Chronic Pain What is Chronic Pain? Chronic Pain is pain that last longer than six months. Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating. It is often the result of damaged tissue (nociceptive pain) or can be attributed to nerve damage (neuropathic pain). The pain may be caused by injuries, accidents, or health conditions; other times there is no clear cause for the pain. Signals of pain remain active in the nervous system for months to years, taking a toll on the person physically and emotionally. Further, pain can be increased or prolonged by psychological conditions such as depression, fear, stress, or anxiety. How is Chronic Pain Treated? Individualization is key! Work with your doctor to create an optimal treatment plan. Medication Types - Anti-inflammatories o Examples: Tylenol, Advil, Motrin, Naprosyn, Voltaren - Anticonvulsants o Seizure medications which have been effective in relieving nerverelated pain o Examples: Lyrica, Neurontin, Tegretol - Antidepressants: o Medications which adjust brain chemicals which help to control pain Examples: Elavil, Pamelor, Norpramin (tricyclic antidepressants); Cymbalta (SNRI- serotonin and norephinephrine reuptake inhibitor) - Pain relief creams: o Examples: Zostrix - Skin patches: o Examples: Lidoderm, Lidopain - Narcotics: o Used to treat severe pain; can become addictive but are effective for the right patients o Often combined with other medications to provide better relief o Examples: Codeine, fentanyl, morphine, oxycodone - Other: o Ultram ER: non-narcotic drug for moderate to moderately severe pain These medications need to be taken regularly—daily or at specific hourly intervals—to provide maximum relief. Other Targeted Procedures for Treating Chronic Pain - Nerve blocks - Radiofrequency ablation - TENS - Trigger point injection - Pain pacemakers - Spinal drug pumps - Surgery Non-Pharmacological Treatments: - Biofeedback (learning to control tension, breathing, heart rate) - Relaxation techniques (deep breathing, meditation, guided imagery) - Acupuncture Many people with chronic pain experience breakthrough pain. Breakthrough pain refers to flares of pain that occur even when pain medication is being used regularly. It can be spontaneous, set off by minor events such as rolling over in bed, or may be the result of medication wearing off before the next dose. What About Chronic Pain and my Emotions? - Chronic pain can be exacerbated by depression, anxiety, stress, and anger by reducing the body’s natural painkillers and increasing the body’s sensitivity to pain. - Counseling, both for the individual and their family, teaches coping skills to deal with chronic pain, helps to regain a sense of control, and improves the likelihood one will follow through with treatment. What Health Behaviors Can I Change? - Physical o Take part in low-impact activities (walking, swimming) to maintain muscle tone and fitness o Pace activities to avoid overactivity and underactivity o Take medications as prescribed - Social o Stay involved with friends and family o Engage in enjoyable activities o Discuss what is helpful and not helpful with those close to you Bottom Line: If you have pain, get it under control right away!