No matter what part of your body hurts, the pain you feel is a warning that something is wrong and needs attention. If you develop a single chronic condition, such as migraine headaches or lower back pain from an injury, you may get relief from conventional treatments. But some people are more sensitive to pain, have multiple and more debilitating chronic pain conditions, or may require different types of treatment.
Below are some of the most chronic pain conditions, and how you might want to treat them.
Migraine Headaches
While they're not fully understood, migraines are associated with changes in chemicals and blood vessels in the brain. A severe migraine gets worse before it gets better and may be accompanied by nausea, vomiting, and temporary visual disturbances known as auras.
Treatments: Migraines are treated with over-the-counter (OTC) and prescription non-steroidal anti-inflammatory drugs (NSAIDs), particularly naproxen, or prescription drugs known as triptans or ergots. Doctors may also prescribe antidepressants, anti-seizure medications, or calcium channel blockers normally used to treat high blood pressure because these drugs also help reduce the pain of migraines. Since there are many different types of migraines, some of which must be treated differently than others, it’s important to get a specific diagnosis. The wrong type of treatment can actually make a migraine worse.
Tension Headaches
These are characterized by a tightening of the muscles between the head and the neck, with pain primarily in the forehead, temples or the back of the head and neck.
Treatments: Though they may or may not be associated with anxiety or depression, chronic tension headaches are usually treated with antidepressants such as amitriptyline, which also have pain-killing properties.
Sinus Headaches
Caused by sinus infections and allergic inflammation, sinus headaches are usually felt in the forehead and across the nose and cheekbones. A sinus headache from infection is often accompanied by fever. Moving your head or straining facial muscles by blowing your nose or other activity can worsen the pain.
Treatments: Antibiotics, antihistamines, and decongestants are most often used to treat sinus headaches and facial pain.
Arthritis
There are many different types of arthritis, and it is important to get a diagnosis to determine which type you have and to rule out other conditions. The most common type is osteoarthritis, which can cause chronic stiffness and pain in joints in your hips, knees, feet, ankles, fingers, shoulder, and lower back.
Treatments: Topical prescription and OTC creams and gels can help numb pain and reduce inflammation. Cortisone injections to the joint can greatly ease pain, but the number of shots you can receive is limited, because too much cortisone can actually cause further joint damage. You may be recommended hyaluronic acid injections, which can help lubricate and cushion knee joints. Surgery and joint replacement is an option in some cases.
While many people with arthritis are reluctant to exercise, mild to moderate activity that includes range-of-motion, strengthening, and aerobic exercises can help strengthen the muscles that surround your joints, increase your range of motion and reduce your overall pain level. And if you’re overweight, losing weight helps, because it reduces the pressure of excess pounds on the weight-bearing joints in your knees and feet. In the case of severe arthritis, an occupational therapist can teach you tools and techniques to use during everyday activities to put less pressure on your joints, such as using a bench in the shower to reduce pressure on your knees or feet, or using large-grip kitchen utensils that are easier on finger joints.
Pain from Injuries
Painful conditions like muscle spasms, bone fractures and dislocations and inflamed tendons and joints can result from sports injuries and accidents. These conditions can affect your back, your limbs, your hands—just about any part of your body that moves.
Treatments: Though you should see a doctor to get a clear diagnosis, you will probably be able to treat minor pain at home with NSAIDs, heat or ice, and rest. But if you have severe pain, any unusual pain or numbness, pain that extends to your legs, pain that results from a fall or other injury or accident, or pain that does not improve over time with home treatment, you may need to see a specialist.
Professional treatment depends on the type, location and severity of pain. You may need prescription painkillers, muscle relaxers, anti-inflammatory or numbing injections and in some cases, surgery. A physical therapist can teach you exercises you can continue to do at home and also use other types of treatments involving heat, ultrasound, or electrical current.
Pelvic Pain
In women, pelvic pain may be related to menstrual periods or sexual activity and it can be a sign of an underlying condition in the uterus, cervix or other pelvic organs, or even the urinary tract or bowel area. Pelvic pain can be a symptom of fibroids, common and benign tumors that grow in the uterine wall, or endometriosis, a condition where uterine tissue grows outside of the uterus and spreads to the ovaries, bowel or other areas. Both of these conditions can cause pain, especially during menstrual periods. In men, pelvic pain can be a sign of prostate problems, such as prostatitis or inflammation of the prostate.
Treatments: NSAIDs, antidepressants, hormonal treatments, regular exercise and physical therapy are all used to relieve pelvic pain. Underlying conditions that result in pelvic pain may also require surgery.
Widespread Pain
Although we name most pain by its specific location—headache pain, abdominal cramps, knee osteoarthritis—your discomfort may actually originate in your brain, according to Daniel Clauw, MD, director of the Chronic Pain and Fatigue Research Center at University of Michigan, Ann Arbor. That’s not to say "it’s all in your head" and doesn’t really exist, but that neurotransmitters, or brain chemicals, may be responsible for the degree of pain you feel.
"It’s like a volume control setting for pain throughout your body," Clauw explains. "If your neurostransmitters increase that volume, you’ll be more sensitive to pain."
Clauw’s volume control analogy helps explain why two different individuals with the same complaints and even the same x-ray findings can feel markedly different levels of pain. If you have experienced difficult-to-treat chronic pain conditions in different parts of your body throughout your entire life, or for instance, migraines nearly every day as opposed to only a few times a month or year, you may have this type of “brain pain” that makes you more sensitive to pain than others, and you may not respond as well as others to conventional treatments like surgery or injections. The role of neurotransmitters also helps explain the chronic, arthritis-like pain of fibromyalgia, which can cause a variety of symptoms such as headaches, stiffness, and painful menstrual cycles, and is often accompanied by other painful conditions like endometriosis and inflammatory bowel disease.
Treatments: If you suffer from this type of widespread, chronic pain, you probably need more or different types of treatments than someone who only feels pain due to damage or a disorder in one specific area of the body. Your doctor(s) can help you develop a personalized treatment plan, which may include a combination of medications, physical therapy, rest, and exercise.
Word to the Wise
No matter what kind of pain you're dealing with, it's important to "Speak with your doctor about your medical history, to help determine the nature of your pain," says Clauw. "If there is a history of chronic pain conditions, such as menstrual cramps starting in your teens, abdominal pain from a condition like irritable bowel in your twenties or thirties, and then you develop backaches or arthritis, for instance, you may have a higher sensitivity to pain that requires nonconventional treatment."
Daniel Clauw, M.D., reviewed this article.
Sources
Daniel Clauw, M.D. E-mail to author April 5, 2016.
"Drug Types." Arthritis Foundation. Page accessed June 1, 2016.
"Joint Surgery." Arthritis Foundation. Page accessed June 1, 2016.
"Exercising with Osteoarthritis." Arthritis Foundation. Page accessed June 1, 2016.
Harvard Medical School. "Headache: When to Worry, What to Do." Harvard Health Publications. Last reviewed September 30, 2015.
"Sinus Headache." University of Maryland Medical Center. Last reviewed October 19, 2015.
"Chronic Pelvic Pain." The American Congress of Obstetricians. FAQ099 August 2011. Accessed April 1, 2016.
