About Long Term Chronic Pain: Treatment and Prevention

Treatment for chronic pain blocks pain in the spinal cord nerves and in the nerves in the thalamus and cortex leading to the spinal cord. Treatments range from traditional medications to alternative therapies such as acupuncture.

Painkillers, also called analgesic drugs, are often used to lessen chronic pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (ASA), ibuprofen, and naproxen can provide some relief. Opiates, also referred to as narcotics, such as morphine and codeine, relieve pain, but there is a risk of becoming dependent on them, and they have some unpleasant side effects such as drowsiness, nausea, and constipation. For severe pain small amounts of opiates can be injected under the skin or into veins. Although many people fear becoming addicted to opioid medications, addiction is extremely rare when the medication is being used to treat pain. Addiction involves a psychological need to abuse drugs that is different from tolerance (needing higher doses of medication to keep the same level of pain control) and dependence (experiencing withdrawal symptoms if the medication is stopped suddenly).

Anesthetics such as lidocaine and mexiletene, given as ointments or patches, can relieve severe chronic pain if they're taken slowly and steadily in very small amounts.

Corticosteroids reduce the pain of bone cancer and anticonvulsant drugs such as carbamazepine relieve the pain of damaged nerves. Antidepressants can be taken to increase brain levels of serotonin. Serotonin is part of the body's natural pain relief system. Some types of antidepressants are also helpful for nerve-related pain.

Electrodes can also be implanted into the brain to release endorphins, natural pain relievers. This method is still experimental but works well. Transcutaneous electrical nerve stimulation (TENS) directs electrical energy to the painful sites on the body. The energy starts a natural reaction in the spinal cord that relieves the pain. Not all people respond to TENS, but it takes away the pain completely for some individuals.

If someone suffers from chronic pain that's carried by one or more specific nerves, they can have a nerve block. An injected anesthetic blocks the nerve from carrying the pain signals. Of people who have tried it, 50% were cured of pain, and the remaining 50% had the pain return within a year. People can also have the nerves destroyed by surgery or by hot or cold treatments. The pain can return, however, and some people may lose feeling or movement in the part of the body controlled by the destroyed nerve.

Acupuncture is used to treat many painful conditions, including migraine and back pain. In acupuncture, the acupuncturist will insert thin needles just under the skin at specific points on the body. Acupuncture probably stimulates natural anti-pain chemicals in the spinal cord. Relaxation and meditation techniques can help relax muscles, relieve anxiety, and stop the cycle of pain.

Biofeedback relieves chronic pain very well. In biofeedback, an instrument measures breathing, heart rate, and other specific bodily responses and feeds them back in the form of light or sound. People can then learn to control these bodily responses through relaxation and cognitive techniques.

Various forms of psychological treatments have been used to help relieve chronic pain. Cognitive behaviour therapy can help people substitute positive thoughts for negative ones. Behaviour therapy tries to change the attitudes of people with chronic pain.

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