sensation and brain signaling of pain.

At the polar opposite is pain. Somewhere in the middle is pain that’s being managed. It’s not completely gone, but the patient doesn’t rely on prescription drugs to get rid of every ache and twinge. And there are numerous other techniques or methods that can be used to mitigate – but not eliminate – pain. This is pain management.

If you have long-term or chronic pain, it’s important that you learn how to manage your pain. This requires seeing your doctor for an assessment.

Types of Pain

There are two types of pain: acute and chronic. Acute pain can come on suddenly and be gone just as quickly. It rarely lasts long. Chronic pain, on the other hand, typically lasts for long periods – six months or more – is resistant to most medical treatments, and can cause severe problems. Chronic pain may begin as the result of an accident, injury or illness, or exist without any history of accident, injury, or illness or evidence of body damage.

The emotional toll of chronic pain may also make the pain seem worse, according to medical experts. Anxiety, stress, tension, fatigue, anger, and depression interact with chronic pain in complex ways, often causing the body’s production of natural painkillers to decrease while, at the same time, increasing the level of substances that amplify the pain sensations. This results in a vicious cycle for the person experiencing the pain. Research shows that the immune system may be suppressed or severely compromised by unrelenting pain.

Signals of chronic pain can remain active in the person’s nervous system for weeks, months, and even years. Such longstanding suffering may exact a physical as well as emotional toll on the patient.

Putting chronic pain into perspective, here are two statistics on arthritis and low back pain – common pain complaints among those over age 50 – that are pretty unnerving. Low-back pain disables 5 million people each year in the United States, and results in 93 million lost work days. Some 66 million Americans have arthritis and one-third of them are forced to restrict their daily activities because of pain.

Symptoms of Chronic Pain

Chronic pain symptoms include the following:

• Mild to severe pain that does not go away
• Pain that may be described as shooting, stabbing, aching, burning, or electrical
• Discomfort, tightness, stiffness, or soreness

Beyond these symptoms, other problems associated with chronic pain include:

• Fatigue
• Weakness
• Mood changes, including anxiety, depression, fear, hopelessness, irritability, and stress
• Inability to sleep
• Disability
• Compromised immune system
• Increased need to rest and withdrawal from activity

How Pain Management Works

Doctors have various treatment options at their disposal to help their patients manage pain. In fact, a whole industry has sprung up consisting of physicians who specialize in pain management. The treatments they use include physical neurological techniques or drug interventions. Pain management can help patients with either chronic or acute pain to achieve a more satisfying life or return to their normal lifestyle.

Each patient is thoroughly evaluated according to specific pain complaints, type of lifestyle, and overall health and well being. A treatment plan is recommended and the patient decides to go ahead with it or not.

Methods include acupuncture, spinal nerve block, trigger point therapy, physical therapy, synaptic, and, of course, pain medication. Sometimes psychotherapy helps patients learn new coping skills so they can adjust to or manage their pain. That’s because of the mind-body links associated with chronic pain.

Here’s a brief look at some types of pain management treatment:

• Trigger Point Injections – This is a procedure to treat painful areas of muscle that contain trigger points – or knots of muscles that form when muscles don’t relax. The physician or health care professional uses a small needle to inject a local anesthetic (which may include a steroid) into the trigger point. The trigger point becomes inactive and the pain is alleviated. Trigger point injections usually involve a brief treatment period and provide sustained relief from pain. This procedure has been used to treat muscle pain in the arms, neck, legs, and lower back, as well as fibromyalgia, tension headaches, and myofascial pain syndrome that do not respond well to other treatment.

• TENS – Transcutaneous electrical nerve stimulation therapy (TENS) uses electrical stimulation to lessen pain. Electrodes are placed on the patient’s skin near the source of the pain and low-voltage electrical current is delivered during the procedure. In effect, the electricity stimulated nerves in the affected area and sends signals to the brain that scramble pain signals. TENS is not painful for the patient and may prove an effective therapy for pain such as diabetic neuropathy. But TENS is not now recommended for low-back pain, according to the American Academy of Neurology.

• Bioelectric Therapy – This treatment blocks pain messages sent to the brain. It also prompts the body to produce chemicals called endorphins that decrease or eliminate painful sensations by blocking the pain message from going to the brain. Bioelectric therapy can be used to treat acute and chronic pain-causing conditions such as back and muscle pain, arthritis, headaches and migraines, TMJ disorder, scleroderma, and diabetic neuropathy. This therapy should be part of a total pain management program. It is effective in providing temporary pain control and, when used with conventional pain-relieving medications, may allow some pain sufferers to reduce their dose of some pain relievers by up to 50 percent.

• Physical Therapy – Working with a physical therapist, the patient is instructed in various stretching and other pain-relieving techniques. The physical therapist may also use TENS, heat, massage, and ice during the therapy sessions.

• Exercise – Research shows that regular exercise helps patients to diminish pain in the long term by improving strength, flexibility, and muscle tone. Exercise also produces endorphins in the body. These are the body’s natural painkillers. Exercise doesn’t need to be too strenuous to be beneficial, particularly to individuals who are elderly. Swimming, walking, rowing, yoga, and biking are easier than some other forms of exercise.

• Alternative Therapies – Acupuncture and the use of some nutritional supplements has shown benefits for relieving pain. Other alternative therapies, such as herbal and chiropractic therapies, massage, therapeutic touch, and dietary approaches seem to have potential for pain relief in some people.

• Mind-Body Therapies – These are treatments that help the mind’s ability to affect the body’s functions and symptoms. Mind-body therapies use various approaches, including guided imagery, meditation, relaxation techniques (such as meditation and yoga), electromyographic (EMG) biofeedback, hypnosis, and visualization. Another technique is to keep a pain diary, where you record pain episodes as to causes and corrective factors. Then, review the diary regularly to see where changes can be made. The idea is to view pain as part of your life, but not all of your life.

New Pain Treatments in Development

The good news for chronic pain sufferers is that there are some promising pain treatments currently in development. Some are disease-specific treatments, such as procedures that treat spine compression fractures to relieve back pain. Sodium-channel blocker drugs specific for pain cells are being developed, as well as chemicals isolated from plants, like hot peppers, which could reduce inflammatory pain in people with severe arthritis.

Researchers are also working on new synthetic opioids that have fewer side effects than the current drugs being prescribed to treat intractable pain, such as cancer and other severe pain.

Boomers and Pain

An estimated one in five older Americans regularly takes a painkiller. With all the boomers reaching retirement age and the plethora of television ads for prescription drugs for every kind of ailment, it’s no wonder that prescription drug misuse, abuse, and addiction are becoming more prevalent in America.

But that’s decidedly not the right road to take. Every person needs to be more aware of what’s going on with their body, see their doctor regularly, and take steps to prevent disease, accidents, and injuries in the first place. In addition, people need to learn how to take better care of themselves physically and emotionally. It’s not rocket science, but it does take discipline.

Learning how to manage pain, once you do have it, also takes discipline and a willingness to see it through. Getting up and exercising may not sound like a great idea when you have low-back pain, but your lower back muscles may have become atrophied from lack of use and this is exactly what may be needed. Gradual stretches, strength training, heat, massage, and ice are the techniques used in physical therapy. The theory is – and there’s a great deal of evidence to support it – when you strengthen your body, you’re better able to manage pain.

Naturally, you wouldn’t begin an exercise regimen without first consulting your doctor and getting a referral to a physical therapist, if that’s what is recommended in your situation. Your physician may also recommend that you get regular massage, go for acupuncture treatments, lose weight, or go for cognitive behavioral therapy (CBT).

Change Your Point of View

In the end, you don’t need to suffer needlessly. But you also don’t want to wind up addicted to painkillers just to get through the day. The first step is to see your doctor and discuss what’s going on with you. Together, you can work up a plan that is appropriate and less harmful to your health than endlessly taking drugs.

In the cases of intractable pain, a visit to the pain management specialist may be what’s necessary.

Remember that pain is a complex issue. There is no single solution for everyone. But each person does need to take responsibility for learning about and pursuing healthy ways to reduce pain and how to come to terms with it and still function.

Pain management – not pain elimination. Maybe changing your point of view is the first step in the right direction.