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!