The Medications And Therapy Used In A Pain Management Clinic
Pain Clinics – What Are They & What Do They Do?
Typically, a pain clinic is a location where doctors offer solutions to intractable pain. Conditions that generally respond well to pain clinic services are arthritis, back pain, and cancer. In addition, migraine headaches, shingles pain, and carpal tunnel syndrome pain frequently respond favorably to pain clinic treatments. Many primary care doctors refer their patients to pain clinics when they have exhausted other methods of pain relief.
Generally, pain management that is offered at a pain clinic include a combination of therapies. These treatments include medications, physical therapy, and nerve blocks. In addition, massage therapy is often an effective treatment for pain relief, swelling and stress. Not only does the pain clinic treat acute pain, it also performs diagnostic services to determine where the pain is originating.
There are two main types of pain clinics.
Interdisciplinary Clinics: Are one-stop shops where a team of health professionals works together to help patients by using a variety of evidence-based approaches. Programs that utilize an interdisciplinary approach are best, says Clauw, and may include physical and occupational therapists, psychologists, dietitians, nurses, doctors and other healthcare providers.
Block Clinics: Offer procedures such as injections and nerve blocks. These procedures are usually performed by an anesthesiologist, most often for specific problems such as low back or neck pain. But unless your doctor refers you to this type of provider, Clauw advises against block clinics.
How is chronic pain treated?
Although no single cure is available for chronic pain, there are many ways to treat and manage it. The first step should be to treat any underlying conditions that may cause pain. These treatment methods will vary according to the specific disease or medical condition. The treatment also will depend on the type of chronic pain involved.
Non-drug treatments for chronic pain
- Exercise: Light to moderate exercise may help improve blood and oxygen flow to muscles and reduce stress. It may be especially helpful for people with low back pain, arthritis, psychogenic pain, and many others.
- Heat and/or cold application: Applying heat and/or cold regularly to a sore area via a safe mechanism (such as hot or cold packs that have temperature limits built in to prevent burning or freezing skin) can be very effective for treating many types of pain.
- Acupuncture: Acupuncture done by a trained therapist can provide relief for all types of chronic pain.
- Massage: Massage therapy has been shown to be effective for muscle and mechanical pain and may be useful for other kinds of chronic pain as well.
- Spinal cord stimulation: Electrodes are placed inside the epidural part of the spinal cord. The patient can send electrical pulses to the spinal cord using an implanted electrical pulse generator. The electrical impulses interrupt the pain signal to the brain providing relief.
- Deep brain stimulation: This technique is only used to treat chronic pain in cases that do not respond to more conservative treatment. It requires surgical stimulation of areas of the brain, usually the motor cortex or thalamus.
IF I AM TAKING NARCOTIC (OPIOID) MEDICATION FOR CHRONIC PAIN, DOES THAT MEAN I AM ADDICTED?
Taking opioids in the way that they have been prescribed by your doctor for the treatment of chronic pain is associated with a very low risk of becoming addicted to those opioids. There are some predisposing factors to opioid addiction. These include having a history or a family history of substance abuse or of certain psychiatric illnesses. The following are definitions for addiction, tolerance, and physical dependence according to the American Pain Society:
- Addiction has a genetic basis in addition to a psychological aspect to the behavior. Addiction is associated with a craving for the abused substance (such as an opioid), and continued, compulsive use of that substance despite harm to the person using the substance. In addition to having a genetic predisposition, there may be an environmental influence affecting both the development and manifestation of the additive behavior.
- Tolerance occurs after prolonged exposure to a drug. The effects of that drug results in progressive decrease in its effectiveness.
- Physical Dependence is usually seen in the form of drug withdrawal after the drug has been abruptly stopped or rapidly reduced. It can also be seen when an opioid antagonist is given to someone who is taking an opioid. It is a state of adaptation. Withdrawal symptoms last from approximately 6 to a peak of 24 to 72 hours after the drug has been withdrawn. Some of the symptoms include nausea, vomiting, sweating, abdominal pain or diarrhea and can occur after taking the opioid for as short a period as 2 weeks. It is not a sign of addiction.
If you are prescribed opioids by your doctor, you are to take the opioids as they have been prescribed. If your pain continues despite taking the opioid, it is inadvisable to take more opioid than prescribed without first seeking the advice of your doctor. Taking a long-acting opioid a few times per day is less likely to give the sensation of euphoria that may be associated with some short acting opioids. Long-acting opioids are not meant to be taken on an “as needed” basis and should be taken whether or not you have pain and should not be taken more frequently than prescribed by your doctor. Constipation is one of the more frequently seen side effects of chronic opioid use, remedies, such as stool softeners and stimulants, are available.
Reduce stress in your life. Stress intensifies chronic pain.
Negative feelings like depression, anxiety, stress, and anger can increase the body’s sensitivity to pain. By learning to take control of stress, you may find some relief from chronic pain.
Several techniques can help reduce stress and promote relaxation. Listening to soothing, calming music can lift your mood — and make living with chronic pain more bearable. There are even specially designed relaxation tapes or CDs for this. Mental imagery relaxation (also called guided imagery) is a form of mental escape that can help you feel peaceful. It involves creating calming, peaceful images in your mind. Progressive muscle relaxation is another technique that promotes relaxation.