| Management of Chronic Pain |
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Making the journey from patient to person takes time. The isolation and fear that can overwhelm
a person with chronic pain grows over time. And the return to a fuller, more rewarding life also
takes time.
Learn all you can about your physical condition. Understand that there may be no current cure and accept that you will need to deal with the fact of pain in your life.
Take an active role in your own recovery. Follow your doctor's advice and ask what you can do to move from a passive role into one of partnership in your own health care.
Look beyond your pain to the things that are important in your life. List the things that you would like to do. Setting priorities can help you find a starting point to lead you back into a more active life.
We all walk before we run. Set goals that are within your power to accomplish or break a larger goal down into manageable steps. And take time to enjoy your successes.
We all have basic rights. Among these are the right to be treated with respect, to say no without guilt, to do less than humanly possible, to make mistakes, and to not need to justify your decisions, with
words or pain.
Our bodies and minds are one. Emotions directly affect physical well being. By acknowledging and dealing with your feelings, you can reduce stress and decrease the pain you feel.
Pain increases in times of stress. Relaxation exercises are one way of reclaiming control of your body. Deep breathing, visualization, and other relaxation techniques can help you to better manage the pain
you live with.
Most people with chronic pain fear exercise. But unused muscles feel more pain than toned flexible ones. With your doctor, identify a modest exercise program that you can do safely. As you build
strength, your pain can decrease. You'll feel better about yourself, too.
As you learn to set priorities, reach goals, assert your basic rights, deal with your feelings, relax, and regain control of your body, you will see that pain does not need to be the center of your life.
You can choose to focus on your abilities, not your disabilities. You will grow stronger in your belief that you
can live a normal life in spite of chronic pain.
To regain control of your life, it is important to learn how to cope with chronic pain. Although your pain may never go away, it is possible to reduce pain levels and, more importantly, to improve the
quality of your life.
To do so, you may need a multidisciplinary approach to chronic pain. While many people with pain have tried
every available medical intervention without great success, sometimes these therapies are most effective
when performed together in a controlled setting.
A multidisciplinary pain program can provide you with the necessary skills, medical intervention, and direction
to effectively cope with chronic pain. Here is advice on how to locate a pain management program in your
area, what to look for in a well-defined pain program, and what other issues to consider.
Consumer Guidelines to Selecting a Pain Unit
Try to meet several of the staff members to get a sense of the people you will be dealing with while on the unit. The program should have a complete medical staff trained in pain management techniques
including:
Make sure the program includes most of the following features:
Be sure your family can be involved in your care:
Also consider these additional factors:
Make sure that, before accepting you, the unit reviews your medical records and gives you a complete physical evaluation to be sure you can participate in the program. Obtain copies of your recent
medical records to prevent duplicate testing. Try to talk with both present and past program participants to
get their feedback about their stay on the unit. Pain programs are difficult, but pain management can make a
significant difference in your life. You must realize, however, that much of what you gain from comprehensive
pain management will be up to you.
Your pain physician may suggest that you use certain over-the-counter pain relievers or may prescribe
stronger medicine for your condition. Do not mix pain prescription drugs with over the counter pain relievers
without consulting your physician. Advise your doctor if you are taking any herbal medicines or dietary
supplements.
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.
a person with chronic pain grows over time. And the return to a fuller, more rewarding life also
takes time.
 | Accept the Pain |
| Get Involved |
| Learn to Set Priorities |
| Set Realistic Goals |
| Know Your Basic Rights |
words or pain.
| Recognize Emotions |
| Learn to Relax |
you live with.
| Exercise |
strength, your pain can decrease. You'll feel better about yourself, too.
| See the Total Picture |
You can choose to focus on your abilities, not your disabilities. You will grow stronger in your belief that you
can live a normal life in spite of chronic pain.
| Choose a Multidisciplinary Pain Program |
quality of your life.
To do so, you may need a multidisciplinary approach to chronic pain. While many people with pain have tried
every available medical intervention without great success, sometimes these therapies are most effective
when performed together in a controlled setting.
A multidisciplinary pain program can provide you with the necessary skills, medical intervention, and direction
to effectively cope with chronic pain. Here is advice on how to locate a pain management program in your
area, what to look for in a well-defined pain program, and what other issues to consider.
Consumer Guidelines to Selecting a Pain Unit
 | Make sure you locate a legitimate program | |
| Hospitals and rehabilitation centers are more likely to offer comprehensive treatment than | |
| are "stand alone" programs. Facilities that offer pain management should include several specific components, listed below |
| The Commission on Accreditation of Rehabilitation Facilities Toll Free Telephone: | |
| (800) 281-6531 can provide you with a listing of accredited pain programs in your area (your health insurance may require that the unit be CARF accredited in order for you to receive reimbursement). | ||
| You can also contact the American Pain Society, an organization for health care | |
| providers, at (847) 375-4715 additional information about pain units in your area. | ||
| American Pain Foundation Toll-Free at 1-888-615-PAIN (7246) |
| Choose a good program that is convenient for you and your family: | |
| Most pain management programs are part of a hospital or rehabilitation center. The | |
| program should be housed in a separate unit designed for pain management. | ||
| Choosing a program close to your home will enable you to commute to the program each | |
| day. | ||
| Learn something about the people who run the program: |
including:
 | Physician (a neurologist, psychiatrist, physiatrist, or anesthesiologist with expertise in pain | |
| management) | ||
| Registered nurse | |
| Psychiatrist or psychologist | |
| Physical therapist | |
| Occupational therapist | |
| Biofeedback therapist | |
| Family counselor | |
| Vocational counselor | |
| Massage Therapy | |
| Other personnel trained in pain management intervention |
Make sure the program includes most of the following features:
| Biofeedback training | |
| Group therapy | |
| Counseling | |
| Occupational therapy | |
| Family counseling | |
| Assertiveness training | |
| TENS units | |
| Regional anesthesia (nerve blocks) | |
| Physical therapy (exercise and body mechanics training, not massage, whirlpool, etc.) | |
| Relaxation training and stress management | |
| Educational program covering medications and other aspects of pain and its management | |
| Aftercare (follow-up support) |
Be sure your family can be involved in your care:
| Family members should be required to be involved in your treatment. | |
| The program should provide special educational sessions for family members. | |
| Joint counseling for you and your family should also be available. |
Also consider these additional factors:
| What services will your medical insurance reimburse and what will you be expected to | |
| cover? | ||
| Will you need a PCP referral? | |
| What is the unit's physical set-up (is it in a patient care area or in an area by itself)? | |
| What is the program's length? | |
| Is the program inpatient or outpatient | |
| If you choose an out-of-town unit, can your family be involved in your care? | |
| Do you understand what will be required of you (responsibility to take care of personal | |
| needs, etc.)? | ||
| Does the unit provide any type of job retraining? |
Make sure that, before accepting you, the unit reviews your medical records and gives you a
medical records to prevent duplicate testing. Try to talk with both present and past program participants to
get their feedback about their stay on the unit. Pain programs are difficult, but pain management can make a
significant difference in your life. You must realize, however, that much of what you gain from comprehensive
pain management will be up to you.
Your pain physician may suggest that you use certain over-the-counter pain relievers or may prescribe
stronger medicine for your condition. Do not mix pain prescription drugs with over the counter pain relievers
without consulting your physician. Advise your doctor if you are taking any herbal medicines or dietary
supplements.
| Common pain relievers - Nonaspirin pain relievers such as acetaminophen (Tylenol®) | |
| can relieve headaches and minor pain but do not reduce swelling. They are sometimes used in combination with other drugs to provide greater pain relief. |
| Anti-inflammatory drugs - Aspirin (Anacin®, Bayer®), coated or buffered aspirin | |
| (Ascripton®, Bufferin®) and aspirin with acetaminophen (Excedrin®) may be used to reduce swelling and irritation as well as to relieve pain. There also are non-steroidal anti- inflammatory drugs (NSAIDs, commonly called "N-sayeds") such as ibuprofen (Advil®, Motrin®) and naproxen (Aleve®). Anti-inflammatory drugs are used to relieve pain, inflammation and fever. There also are steroidal drugs (like cortisol and prednisone), available only by prescription, that are used to treat more serious inflammatory conditions such as chronic arthritis. |
| Opioid pain medications - Morphine-like drugs called opioids are prescribed to treat | |
| acute pain or cancer pain. They are occasionally used for certain chronic, noncancer pain as well. |
| Anti-depressants - These drugs were originally used only to treat depression. Studies | |
| now show, however, that they also can relieve certain pain. Available only by prescription, they often are used to help you sleep better at night. |
| Anti-seizure medicines - These medications are used to relieve what some patients | |
| describe as "shooting" pain by decreasing abnormal painful sensations caused by damaged nerves. |
| Other medicines - The doctor may also prescribe other types of medication that will be | |
| helpful for your specific pain problems. In addition, medications that counteract the side effects of opioids or treat the anxiety and depression associated with pain may also be prescribed. |
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.
| 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, surgery may be recommended. | |