Medication alone may not be enough to manage certain kinds of pain. Some medicines are more effective in fighting pain when they are combined with other methods of treatment. In some cases, the patient's pain condition may respond to treatment instead of medication.
In fact, for some patients, certain therapies may eventually replace the need for taking any pain medicine, or less of it, over time. Here are just some of the available treatments being used successfully to treat pain patients.
Nonprescription Drugs - Milder forms of pain may be relieved by over-the-counter medications such as Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and Aleve. Both acetaminophen and NSAIDs relieve pain caused by muscle aches and stiffness, but only NSAIDs can also reduce inflammation (swelling and irritation). Topical pain relievers are also available, such as creams, lotions, or sprays that are applied to the skin in order to relieve pain from sore muscles and arthritis.
Prescription Drugs - If over-the-counter drugs do not provide relief, your doctor may prescribe stronger medications, such as muscle relaxants, anti-anxiety drugs (such as Valium), antidepressants, prescription NSAIDs such as Celebrex, or a short course of stronger painkillers (such as Codeine, Fentanyl, Percocet or Vicodin). A limited number of steroid injections at the site of a joint problem can reduce swelling and inflammation.
Trigger point injection - is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. During this procedure, a health care professional, using a small needle, injects a local anesthetic that sometimes includes a steroid into a trigger point. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief.
Injection treatments - Local anesthetics (such as Novocain®), with or without cortisone-like medicines, can be injected around nerve roots and into muscles or joints. These medicines reduce swelling, irritation, muscle spasms and abnormal nerve activity that can cause pain.
Nerve blocks - Often a group of nerves, called a plexus or ganglion, that causes pain to a specific organ or body region can be blocked with local anesthetics. If successful, another solution that numbs the nerves can then be injected.
Physical and aquatic therapy - The physiatrist or physical therapist may suggest an exercise program tailored for you that will increase your daily functioning and decrease your pain. Other treatments may include whirlpool therapy, ultrasound and deep-muscle massage.
Electrical stimulation - Transcutaneous electrical nerve stimulation (TENS) is the most common form of electrical stimulation used in pain management. It is not painful and does not require needles or medicine. TENS consists of a small, battery-operated device that can diminish pain by stimulating nerve fibers through the skin.
Acupuncture - This ancient Chinese practice uses very thin needles at very specific points on the skin to treat disease and pain. Practitioners of acupuncture undergo specialized training in these techniques and may offer this treatment for certain painful conditions.
Psychological support - Many patients who are in pain feel the emotional effects of suffering along with the physical aspects of pain. These may include feelings of anger, sadness, hopelessness or despair. In addition, pain can alter one's personality, disrupt sleep, interfere with work and relationships and often have a profound effect on family members. Support and counseling from a psychiatrist or psychologist, combined with a comprehensive pain treatment program, may be needed to help you manage your condition. These trained professionals also can teach you additional self-help therapies such as relaxation training or biofeedback to relieve pain, lessen muscle spasms and reduce stress.
Surgery - When necessary, surgical treatment may be recommended. In rare instances when severe pain has not responded to other treatments and procedures, surgery on certain nerves can be done to give the patient some relief and allow them to resume near-normal activities. Usually all other avenues of treatment are tried before surgery is considered.
