Treatments For PAIN

Are you in pain but avoid going to the doctor because you hate hospitals? There are many of us who’d rather like to suffer from pain than visiting a doctor. We either hate the smell and feel of hospitals, or don’t like the idea of popping pills. So why not consider alternative treatments for pain management?
Pain is one of the most common causes for seeing a doctor worldwide. It is the major symptom in many physical ailments and may adversely affect the functioning capacity of an individual and deteriorate the quality of life. Pain may spring from a broken bone, dislocated or worn-out joint, bruised muscle, strained or sprained ligament, impinged nerve or irritation of nerve roots.
What is alternative pain treatment?
Pharmaceutical medications may not be the only means of pain relief available to you. Nowadays, alternative treatments for pain management are becoming increasingly popular. The term alternative treatment refers to a therapeutic intervention or medical treatment that does not enjoy adequate scientific documentation or approval as a safe and effective means to treat a specific medical condition.
But nowadays, a marked craze for various alternative treatments is noticeable among the masses. People have realized that pharmaceutical drugs are not free from side-effects. So they think that the alternative treatment forms are a better option to rely upon. Our focus of discussion now will be on the various alternative treatments for pain management. Each type differs from one another in terms of principles and methodology.
Are they safe?
Yes, these methods are almost always safe. And in fact these are safer than most of your allopathic medications and treatments because they aren’t accompanied by side effects.
Alternative pain treatments like acupressure and acupuncture are safe, and so are mind-body therapies. Most treatments that will use medication will also be herbal-based.
7 Top pain relief alternative therapies
The various alternative treatments or therapies for pain management are discussed below:
1. Mind-body therapies                                                                                                                                                                                                                            These therapies encompass various modes of treatment directed to enhance the mind’s ability to control bodily functions and symptoms of the diseased body. Hypnosis, meditation, bio-feedback, guided imagery and relaxation techniques are some approaches that fall under the label of the mind-body therapies. These approaches claim that they can alleviate chronic pain-related discomfort.
2. Acupuncture and acupressure
Acupuncture is a mode of treatment that originated in China in the 16th century. It involves the use of very fine needles that are poked into the patient’s body. This method of treatment fosters the balance of energy in the body. The needles are poked in certain points of the body and this stimulates the vital energy meridians of the body. The World Health Organization certifies acupuncture as an effective pain relief method. Acupressure‘ is based on the same theory as acupuncture. But here, instead of needles, pressure is applied at the distinct points of the body.
3. Chiropractic treatment and massage
Chiropractic treatments claim to alleviate pain in patients suffering from back and neck pain. But their effectiveness as a pain management mode is still very much under research. Massage, if done perfectly, can relieve pain. It takes off pain by boosting blood circulation and eliminating tension and stiffness from the affected region of the body. Massaging can also stop the production of certain pain-generating chemicals in the body. Massaging like chiropractic treatments can lessen back pain and neck pain.
4. Therapeutic touch and Reiki
These methods claim to energize the self-healing processes within the patient’s body. These methods do not require any physical proximity between the patient and practitioner. It is a flow of positive energy that can travel through any medium and brush aside pain or any other bodily disorder. The efficacy of these modes of treatments is yet to be proved.
5. Herbal remedies
There are many pain relief herbs like capsaicin, turmeric, fever few, devil’s claw, kava kava, ginseng and ginger. But before using these herbs, one needs to consult a doctor because sometimes some herbs may react with other medications and produce undesirable side-effects.
6. Nutritional supplements
Certain nutritional supplements can alleviate pain and there is a definite evidence of this in the various scientific studies. Fish oil supplements, chondroitin sulfate, glucosamine sulfate are some among the many nutritional supplements that can manage pain.
7. Pain healing dietary approaches
It is believed that by curbing the intake of dietary fat and switching over to pure and raw plant food, one can get relief from pains and aches. This dietary change actually checks the inflammatory response in the body and thereby eases pain.
So now you know about the various alternative treatments for pain management. But remember that none of these measures are scientifically proven. If you don’t want to try anything that isn’t backed by science, allopath treatment is your only solution. It is, however, recommended to consult your doctor before opting for any of these.

Vancouver Acupuncture Treatments For PAIN

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Vancouver Acupuncture Treatments For PAIN

Qi Integrated Health clinic in Kitsilano Vancouver is known for utilizing acupuncture to treat both acute and chronic pain. The following is the treatment summary for one of our patients who experienced pain relief through her acupuncture treatments:

“Recently, a patient came into our clinic with “frozen shoulder” (inability to lift the shoulder past 15 degrees). The patient was experiencing a consistent high level of pain that made day-to-day activities very uncomfortable. After a comprehensive intake, a treatment protocol of acupuncture and e-stim combined with cupping was indicated. Upon completion of 3 treatments in a 10-day period the patient had regained full range of motion in their shoulder. The patient has not experienced any reoccurring symptoms since undergoing our HEAL process of treatment.”

Read more of our patients success stories here.

Using Acupuncture to Treat Pain – H.E.A.L. Process

We treat PAIN! You can be assured that when you receive your acupuncture treatments at Qi Integrated Health that you will receive the best treatment possible. All of our practitioners are highly qualified and are registered professionals in BC. Our acupuncturists are Registered Acupuncturists governed by the CTCMA. A portion of our treatments are covered by MSP and extended health plans if you are eligible.

Our Acupuncture healing process comprises 4 stages: H.E.A.L.

Help – The help stage is defined when the patient is unable to go more than 3 days without pain, despite undergoing any current treatment such as oral pain medication, massage, physiotherapy, etc.

Following intake, assessment and diagnosis, the typical treatment protocol is 3 acupuncture treatments over a period of 10 days. This allows us to determine how your acute or chronic pain symptoms respond to acupuncture treatment. The addition of treatment tools such as cupping, e-stim, or topical herbal medication may also be incorporated into the treatment.

Once the patient is able to go 3 or more days without pain we can move onto the next stage of the H.E.A.L. process.

Educate – The second stage of H.E.A.L. involves educating the patient to supplement their healing process with the reintroduction of exercise. We introduce proper exercise and stretching techniques that work with their therapeutic treatment to facilitate a more rapid recovery process. With stretching we target the muscle groups that have been guarding or bracing the site of injury/weakness and work to release those muscles. With exercise we look to create strength in order to support lasting changes.

During this stage the patient will visit the clinic once every 7-10 days. Treatment consists of acupuncture, and may also incorporate chiropractic care, massage therapy, and/or yoga therapy* in conjunction (on the same day or spaced apart depending on what the condition indicates). This stage may have many small setbacks on the road to change, but once the patient is able to exercise fully with a normal response (24 hours or less of pain) we can move onto the Action stage of the H.E.A.L. process.

*Yoga Therapy with Dr. Robin Armstrong is covered under chiropractic for extended medical benefits.

Action - By this stage the patient has the ability to be more physically active and will have regained full range of motion. The patient recognizes the difference between good vs. bad pain and has the knowledge/tools to deal with it. Good pain lessens over 24 hours; bad pain either doesn’t change or gets progressively worse. During this stage, follow up appointments are once every 3 weeks or so to maintain progression of strength and healthy balance in the body. Once the practitioner determines that balance is properly restored, we move onto the final stage of H.E.A.L. – LIVE.

Live – At this stage, the patient is able to resume a regular, pain-free life. Once balance within the body is established and remains consistent, “tune up” acupuncture treatments can be once every season. Because we are such creatures of habit, flare-ups can sometimes occur. If the pain does flare up, we start back at the beginning of the H.E.A.L. process. The patient will typically move through the process more quickly this time, as the path to balance has already been laid out and the body just needs a reminder in order to correct itself.

less painful allergy treatment changed life

Man said new, less painful allergy treatment changed life
“I don’t have to worry about being outdoors and worrying about what’s going to happen afterwards,” he said.

OKLAHOMA CITY – Joel Baker is a pastor at a local church.
When he realized his allergies were affecting his quality of life, he knew he needed to take action.
“I had to have boxes of tissues around all the time,” he said.
He started the standard treatment of allergy shots.
“I had to give it to myself in the thigh; it was a pain literally a pain,” he said.
Now Joel has found something that works even better and is far less painful.
He puts a drop under his tongue every day; it’s called sub-lingual immunotherapy.
Dr. Mark Lipe from the Allergy Artists of Oklahoma said, day by day, the drops build up your tolerance.
“We are exposing the patient to the allergens so they can build up their immune system,” he said.
Lipe said the treatment can be used for infants and small children because there is less risk of shock.
“It’s significantly safer than tradition shot therapy,” he said. “It’s a much more natural way to be exposed to these antigens. You’re exposed through mucus membranes and so it’s a much more natural way that you’re exposed.”
For Joel, it is pain-free and life-changing.

The pain neuropathy and

To use psychological therapy on a problem that is biochemical in nature (meaning nutritional) is absurd and wrong-minded. Success is extremely doubtful and certainly will not happen over the long run if it’s the placebo effect that makes it seem as though success is reachable.
Diabetic neuropathy with its pain is so debilitating. The pain leads to a more sedentary life style, a negative attitude that makes it more difficult to stick to diet. The weight gain and poor diabetic control worsen the neuropathy and the pain. The available medications provide some relief at the cost of side affects. This study which shows a way to improve life style and symptoms without medication and its attendant side affects is welcome. Will there be enough providers capable of providing the CBT for the vast number of patients suffering from diabetic neuropathy? The study data may also be applicable to people with type I diabetes as well as other patients who have pain. I look forward to extending this approach into these areas.


To use psychological therapy on a problem that is biochemical in nature (meaning nutritional) is absurd and wrong-minded. Success is extremely doubtful and certainly will not happen over the long run if it’s the placebo effect that makes it seem as though success is reachable.

Challenge thoughts to treat diabetic pain

Challenge thoughts to treat diabetic pain
This work was supported by a grant from the Veterans of Foreign Wars to the diabetes research program at VA BHS.
"This study demonstrates that the millions of people who are experiencing pain and discomfort from type II diabetes mellitus do not need to rely solely on medication for relief," says John D. Otis, associate professor of psychiatry at Boston University School of Medicine. (Credit: iStockphoto)
BOSTON U. (US) — A type of psychological therapy that focuses on changing negative thoughts and behaviors can help relieve pain for people with painful diabetic neuropathies, research shows.

No ‘study drugs’ for healthy kids, say doctors
Published in the Journal of Pain, a new study is the first to examine cognitive behavioral therapy (CBT) as treatment for people with type II diabetes mellitus, the most common form of the disease that affects more than 20 million people in the US.
The onset of type II diabetes mellitus is often gradual, occurring when a person is unable to make or use insulin efficiently. As a result, abnormally high levels of sugar accumulate in the blood, resulting in a condition called hyperglycemia.
Straight from the Source
Untreated hyperglycemia can develop into diabetic neuropathies, or nerve damage, which causes painful burning and stinging sensations in the hands and feet and permanent nerve damage. Although pain medications for this condition exist, they often have negative side effects such as headaches, dizziness, and nausea.
Researchers assessed whether CBT, a psychological treatment approach aimed at changing maladaptive thoughts and illness-supporting behaviors, could be of benefit to veterans with painful diabetic neuropathies.
The study, which was conducted at the VA Boston Healthcare System, compared participants receiving CBT to those receiving treatment as usual. Participants were US veterans 18 and older who had been diagnosed with type II diabetes and experienced neuropathic pain for more than three months.
Participants attended 11, hour-long CBT sessions, which focused on teaching participants relaxation techniques and how to identify and challenge thoughts that contribute to pain. In addition, participants were taught how to keep active and plan enjoyable activities such as exercise, going for walks, or having dinner with friends.
At a four-month follow-up, participants who received CBT reported feeling less pain and reported that pain interfered less with their daily lives when compared to participants who received standard treatment.
“This study demonstrates that the millions of people who are experiencing pain and discomfort from type II diabetes mellitus do not need to rely solely on medication for relief,” says John D. Otis, associate professor of psychiatry at Boston University School of Medicine.
“More broadly, the results of this study add to a growing body of literature demonstrating that cognitive behavioral therapy is an effective psychological treatment approach for chronic pain management.”

‘Pretty tough’ O.J. Mayo plays through pain but will undergo treatment

‘Pretty tough’ O.J. Mayo plays through pain but will undergo treatment

O.J. Mayo was having a sterling night until he came down awkwardly late in the third quarter and came up favoring his right ankle.

Mayo limped to the bench, but returned early in the fourth quarter.

“It’s OK,” Mayo said. “But get to me tomorrow morning. That’s how those things go.”

Mayo said he will get treatment overnight and see how it feels Monday at practice in Milwaukee.”

“I think he’s sore, but he went back in and seemed to be OK,” Carlisle said. “He’s pretty tough. He hasn’t missed anything all year, so I was encouraged he was able to go back in the game. I’m sure it’ll be sore, but hopefully he’ll be OK for Tuesday.”

Also on the injury front, Shawn Marion missed his second consecutive game with a bruised left calf muscle. Marion said he was hoping to go through practice Monday in Milwaukee and try to play against the Bucks on Tuesday.

Marion suffered the injury in the first quarter of Wednesday’s win over Houston. He sat out at Detroit on Friday, as well as Sunday’s match with Minnesota.

“It’s sore to the touch,” Marion said. “I can feel it when I walk.”

Gout Treatment

What You Know About Gout Treatment



Once you’ve been diagnosed with gout by a doctor, it’s a good idea to start learning about gout treatment immediately. Since gout treatment includes both preventing future episodes, and treating them when they occur, sticking to your routine can help to prevent a lot of pain and medical expenses!

In this article, we’ll look at both aspects of gout treatment – starting with prevention, and then looking at how to treat an active episode.

Gout Treatment – Preventing Gout Attacks


A big part of gout treatment is about preventative medicine. You don’t want to experience the pain, discomfort, and unpleasantness of a gout attack, and there are several things you can do to achieve that.

Speak to your doctor about a medication that helps to eliminate the uric acid from your body faster. There are several forms of gout treatment, including Uricosuric agents, and xanthine oxidase inhibitors, which work differently, but are both effective parts of gout treatment and prevention.
Watch your weight. Being overweight puts more strain on your joints, and it increases the risk that your gout will flare up.
Avoid alcohol, and in particular, beer. Beer has been proven to cause your body to release more uric acid, and it works against your gout treatment.
Watch your diet, and avoid meat and seafood when possible. These contain high levels of a chemical called purine, which is particularly bad for gout sufferers.
Exercise moderately.
Speak to your doctor about your other medication. Some medication, like aspirin, while good for your heart, may raise your uric acid levels, and trigger a gout episode.
Gout Treatment – Treating Gout Attacks


Even if you are careful about gout prevention, there will probably still be times when gout treatment is necessary. Here are a few tips to help reduce the symptoms of an attack:

The first thing your doctor will recommend, in most cases, when you’re looking for gout treatment, is rest. You will need to elevate the joint, and not use them.
Your doctor will probably also prescribe an anti inflammatory, like ibuprofen, but remember, aspirin can make gout symptoms worse, so don’t take it, or any other over the counter drugs, until you have spoken to your doctor.
In severe cases, and depending on your doctor’s advice, your gout treatment may also include colchicine, and corticosteroids.
When it comes to illnesses like gout, the old adage ‘prevention is better than cure’ certainly, hold true. Waiting to treat gout, rather than practising preventative measures, can mean that you have to live with a lot more pain than is strictly necessary – and no one wants that! A few lifestyle changes, and a good doctor, who understands the disease, can make all the difference.

However, it should be comforting to know that you don’t have to suffer without any relief – in fact, there are several treatments that can be effective. So whether you’ve been newly diagnosed, or whether you have been suffering from gout some time, it’s worth finding out more about gout treatment, and avoiding at least some of the pain and discomfort.

Tooth pain - Tooth pain causes, prevention and treatment

Tooth pain is a common symptom, tooth pain usually refers to pain around the teeth or jaws, indicating inflammation and possible infection.

Tooth pain causes - Some of the most common causes are:
Most of tooth pain from gingivitis and periodontitis, dental caries (tooth decay) or fractured teeth and lead to the pulp (nerve teeth) caused by the infection.
tooth decay (dental caries)Tooth fracture gum disease, Infected gumsloose or broken fillingdental abscessAn exposed tooth root, Tooth Root Sensitivities.
The following problems can also cause symptoms similar to tooth pain, These include (but are not limited to):
ear infection
oral cancer
ulceration of the soft tissues can sometimes be mistaken for toothache.
Tooth pain symptoms:
There may be severe pain to pressure, or to hot or cold stimul. The pain can also get worse when you lie down because more pressure is put on the tooth.
Pain with chewing, particularly if the food or drink is hot or cold.Hot or cold sensitivityswelling around the tooth, and swelling of the jaw.

Tooth pain treatment and prevention
Self-Care at Home
1. rinsing with warm salt water
2. using dental floss to remove any food particles
3. taking aspirin or acetaminophen to relieve pain
4. using clove oil to numb the gums;
5. Avoid very cold or hot foods because this may make the pain worse.

Professional treatment
Treatment will depend on the underlying cause of the tooth pain.In most cases, dental or jaw pain can be cared for with pain medications and antibiotics.In some cases, the doctor may try an injection around the tooth for pain control. Fillings , pulling teeth, or other procedures may be performed as required.

Tooth Root Sensitivities: Flouride gel and sensitivity toothpastes that contain flouride will both help the root to become stronger and in turn reduce the toothache.

Tooth Decay: Tooth decay is the destruction of tooth enamel by dental plaque that causes holes known as cavities. In most cases, a dentist treats cavities by using a dental drill to remove the decayed material before filling the remaining space with dental amalgam or composite resin. The obvious prevention for tooth decay is to eat as little sugar. Fluoridation and dental sealants can also help prevent decay. Brush your teeth at least twice a day with a fluoride-containing toothpaste. Preferably, brush after each meal and especially before going to bed.

Gum Disease: Gum disease, including gingivitis and periodontitis. Gum disease is usually preventable. Brush twice a day for at least 3 minutes each time and floss daily. Don't smoke! Cigarettes and chewing tobacco cause mouth irritation and are very unhealthy for gums and teeth. If the bone has been destroyed, your dentist may employ a new technique called tissue regeneration, which involves grafting the bone to offer a better chance of bone re-growth.

Vaporized of Marijuana Effective Pain Treatment

Vaporized Marijuana is a Safe and Effective Pain Treatment


“Both the low and medium doses proved to be salutary analgesics for the heterogeneous collection of neuropathic pain conditions studied.…


When we talk about the medicinal benefits of marijuana, those who disapprove of its use tend to roll their eyes. But the fact is, this powerful plant has numerous potential applications in healthcare and pain management in particular. A new study has once again demonstrated that the vilified plant can safely and effectively treat general pain along with the painful symptoms of neuropathy.

Neuropathy is damage to the nervous system – particularly the peripheral nervous system (not including the brain and spinal cord). It is characterized by pain and numbness especially in the hands and feet, and is often the result of diabetes. Neuropathy can also be caused by injuries, toxic exposure, infections, and more.

This latest study was conducted by researchers at the University of California Davis Medical Center and was published in The Journal of Pain. It was a double-blind, placebo-controlled, crossover study that looked at the effectiveness of using vaporized, inhaled cannabis in 39 participants. These participants were experiencing neuropathic pain despite having tried traditional treatments (like opiate drugs). All participants continued to take their prescribed medications throughout the 4 week study period.

Researchers gave participants doses of cannabis with moderate THC levels (3.53 percent) or low THC levels (1.29 percent). (THC, or tetrahydrocannabinol, is the plant’s primary psychoactive chemical). Some also received a placebo with no THC. They found both doses of cannabis to be effective in reducing pain significantly.

Control Cancer Pain - Overview

Cancer Pain - Overview
There are many other ways to control cancer pain, including:

Heat or cold.
Massage, exercise, and physical therapy.
Relaxation exercises, biofeedback, or guided imagery.
Acupuncture.
Older adults are at risk for not getting enough pain medicine. If you are a caregiver for an older adult who has cancer, talk with that person to make sure that the pain is under control. Talk with the person?s doctor, too, about a pain management plan.

Learning as much as you can about your pain may help. Talking to a counselor can help you manage your cancer pain or the discomfort from cancer treatments. Emotional support from your friends and family may also help.

What is a pain control diary?
This is a record of your pain treatment and how it helped or did not help you. You can write down when you used each treatment, how it worked, and any side effects it caused. Having it written down helps you let your health care team know exactly how well your treatment is working.

Will you get addicted to pain medicine?
Many people who take pain medicine worry about getting addicted. Addiction to pain medicine is rare if you have not had a problem with addiction in the past and you take your medicine as directed under your doctor?s care. When you no longer need these medicines, your doctor will slowly lower the amount you are getting until your body no longer needs the medicine.

Do not let your fear about becoming addicted get in the way of pain relief. Ask for pain relief if you need it. Pain is easier to control when you treat it as soon as it starts. You may also be able to predict pain and treat it before it begins, such as before physical activity. Pain is harder to control if you wait until it is bad.

Cancer Pain - Overview

Cancer Pain - Overview
Can cancer pain be controlled?
Cancer pain can be controlled in almost every case. This does not mean that you have no pain, but it does mean that the pain stays at a level that you can bear.

Cancer and its treatments can be painful. A tumor that presses on bones, nerves, or organs can cause pain. Surgery for cancer can cause pain. So can chemotherapy and radiation. Some medical tests, such as bone marrow aspiration, can also cause pain. There are a number of ways to control each of these kinds of pain.

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There are different kinds of cancer pain. These include:

Acute pain. This is bad pain that lasts a short time.
Chronic pain. This is mild-to-intense pain that comes and goes over a long time.
Breakthrough pain. This is sudden, severe pain that lasts for a short time while you are taking medicines that usually control your pain.
There are a number of ways to control each of these kinds of pain.

You are the only person who can say how much pain you have or if a certain pain medicine is working for you. Telling your doctor exactly how you feel is one of the most important parts of controlling pain.

What does your doctor need to know?
The more specific you can be about your pain, the more your doctor will be able to treat it. It often helps to write everything down. Include:

When your pain started, what it feels like, and how long it has lasted.
Any changes in your pain.
If the pain is constant or if it comes and goes.
If you have more than one kind of pain. Use words such as dull, aching, sharp, shooting, or burning.
What makes your pain better or worse.
A rating of your pain on a scale of 0 to 10, with 10 being the worst pain you can imagine.
Tell your doctor exactly where you feel pain. You can use a drawing. Say if the pain is just in one place, if it is in several places at the same time, or if it moves from one place to another.

How is cancer pain managed?
Pain control often starts with medicine. Many drugs are used to treat pain. You and your doctor may need to adjust your medicine as your pain changes. Your doctor may suggest different drugs, combinations of drugs, or higher doses.

For a tumor that causes pain, removing or destroying all or part of the tumor, if possible, often helps. Doctors use radiation, surgery, and other treatments to do this.

For nerve pain, doctors may use nerve blocks. With a nerve block, medicine is injected right into the nerve that affects the painful area. They provide short-term pain relief by preventing the nerve from sending pain signals. Or sometimes medicine is delivered directly to the spine, as with spinal anesthesia or an epidural.

Pain Management: Palliative Care

Pain Management: Palliative Care


Palliative care is a special type of medical care that focuses on treatment of symptoms people may have when they are living with a chronic (long-standing) illness, such as cancer or heart failure. It is often compared to the hospice care that is offered to terminally ill people.

In palliative care, the goal is to provide the best quality of life possible -- even if someone is not terminally ill. Palliative care can be used when a person is getting treatment for a disease as well as when there is no useful treatment for the disease.

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Features of Palliative Care

Palliative care deals with the treatment of problems including pain, nausea, loss of appetite, depression, and fatigue. All symptoms are addressed, including physical, emotional, and spiritual problems.

Another key feature of palliative care is its focus on not only the patient but the family, as well. Chronic illness puts special stress on families, and having support can be very helpful. Talking about and planning for the future can help prepare a person and the person's family to make the best choices for everyone involved.

What Is the Difference Between Palliative Care and Hospice?

Hospice care is a special form of palliative care offered to those with chronic illness who may have less than six months to live. The focus is on caring for the patient and his or her symptoms, not curing the disease. All doctors can admit a patient directly to hospice.

What Are the Benefits of Palliative Care?

High-quality palliative care can make the difference between a comfortable existence and one that involves much suffering. Palliative care also can help a patient's loved ones begin to deal with the issues of grief and bereavement.

Where Is Palliative Care Provided?

Palliative care is being offered in more and more hospitals throughout the country. It may also be available in outpatient clinic or home settings. To find doctors certified in Palliative Medicine, go to the Web site for the American Board of Hospice and Palliative Medicine at www.abhpm.org.

Pain Management: Recognizing Addiction

Pain Management: Recognizing Addiction


Most people who take pain medicines as prescribed by their doctor don't develop pain medicationaddiction. But some do become addicted. People more likely to become addicted to narcotics include those who have been addicted to other substances in the past or who have a family history of addiction.

Signs of addiction include:

Loss of control over pain medication use
More frequent use of the pain medication per day
Taking pain medication for other reasons besides pain, such as when depressed
Taking pain medication that was prescribed for another person
What to Do If You Suspect Addiction?

If you think you or someone you love may have a problem with addiction, talk to your doctor about your concerns.

Addiction Can Be Overcome

Getting past painkiller abuse requires a doctor's supervision and may involve a detox program. Once the addicted person has completed addiction detox and therapy, the person's family, friends and doctors all must work together to recognize signs of relapse. Participating in a relapse support group and a 12-step drug-dependency program can help people stay on track.

Chronic Pain - Home Treatment

Chronic Pain - Home Treatment

Participate in a physical therapy or exercise program that includes stretching several times a day.
Keep your appointments with your doctor, especially if you have moderate to severe or constant chronic pain.
Make lifestyle changes, such as:

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Get enough sleep every night. If you are tired during the day and have trouble sleeping, try to:
Set a bedtime and a wake-up time-and stay with these times, even on weekends. This helps your body get used to a regular sleep time.
Get some exercise during the day.
Avoid taking naps, especially in the evening.
Avoid drinking or eating caffeine after 3 p.m. This includes coffee, tea, cola drinks, and chocolate.
Treat medical conditions and mental health concerns early, before they get worse and become harder to treat. Untreated health conditions (such as shingles) or mental health problems (such as depression or anxiety) can make chronic pain harder to treat.
Exercise regularly with aerobic exercise-such as swimming, stationary cycling, and walking-to build your strength and health. Water exercise may be especially helpful in reducing pain that gets worse during weight-bearing activities, such as walking. Talk to your doctor before you begin an exercise program. Start slowly and increase your efforts bit by bit. If your joints are stiff, try taking a warm bath or shower first to loosen up. Also, do some stretching exercises each day.
Schedule your day so that you are most active when you have the most energy. Learn to move in ways that are less likely to make your pain worse.
Eat a balanced diet. Good nutrition will help you stay healthy and strong. For more information on good nutrition, see Healthy Eating.
Stop smoking. Smoking may affect your level of pain and may reduce how well your chronic pain treatment works.
Reduce stress in your life. Try a relaxation therapy such as breathing exercises or meditation. For more information, see the topic Stress Management.
Other ideas include:

Trying assistive devices, if recommended by your doctor, that help you do your daily activities. These devices can help you to be more mobile and independent. For example, use a cane or crutch, braces, splints, or devices such as doorknob extenders or an elevated toilet seat.
Joining a support group. A support group is made up of people with similar experiences who can understand your feelings and provide comfort. A support group can keep you from feeling isolated and alone. Being around others who share your problem can help you and your family learn how to accept and manage chronic pain. To find a group near you, contact the American Chronic Pain Association at 1-800-533-3231 or online at www.theacpa.org.
Preventing falls by taking care of yourself, learning ways to keep your balance, learning about your medicines, and making your home safer. Use night-lights in hallways and bathrooms.
Doing self-massage or trigger point massage therapy.
If you are a caregiver for a person who has chronic pain, your own stress and worry can also cause you to have symptoms of depression, vague body pains, digestive disorders, or headaches. Experts say that it is important to take care of yourself, too, and not to feel guilty about it. For more information, see the topic Caregiver Tips.

Chronic Pain - Surgery

Chronic Pain - Surgery
Surgery is not often used to treat chronic pain. The decision to have surgery depends on your condition and the cause of your pain. Surgery is usually considered only after other treatments have failed or if it is considered medically necessary.

Surgery may provide pain relief, but it also may permanently damage your ability to perceive other sensations, such as light touch and temperature changes. It can also cause a different pain to occur.

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Surgery Choices
The most common, effective implanted pain control systems include:

Intrathecal drug delivery. An intrathecal pain pump is a small tube inserted in the spinal canal where the pain signals go to the brain. This tube is connected to a small reservoir of medicine inserted under the skin of your belly. The medicine is regularly delivered to the area of pain through the tube.
Spinal cord stimulation. Spinal cord stimulation (SCS) is a procedure that uses an electrical current to treat chronic pain. An electrical generator is put under the skin. This generator sends electrical pulses to a certain area of the spinal cord through electrodes placed in the spinal cord by a specialist.
Radiofrequency ablation (also called radiofrequency lesioning) is a procedure that can disrupt the flow of pain signals. First, you will need to have a test that uses a nerve block, which numbs specific nerves, to help your doctor find the nerves that are causing your pain. Then the doctor places an instrument under your skin through which electrical stimulation heats the surrounding tissue. The heat "stuns" your nerves, blocking them from sending pain signals to your brain.
Chemical sympathectomy. Sympathectomy prevents the flow of pain signals. In chemical sympathectomy, the malfunctioning nerve or nerves are destroyed with chemicals, usually stopping or reducing the pain. This procedure, though, may also destroy other sensations besides pain or create other sensations such as burning or numbness. This treatment may be used for a type of chronic pain called reflex sympathetic dystrophy, which is a condition that affects the nervous system. This procedure is not commonly done, because it can cause side effects that include new pain and sweating. Your doctor may want to try a sympathetic nerve block first, in which local anesthetic is injected into the nerve to relieve pain.
Decompression is another type of surgery used for nerve pain, such as from trigeminal neuralgia. The doctor cuts open your skin and then tries to move away blood vessels or other body structures that are pressing on nerves and causing pain.
What To Think About
Surgically implanted devices are not commonly used to treat chronic pain. They may not always control chronic pain in the long term and can lead to other problems that can complicate chronic pain or sometimes make it worse.

Pain Management: Cancer Pain

Pain Management: Cancer Pain

It’s important to start cancer pain treatment as early as possible to get the most benefit.

The majority of people with cancer will experience pain at some time or another. The pain can result from the cancer itself, or from the cancer's treatment. In addition, some people who have been cured of their cancer can continue to suffer from pain.

Cancer pain, or the discomfort that stems from cancer and its treatment, can be controlled most of the time. There are many different medicines and methods available to control cancer pain. People who have cancer and are feeling pain need to inform their doctor immediately. The earlier pain treatment is started, the more effective may be.

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What Causes Cancer Pain?

There are many causes of cancer pain, but often cancer pain occurs when a tumor presses on nerves or body organs or when cancer cells invade bones or body organs. Cancer treatments such as chemotherapy, radiation, or surgery also may cause pain.

What Are the Symptoms of Cancer Pain?

The symptoms of cancer pain vary from person to person. The amount of pain present may depend on the type of cancer, the stage or extent of the disease, and the person's pain threshold (tolerance for pain). Pain can range from mild and occasional to severe and constant.

What Medicines Are Used To Treat Cancer Pain?

Mild to Moderate Pain

Pain relievers: Acetominophen (Mapap, Tylenol) and a group of pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Aleve, Motrin) can treat mild to moderate pain. Many of these are over-the-counter drugs that do not require a prescription, but some do require a prescription. Patients should check with a doctor before using these medicines, especially if they are getting chemotherapy. NSAIDs can interfere with blood clotting.

Moderate to Severe Pain

Narcotic pain relievers: These drugs include codeine,  morphine (Kadian, MS contin, MSIR, Oromorph), hydrocodone (Lortab, Norco Vicodin), oxycodone (OxyContin, Oxyfast, Roxicodone), hydromorphone (Dilaudid, Exalgo), and fentanyl (Actiq, Duragesic, Fentora). Narcotic pain relievers require a prescription and may be used along with mild pain relievers for moderate to severe pain.



Tingling and Burning Pain

Antidepressants: Certain antidepressants are used to relieve pain even if the person isn't depressed. Amitriptyline (Elavil, Endep, Vanatrip), and nortriptyline (Pamelor) are antidepressants sometimes used to treat pain.
Anticonvulsants (anti-seizure medications): Despite the name, anticonvulsants like gabapentin (Fanatrex, Gabarone, Neurontin)  and carbamazepine (Carbatrol, Equetro,Tegretol) are used not only for seizures, but also to control burning and tingling pain, painful symptoms of nerve damage.
Other drugs: Corticosteroids such as  prednisone (Deltasone, Orasone, Sterapred)  are used to lessen swelling, which often causes pain.


How Else Can Cancer Pain Be Treated?

Although cancer pain is usually treated with medicine, surgery to remove a tumor or radiation therapy to shrink a tumor can be used along with medicine to provide additional pain relief. In most cases, doctors treat cancer pain with pain-relief medicines called analgesics or with non-drug treatments such as physical therapy and rehabilitation, imagery, biofeedback and relaxation techniques. Other treatment options for cancer patients include nerve blocks, which involve the injection of pain medicine into or around a nerve or the spine.

Pain Management: Treating Pain in Children

Pain Management: Treating Pain in Children
The most difficult task involved in treating pain in children is obtaining an objective and accurate measurement of the pain.

In general, there are three ways in which doctors can assess the level of pain a child is feeling:

Self-reported measures of pain: Doctors may ask children to rate their pain on a scale of 1-10 or show pictures that reflect different emotions and ask them which best illustrates how they are feeling.
Behavioral measures of pain: Doctors will evaluate the child's motor responses, facial expressions, crying and behavior (for example, sleep-wake patterns).
Physiologic measures of pain: Doctors measure blood pressure and pulse changes, as well as take note of palm sweating.
Medications Used to Treat Pain in Children
Pain medications: Acetaminophen (Tylenol), available over the counter, and opioids (requires a doctor's prescription) are often used to relieve pain in children. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin, Advil) generally are not recommended for babies who are younger than 6 months old, but may be recommended for older children. Aspirin should not be used in children under the age of 19 unless instructed by your doctor, as it can cause Reye’s syndrome if used during or after a viral or fever-causing illness. Opioids are narcotic pain medications that contain natural, synthetic or semi-synthetic opiates. Opioids are often used to treat acute pain, such as short-term pain after surgery.
Antidepressants: Antidepressants are drugs that can treat pain and/or emotional conditions by adjusting levels of neurotransmitters (natural chemicals) in the brain. These medications can increase the availability of the body's signals for well-being and relaxation, enabling pain control for people with chronic pain conditions that do not completely respond to usual treatments.
Patient-controlled analgesia (PCA): Children who are four to six years old may be able to use PCA with the help of a parent or nurse. Children who are seven years or older can independently use the PCA pump.
Epidural analgesia: Epidural analgesia is usually performed around major surgeries such as abdominal, lower extremity or spinal surgeries for postoperative pain control. Pain medication is injected into the epidural space of the spinal cord.
While these medication are the same as those given to adults for pain, the dosing is not the same for children. The dose of medicine will likely be smaller for children than for the average adult, because it is based on the patient's weight. It is very important to follow the exact dosing prescribed by your child's doctor.

Alternative Treatments for Chronic Pain

Alternative Treatments for Chronic Pain

In the past decade, strong evidence has accumulated regarding the benefits of mind-body therapies, acupuncture, and some nutritional supplements for treating pain. Other alternative treatments such as massage, chiropractic therapies, therapeutic touch, certain herbal therapies, and dietary approaches have the potential to alleviate chronic pain in some people. However, the evidence supporting these therapies is less concrete.

Mind-Body Therapies for Chronic Pain

Mind-body therapies are treatments that are meant to help the mind's ability to affect the functions and physical symptoms of the body. Mind-body therapies use various approaches including relaxation techniques, meditation, guided imagery, biofeedback, and hypnosis. Relaxation techniques can help alleviate discomfort related to chronic pain.

Visualization may be another worthwhile pain-controlling technique. Try the following exercise: Close your eyes and try to call up a visual image of the pain, giving it shape, color, size, motion. Now try slowly altering this image, replacing it with a more harmonious, pleasing -- and smaller -- image.

Another approach is to keep a diary of your pain episodes and the causative and corrective factors surrounding them. Review your diary regularly to explore avenues of possible change. Strive to view pain as part of life, not all of it.

Electromyographic (EMG) biofeedback may alert you to the ways in which muscle tension is contributing to your pain and help you learn to control it. Hypnotherapy and self-hypnosis may help you block or transform pain through refocusing techniques. One self-hypnosis strategy, known as glove anesthesia, involves putting yourself in a trance, placing a hand over the painful area, imagining that the hand is relaxed, heavy, and numb, and envisioning these sensations as replacing other, painful feelings in the affected area.

Relaxation techniques such as meditation or yoga have been shown to reduce stress-related pain when they are practiced regularly. The gentle stretching of yoga is particularly good for strengthening muscles without putting additional strain on the body.

Acupuncture and Chronic Pain

Acupuncture is thought to decrease chronic pain by increasing the release of endorphins, chemicals that block pain. Many acu-points are near nerves. When stimulated, these nerves cause a dull ache or feeling of fullness in the muscle. The stimulated muscle sends a message to the central nervous system (the brain and spinal cord), causing the release of endorphins that block the message of pain from being delivered to the brain.

Acupuncture may be useful as an accompanying treatment for many pain-related conditions, including headache, low back pain, menstrual cramps, carpal tunnel syndrome, tennis elbow, fibromyalgia, osteoarthritis (especially of the knee), and myofascial pain. Acupuncture also may be an acceptable alternative to or may be included as part of a comprehensive pain management program.

Chiropractic Treatment and Massage

Chiropractic treatment is the most common nonsurgical treatment for back pain. Improvements of people undergoing chiropractic manipulations were noted in some trials. However, the treatment's effectiveness in treating chronic back and neck pain has not been supported by compelling evidence from the majority of clinical trials. Further studies are currently assessing the effectiveness of chiropractic care for pain management.

Massage is being increasingly used by people suffering from pain, mostly to manage chronic back and neck problems. Massage can reduce stress and relieve tension by enhancing blood flow. This treatment also can reduce the presence of substances that may generate and sustain pain. Available data suggest that massage therapy, like chiropractic manipulations, holds considerable promise for managing back pain. However, it is not possible to draw final conclusions regarding the effectiveness of massage to treat pain because of the shortcomings of available studies.

Alternative Treatments for Chronic Pain

Alternative Treatments for Chronic Pain


Therapeutic Touch and Reiki Healing

Therapeutic touch and reiki healing are thought to help activate the self-healing processes of an individual and therefore reduce pain. Although these so called "energy-based" techniques do not require actual physical contact, they do involve close physical proximity between practitioner and patient.

In the past few years, several reviews evaluated published studies on the efficacy of these healing approaches to ease pain and anxiety and improve health. Although beneficial effects with no significant adverse side effects were reported in several studies, the limitations of some of these studies make it difficult to draw definitive conclusions. Further studies are needed before the evidence-based recommendation for using these approaches for pain treatment can be made.

Nutritional Supplements for Chronic Pain

There is solid evidence indicating that glucosamine sulfate and chondroitin sulfate relieve pain due to knee osteoarthritis. These natural compounds were found to decrease pain and increase mobility of the knee and were well tolerated and safe.

Other dietary supplements, such as fish oils, also show some evidence of benefit, although more research is needed.

Herbal Remedies and Chronic Pain

It has been difficult to draw conclusions about the effectiveness of herbal remedies. If you decide to use herbs to better manage your pain, it is of critical importance to share this information with your doctor. Some herbs may interact with drugs you are receiving for pain or other conditions and may harm your health.

Dietary Approaches to Treating Pain

Some people believe that changing dietary fat intake and/or eating plant foods that contain anti-inflammatory agents can help ease pain by limiting inflammation.

A mostly raw vegetarian diet was found helpful for some people with fibromyalgia, but this study was not methodologically strong. One study of women with premenstrual symptoms suggested that a low-fat vegetarian diet was associated with decreased pain intensity and duration. Weight loss achieved by a combination of dietary changes and increased physical activity has been shown to be helpful for people suffering from osteoarthritis.

Still, further research is needed to determine the effectiveness of dietary modifications as a pain treatment.

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11 Tips for Living With Chronic Pain

11 Tips for Living With Chronic Pain


1. Learn deep breathing or meditation to help with chronic pain.

Deep breathing and meditation are techniques that help your body relax, which eases pain. Tension and tightness seep from muscles as they receive a quiet message to relax.

Although there are many to meditate, the soothing power of repetition is at the heart of some forms of  meditation. Focusing on the breath, ignoring thoughts, and repeating a word or phrase -- a mantra -- causes the body to relax. While you can learn meditation on your own, it helps to take a class.

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Deep breathing is also a relaxation technique. Find a quiet location, a comfortable body position, and block out distracting thoughts. Then, imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon.

2. 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.

3. Boost chronic pain relief with the natural endorphins from exercise.

Endorphins are brain chemicals that help improve your mood while also blocking pain signals. Exercise has another pain-reducing effect -- it strengthens muscles, helping prevent re-injury and further pain. Plus, exercise can help keep your weight down, reduce heart disease risk, and control blood sugar levels -- especially important if you have diabetes. Ask your doctor for an exercise routine that is right for you. If you have certain health conditions, like diabetic neuropathy, you will need to be careful about the types of activities you engage in; your doctor can advise you on the best physical activities for you.

4. Cut back on alcohol, which can worsen sleep problems.

Pain makes sleep difficult, and alcohol can make sleep problems worse. If you're living with chronic pain, drinking less or no alcohol can improve your quality of life.

5. Join a support group. Meet others living with chronic pain.

When you're with people who have chronic pain and understand what you're going through, you feel less alone. You also benefit from their wisdom in coping with the pain.

Also, consider meeting with a mental health professional. Anyone can develop depression if they're living with chronic pain. Getting counseling can help you learn to cope better and help you avoid negative thoughts that make pain worse -- so you have a healthier attitude. Asking for help is a sign of strength, not weakness.

6. Don't smoke. It can worsen chronic pain.

Smoking can worsen painful circulation problems and increase risk of heart disease and cancer.

7. Track your pain level and activities every day.

To effectively treat your pain, your doctor needs to know how you've been feeling between visits. Keeping a log or journal of your daily "pain score" will help you track your pain. At the end of each day, note your pain level on the 1 to 10 pain scale. Also, note what activities you did that day. Take this log book to every doctor visit -- to give your doctor a good understanding of how you're living with chronic pain and your physical functioning level.

8. Learn biofeedback to decrease pain severity.

Through biofeedback, it's possible to consciously control various body functions. It may sound like science fiction, but there is good evidence that biofeedback works -- and that it's not hard to master.

Here's how it works: You wear sensors that let you "hear" or "see" certain bodily functions like pulse, digestion, body temperature, and muscle tension. The squiggly lines and/or beeps on the attached monitors reflect what's going on inside your body. Then you learn to control those squiggles and beeps. After a few sessions, your mind has trained your biological system to learn the skills.

9. Get a massage for chronic pain relief.

Massage can help reduce stress and relieve tension -- and is being used by people living with all sorts of chronic pain, including back and neck pain.

10. Eat a healthy diet if you're living with chronic pain.

A well-balanced diet is important in many ways -- aiding your digestive process, reducing heart disease risk, keeping weight under control, and improving blood sugar levels. To eat a low-fat, low-sodium diet, choose from these: fresh fruits and vegetables; cooked dried beans and peas; whole-grain breads and cereals; low-fat cheese, milk, and yogurt; and lean meats.

11. Find ways to distract yourself from pain so you enjoy life more.

When you focus on pain, it makes it worse rather than better. Instead, find something you like doing -- an activity that keeps you busy and thinking about things besides your pain. You might not be able to avoid pain, but you can take control of your life.

TENS and Electrothermal Therapy for Pain Management

TENS and Electrothermal Therapy for Pain Management


The most common form of electrical stimulation used for pain management is transcutaneous electrical nerve stimulation (TENS) therapy, which provides short-term pain relief. Electrical nerve stimulation and electrothermal therapy are used to relieve pain associated with various conditions, including back pain. Intradiscal electrothermal therapy (IDET) is a treatment option for people with low back pain resulting from intervertebral disc problems.

TENS Therapy for Pain Management

In TENS therapy for pain management, a small, battery-operated device delivers low-voltage electrical current through the skin via electrodes placed near the source of pain. The electricity from the electrodes stimulates nerves in the affected area and sends signals to the brain that "scramble" normal pain perception. TENS is not painful and may be effective therapy to mask pain such as diabetic neuropathy. However, TENS for chronic low back pain is not effective and cannot be recommended, the American Academy of Neurology (AAN) now says.

Intradiscal Electrothermal Therapy (IDET)

Intervertebral discs act as cushions between the vertebrae. Sometimes the discs can become damaged and cause pain. IDET uses heat to modify the nerve fibers of a spinal disc and to destroy pain receptors in the area. In this procedure, a wire called an electrothermal catheter is placed through an incision in the disc. An electrical current passes through the wire, heating a small outer portion of the disc to a temperature of 90 degrees Celsius.

IDET is performed as an outpatient procedure while the patient is awake and under a local anesthesia. Early studies indicate that some patients may have continued pain relief for up to six months or longer. The long-term effects of this procedure on the disc have not been determined.

Radiofrequency Discal Nucleoplasty

Radiofrequency discal nucleoplasty is a newer procedure which utilizes a radio frequency probe instead of heating wire to disintegrate a small portion of the central disc material. The result of this intervention is partial decompression of the disc, which may help relieve pain caused by bulging discs pressing on nearby spinal nerve roots.

Pain Management: Drug Tolerance and Addiction

Pain Management: Drug Tolerance and Addiction


Some medications used to treat pain can be addictive. Addiction is different from physical dependence or tolerance, however. In cases of physical dependence, withdrawal symptoms occur when a substance suddenly is stopped. Tolerance occurs when the initial dose of a substance loses its effectiveness over time. Addiction is a psychological and behavioral response that develops in some people with the use of narcotic pain medicines.

People who take a class of drugs called opioids for a long period of time may develop tolerance and even physical dependence. This does not mean, however, that a person is addicted. In general, addiction occurs in only a small percentage of people when narcotics are used under proper medical supervision.

Addictive Pain Medications

Opioids, a family of drugs that have effects similar to those of opium or morphine, can be addictive. They include:

Codeine
Fetanyl (including brand name Duragesic)
Oxycodone (including brand name OxyContin, Percocet, Percodan, Tylox, and Roxicet))
Morphine (including brand name MS Contin)
Meperidine (including brand name Demerol)
Hydrocodone (including brand name Vicodin and Lortab)
Hydromorphone (including brand name Dilaudid)


Who Is at Risk for Addiction?

Most people who take their pain medicine as directed by their doctor do not become addicted, even if they take the medicine for a long time. However, some people may be at a higher risk of becoming addicted than others. People who have been addicted to substances in the past or those with a family member who is or has been addicted to drugs or alcohol may be at increased risk of becoming addicted to narcotics.

How to Prevent Addiction

The key to avoiding addiction is to take your medicine exactly as your doctor prescribes.

Share with your doctor any personal and/or family history of substance abuse or addiction. Your doctor needs this information to prescribe the medicines that will work best for you. Fears about addiction should not prevent you from using narcotics to effectively relieve your pain.

Remember, it is common for people to develop a tolerance to their pain medication and to need higher doses to achieve the same level of pain relief. Such a situation is normal and is not a sign of addiction. However, you should talk to your doctor if this effect becomes troubling.

Pain Management: Spinal Drug Delivery Systems

Pain Management: Spinal Drug Delivery Systems

Pain relief through spinal drug delivery systems, also called intrathecal drug delivery systems, involves implanting a small pump or using a catheter that delivers medication directly to the spinal cord, where pain signals travel.

In many cases, spinal drug delivery systems are used to treat people who have cancer pain. They have also been used in people with chronic pain.

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What Are the Advantages of Spinal Drug Delivery Systems?

Spinal drug delivery systems increase pain relief and comfort for people with severe pain with less medicine. In addition, the system can cause fewer side effects than oral medications because less medicine is required to control pain. People who have extreme pain can often improve their quality of life and become more involved in daily activities with the help of the systems.

Pain Management and Bioelectric Therapy

Pain Management and Bioelectric Therapy

Bioelectric therapy is a safe, drug-free treatment option for people in pain. It is used to treat some chronic pain and acute pain conditions. It relieves pain by blocking pain messages to the brain. When you are injured, pain receptors send a message to the central nervous system (the brain and spinal cord). The message is registered as pain by certain cells in the body. Using bioelectric currents, bioelectric therapy relieves pain by interrupting pain signals before they reach the brain. Bioelectric therapy also prompts the body to produce endorphins which help to relieve pain.

What Conditions Are Treated With Bioelectric Therapy?

Bioelectric therapy can be used to treat chronic and acute pain conditions including:

Complex regional pain syndrome, also known as reflex sympathetic dystrophy or RSD.
Back pain.
Muscle pain.
Headaches and migraines.
Disorders of blood flow in the upper and lower limbs.
Arthritis.
Temporomandibular joint (TMJ) syndrome (which affects the jaw).
Disorders of the nervous system, such as diabetic neuropathy.
Pain and ulcers of the skin resulting from poor circulation or scleroderma (a chronic condition that can cause thickening or hardening of the skin).
Bioelectric therapy isn't right for everyone. It is not recommended for people who:

Have a pacemaker.
Are pregnant.
Have thrombosis (blood clots in the arms or legs).
Have a bacterial infection.
How Effective Is Bioelectric Therapy?

Bioelectric therapy is effective in providing temporary pain control, but it should only be a part of a total pain management program. When used along with conventional pain-relieving medications, bioelectric treatment may reduce the dose of some pain medications by up to 50%.

What Happens During Bioelectric Therapy?

During bioelectric therapy, several small, flat rubber adhesive discs (called electrodes) are applied to your skin at prescribed areas to be treated. Sometimes rubber suction cups (called vaso pneumatic devices) may be applied to your skin. The electrodes are hooked up to a computer that programs the precise treatment dosage required. High frequency alternating electrical currents are then applied to the electrodes. The currents move through the skin quickly with little discomfort. During treatment, your response to the electrical stimulation is measured.

When electricity is applied, a mild vibrating, tingling sensation is common. This sensation should not be uncomfortable; you should feel a relaxing, soothing pain relief. As the currents are applied, you will provide verbal feedback to the clinician. If the sensation becomes too strong, please tell the clinician right away so the treatment can be adjusted. You should be comfortable and enjoy the treatment, which lasts about 20 minutes.

What Are the Side Effects of Bioelectric Therapy?

In rare cases, skin irritation and redness can occur under the electrodes during bioelectric therapy.

How Often Should I Get Bioelectric Therapy?

The number of bioelectric therapy sessions required depends on each person's condition and response to treatment. One bioelectric therapy session does not usually result in pain relief. Therapy usually begins with about five sessions in one week, followed by three treatments per week. A normal course of treatment includes 16 to 20 treatments.

How Do I Prepare for Bioelectric Therapy?

If you are taking insulin or blood-thinning medications, your doctor may give you specific instructions to follow before getting bioelectric therapy.

You may be asked to fast before the procedure, and you may need to make arrangements for someone to drive you home after treatment.

Back Pain and Spinal Cord Stimulation

Back Pain and Spinal Cord Stimulation

When other pain treatments have failed, spinal cord stimulation may be an option.

Spinal cord stimulation is a procedure that delivers low-level electrical signals to the spinal cord or to specific nerves to block pain signals from reaching the brain.

What Happens During the Spinal Cord Stimulation?

During spinal cord stimulation, a device that delivers the electrical signals is implanted in the body either surgically or percutaneously (through the skin). The patient may turn the current off and on or adjust the intensity of the signals. Most people describe the feelings from the simulator as being pleasant and tingling.

Several kinds of spinal cord stimulation systems are available. The units that are more commonly used are fully implanted and have a pulse generator, which is like a battery. Most of the newer devices feature a rechargeable pulse generator system that can be easily charged through the skin. However, there are some pulse generators that are fully implanted that do not require recharging, but last a shorter time before they need to get replaced. Another system includes an antenna, transmitter, and a receiver that relies upon radio frequency to power the device. In these systems, the antenna and transmitter are carried outside the body, while the receiver is implanted inside the body.

When Is Spinal Cord Stimulation Used?

Spinal cord stimulation is recommended when other treatments have not been successful, when surgery is not likely to help, or when surgery has failed. However, the device is not for everyone; check with your doctor to see if the procedure is right for you.

Pain Management: Patient-Controlled Analgesia (PCA)

Pain Management: Patient-Controlled Analgesia (PCA)

Patient-controlled analgesia (PCA) is a method of pain control that gives patients the power to control their pain. In PCA, a computerized pump called the patient-controlled analgesia pump, which contains a syringe of pain medication as prescribed by a doctor, is connected directly to a patient's intravenous (IV) line.

In some cases, the pump is set to deliver a small, constant flow of pain medication. Additional doses of medication can be self-administered as needed by the having the patient press a button. Other times, a patient can control when he or she receives pain medication and does not receive a constant flow.

Patients recovering from surgery often are equipped with PCA pumps. The machines also can be used by people coping with other kinds of pain.

Children who are four to six years old may be able to use PCA with the help of a parent or nurse. Children who are as young as seven can independently use the PCA pump.

How Often Should the PCA Pump Be Used?

The pump can be used whenever the patient is feeling pain. However, patients should not press the button on the machine if they are feeling too sleepy. The more alert the patient is, the more likely he or she is to participate in a therapy program to aid and possibly shorten recovery. Once the acute pain from surgery is controlled, the patient will be switched to pills for pain relief.

Is it Safe?

PCA pumps have built-in safety features. The total amount of analgesic (pain reliever) that the patient can self administer is within a safe limit.

Trigger Point Injection (TPI) for Pain Management

Trigger Point Injection (TPI) for Pain Management

Trigger point injection (TPI) may be an option in treating pain for some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.

Trying to Manage Chronic Pain? Take This Self-Assessment to Get Your Personal Health Report

What Happens During a Trigger Point Injection?

In the TPI procedure, a health care professional inserts a small needle into the patient's trigger point. The injection contains a local anesthetic that sometimes includes a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections are given in a doctor's office and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain drug, a dry-needle technique (involving no medications) can be used.

When Is Trigger Point Injection Used?

TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI can be used to treat fibromyalgia and tension headaches. The technique is also used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments. However, the effectiveness of TPI for treating myofascial pain is still under study.

 

Pain Management and Nerve Blocks

Pain Management and Nerve Blocks

Nerve blocks are used for pain treatment and management. There are several different types of nerve blocks that serve different purposes.

Often a group of nerves, called a plexus or ganglion, that causes pain to a specific organ or body region can be blocked with the injection of medication into a specific area of the body. The injection of this nerve-numbing substance is called a nerve block.

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How Are Nerve Blocks Used?

Different kinds of nerve blocks are used for different purposes.

Therapeutic nerve blocks are used to treat painful conditions. Such nerve blocks contain local anesthetic that can be used to control acute pain.
Diagnostic nerve blocks are used to determine sources of pain. These blocks typically contain an anesthetic with a known duration of relief.
Prognostic nerve blocks predict the outcomes of given treatments. For example, a nerve block may be performed to determine if more permanent treatments (such as surgery) would be successful in treating pain.
Preemptive nerve blocks are meant to prevent subsequent pain from a procedure that can cause problems including phantom limb pain.
Nerve blocks can be used, in some cases, to avoid surgery.
Types of Nerve Blocks

Various areas of pain require different nerve block types. Below are a few of the available nerve blocks, followed in parentheses by some of the parts of the body for which they are used.

Trigeminal nerve blocks (face)
Ophthalmic nerve block (eyelids and scalp)
Supraorbital nerve block (forehead)
Maxillary nerve block (upper jaw)
Sphenopalatine nerve block (nose and palate)
Cervical epidural, thoracic epidural, and lumbar epidural block (neck and back)
Cervical plexus block and cervical paravertebral block (shoulder and upper neck)
Brachial plexus block, elbow block, and wrist block (shoulder/arm/hand, elbow, and wrist)
Subarachnoid block and celiac plexus block (abdomen and pelvis)
Other Nerve Blocks

Other types of nerve blocks include:

Sympathetic nerve block: A sympathetic nerve block is one that is performed to determine if there is damage to the sympathetic nerve chain. This is a network of nerves extending the length of the spine. These nerves control some of the involuntary functions of the body, such as opening and narrowing blood vessels.
Stellate ganglion block: This is a type of sympathetic nerve block performed to determine if there is damage to the sympathetic nerve chain supplying the head, neck, chest, or arms and if it is the source of pain in those areas. Although used mainly as a diagnostic block, the stellate ganglion block may provide pain relief in excess of the duration of the anesthetic.
Facet joint block: Also known as a zygapophysial joint block, the facet joint block is performed to determine whether a facet joint is a source of pain. Facet joints are located on the back of the spine, where one vertebra slightly overlaps another. These joints guide and restrict the spines movement.
Side Effects and Risks of Nerve Blocks

Nerve blocks do have risks and side effects. They include:

Elevated blood sugars
Rash
Itching
Weight gain
Extra energy
Soreness at the site of injection
Bleeding
Death (in rare cases)
Although many kinds of nerve blocks exist, this treatment cannot always be used. If your pain isn't related to pain in a single or small group of nerves, nerve blocks may not be right for you. Your doctor can advise you as to whether this treatment is appropriate for you.

Trigger Point Injection (TPI) for Pain Management

Trigger Point Injection (TPI) for Pain Management

Trigger point injection (TPI) may be an option in treating pain for some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.

Trying to Manage Chronic Pain? Take This Self-Assessment to Get Your Personal Health Report
What Happens During a Trigger Point Injection?

In the TPI procedure, a health care professional inserts a small needle into the patient's trigger point. The injection contains a local anesthetic that sometimes includes a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections are given in a doctor's office and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain drug, a dry-needle technique (involving no medications) can be used.

When Is Trigger Point Injection Used?

TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI can be used to treat fibromyalgia and tension headaches. The technique is also used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments. However, the effectiveness of TPI for treating myofascial pain is still under study.

Opioid (Narcotic) Pain Medications

Opioid (Narcotic) Pain Medications


Opioid Side Effects

One of the reasons why your doctor needs to manage your pain medications so closely is that they can potentially cause side effects, such as:

constipation
drowsiness
nausea and vomiting
Opioids can be dangerous if you take them with alcohol, or with certain drugs such as:

some antidepressants
antihistamines
sleeping pills
Make sure your doctor knows all of the other medicines you're taking. That includes:

prescriptions
over-the-counter drugs
herbal supplements
Opioid Tolerance and Addiction

After taking opioid pain medication for a while, you might find that you need more and more of the drug to achieve the same effect in reducing your pain. This is called tolerance. It's not the same as addiction, which involves a compulsive use of a drug.

When you use opioid medication over an extended period of time, you can develop dependence. This can occur when your body becomes so used to the drug that if you abruptly stop taking it, you get withdrawal symptoms such as:

diarrhea, nausea, and vomiting
muscle pain
anxiety
irritability
You can also develop an addiction to opioid pain medications. People who are addicted to opioids compulsively seek out the pain medications. They typically have behaviors that lead to negative consequences in their personal lives or workplace.

If you are having a problem with addiction, you might need to see an addiction specialist.

Should You Take Opioid Pain Medications?

Opioids can make a dramatic difference to people with moderate to severe pain. These drugs can be an effective therapy -- as long as you use them safely and follow your doctor's instructions carefully.

Opioid (Narcotic) Pain Medications

Opioid (Narcotic) Pain Medications


When you have a mild headache or muscle ache, an over-the-counter pain reliever is usually enough to make you feel better. But if your pain is more severe, your doctor might recommend something stronger -- a prescription opioid.

Opioids are a type of narcotic pain medication. They can have serious side effects if you don't use them correctly.

If you need to take opioids to control your pain, here are some ways to make sure you're taking them as safely as possible.

Commonly Abused Prescription and Over-the-Counter Drugs
How Opioids Work

Opioid drugs work by binding to opioid receptors in the brain, spinal cord, and other areas of the body. They reduce the sending of pain messages to the brain and reduce feelings of pain.

Opioids are used to treat moderate to severe pain that may not respond well to other pain medications.

Some types of opioid drugs include:

codeine (only available in generic form)
fentanyl (Actiq, Duragesic, Fentora)
hydrocodone (Lorcet, Lortab, Norco, Vicodin)
hydromorphone (Dilaudid, Exalgo)
meperidine (Demerol)
methadone (Dolophine, Methadose)
morphine (Avinza, Kadian, MS Contin, Ora-Morph SR)
oxycodone (OxyContin, Oxyfast, Percocet, Roxicodone)
Your doctor can prescribe most of these drugs to take by mouth. Fentanyl is available in a patch. A patch allows the medication to be absorbed through the skin.

Some opioids, such as oxycodone, are often combined with Tylenol (acetaminophen) in one pill. Examples of these combination drugs are:

Lorcet, Lortab, Norco, Vicodin (hydrocodone and acetaminophen)
Percocet (oxycodone and acetaminophen)


Working With Your Doctor

You'll need a prescription from your doctor before you start taking opioids. The doctor can adjust your opioid dose as needed to help control your pain.

You may receive around-the-clock doses to manage your pain throughout the day and night. Additionally, your doctor may prescribe opioids to be taken "as needed" in case you experience "breakthrough" pain. Breakthrough pain is a flare of pain that you experience despite getting round-the-clock doses of pain medication.

While you're on opioid pain medications, check in with your doctor regularly. Your doctor will need to know:

How your pain is responding to the drug.
Whether you're having any side effects.
Whether you have any potential interactions or medical conditions that could increase your risk for side effects, such as sleep apnea, alcohol use, or kidney problems.
Whether you're taking the drug properly.
Never change or stop taking any opioid medicine without first checking with your doctor. If a pain medication isn't working as well as it should, your doctor may switch you to a different dose -- or try another drug.

When you're ready to stop taking opioid pain pills, your doctor may help wean you off them slowly if you have taken them for an extended period of time to give your body time to adjust. Otherwise, you may have withdrawal symptoms.

Pain Management: Alternative Therapy

Pain Management: Alternative Therapy

Therapeutic Touch and Reiki Healing

Therapeutic touch and reiki healing are thought to help activate the self-healing processes of an individual and therefore reduce pain. Although these so called "energy-based" techniques do not require actual physical contact, they do involve close physical proximity between practitioner and patient.

In the past few years, several reviews evaluated published studies on the efficacy of these healing approaches to ease pain and anxiety and improve health. Although beneficial effects with no significant adverse side effects were reported in several studies, the limitations of some of these studies make it difficult to draw definitive conclusions. Further studies are needed before the evidence-based recommendation for using these approaches for pain treatment can be made.

Dietary Approaches to Treating Pain

Some people believe that changing dietary fat intake and/or consuming plant foods that contain anti-inflammatory agents can help ease pain by limiting inflammation.

A mostly raw vegetarian diet was found helpful for some people with fibromyalgia, but this study was not randomized and was without a control group. One study of women with premenstrual symptoms suggested that a low-fat vegetarian diet was associated with decreased pain intensity and duration. Weight loss achieved by a combination of dietary changes and increased physical activity has been shown to be helpful for people suffering from osteoarthritis.

Still, further research is needed to determine the effectiveness of dietary modifications as a pain treatment.

Nutritional Supplements

There is some evidence indicating that glucosamine sulfate and chondroitin sulfate may be marginally effective for knee osteoarthritis. These natural compounds were found to be well tolerated and safe.

Other dietary supplements, such as fish oils, also showed some early evidence of benefit, although more research is needed.

Herbal Remedies

It has been difficult to draw conclusions about the effectiveness of herbs. If you decide to use herbal preparations to better manage your pain, it is of critical importance to share this information with your doctor. Some herbs may interact with drugs you are receiving for pain or other conditions and may harm your health.

Things to Consider

Alternative therapies are not always benign. As mentioned, some herbal therapies can interact with other medications you may be taking. Always talk to your doctor before trying an alternative approach and be sure to tell all your doctors what alternative treatments you are using.

Pain Management: Alternative Therapy

Pain Management: Alternative Therapy

The term alternative therapy, in general, is used to describe any medical treatment or intervention that  is used in place of conventional medicine. When alternative therapies are used in conjunction with conventional medicine, it is called complementary medicine. Alternative therapy encompasses a variety of disciplines, including acupuncture, guided imagery, chiropractic treatment, yoga, hypnosis, biofeedback, aromatherapy, relaxation, herbal remedies, massage and many others.

In the past decade, strong evidence has been accumulated regarding the benefits of mind-body therapies, acupuncture, and some nutritional supplements for treating pain. Other alternative therapies such as massage, chiropractic therapies, therapeutic touch, certain herbal therapies, and dietary approaches have the potential to alleviate pain in some cases. More research is needed to see how these therapies compare to conventional treatments.

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Mind-Body Therapies

Mind-body therapies are treatments that are meant to help the mind’s ability to affect the functions and symptoms of the body. Mind-body therapies use various approaches, including relaxation techniques, meditation, guided imagery, biofeedback, and hypnosis. Relaxation techniques can help alleviate discomfort related to chronic pain.

Acupuncture

Although the World Health Organization currently recognizes more than 30 diseases or conditions that can be helped by acupuncture treatment, one of the main uses of acupuncture is for pain relief.

Sixteenth Century Chinese doctors believed that illness was due to an imbalance of energy in the body. In acupuncture, disposable, stainless steel needles are used to stimulate the body's 14 major meridians, or energy-carrying channels, to resist or overcome illnesses and conditions by correcting these imbalances.

Acupuncture is also thought to decrease pain by increasing the release of chemicals that block pain, called endorphins. Many acu-points are near nerves. When stimulated, these nerves cause a dull ache or feeling of fullness in the muscle. The stimulated muscle sends a message to the central nervous system (the brain and spinal cord), causing the release of endorphins (morphine-like chemicals produced in our own bodies during times of pain or stress). Endorphins, along with other neurotransmitters (body chemicals that modify nerve impulses), block the message of pain from being delivered up to the brain.

Acupuncture may be useful as an accompanying treatment for many pain-related conditions, including: headache, low back pain, menstrual cramps, carpal tunnel syndrome, tennis elbow, fibromyalgia, osteoarthritis and myofascial pain. Acupuncture also may be an acceptable alternative to or may be included as part of a comprehensive pain management program.

Chiropractic Treatment and Massage

Chiropractic treatment is the most common non-surgical treatment for back pain. Improvements in people undergoing chiropractic manipulations were noted in some trials. However, the treatment's effectiveness in treating back and neck pain has not been supported by compelling evidence from the majority of clinical trials. Further studies are currently assessing the effectiveness of chiropractic care for pain management.

Massage is being increasingly used by people suffering from pain, mostly to manage chronic back and neck problems. Massage can reduce stress and relieve tension by enhancing blood flow. This treatment also can reduce the presence of substances that may generate and sustain pain. Available data suggest that massage therapy, like chiropractic manipulations, holds considerable promise for managing back pain.

Pain Management: Pain Medications

Pain Management: Pain Medications


Antidepressants are drugs that can treat pain and/or emotional conditions by adjusting levels of neurotransmitters (natural chemicals) in the brain. These medications can increase the availability of the body's signals for well-being and relaxation, enabling pain control for people with chronic pain conditions that do not completely respond to usual treatments.

Chronic pain conditions treated by low-dose antidepressants include some types of headaches (like migraines) and menstrual pain. Some antidepressant medications include:

Selective Serotonin Reuptake Inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft)
Tricyclic antidepressants such as amitriptyline (Elavil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), and nortriptyline (Pamelor)
Selective Serotonin and Norepinephrine Reuptake Inhibitors (SSNRIs) such as venlafaxine (Effexor) and duloxetine (Cymbalta)


These drugs require a steady dose of the medicine buildup in the body over a period of time to work. The doses needed to treat pain are often lower than those needed to treat depression.

In general, antidepressants have fewer long-term side effects than frequent, ongoing use of other pain medicines. Generally, SSRIs and SSNRIs have fewer side effects than tricyclic antidepressants. The most common side effects with antidepressants include:

Blurry vision
Constipation
Difficulty urinating
Dry mouth
Fatigue
Nausea
Headache
What Are Anticonvulsants?

Anticonvulsants are drugs typically used to treat seizure disorders. Some of these medications are shown to be effective in treating pain as well. The exact way in which these medicines control pain is unclear but it is thought that they minimize the effects of nerves that cause pain. Some examples include carbamazepine (Tegretol), gabapentin (Neurontin), and pregabalin (Lyrica).

In general, anticonvulsants are well tolerated. The most common side effects include:

Drowsiness
Dizziness
Fatigue
Nausea
Other Pain Treatments

Another means of topical pain relief comes in the form of a lidocaine (Lidoderm) patch, which is a prescription medication.

If your pain is not relieved by the usual treatments, your doctor may refer you to a pain management specialist. Doctors who specialize in pain management may try other treatments such as certain types of physical therapy or other kinds of medicine. They may also recommend TENS, a procedure that uses patches placed on the skin to send signals that stop pain.

Patient-controlled analgesia (PCA) is a method of pain control that allows the patient to control the amount of pain medication administered. This is often used in the hospital to treat pain. By pushing a button on a computerized pump, the patient receives a pre-measured dose of pain medicine. The pump is connected to a small tube that allows medicine to be injected intravenously (into a vein), subcutaneously (just under the skin), or into the spinal area.