An estimated 100 million Americans live with chronic pain. Perhaps you are prone to headaches, never fully recovered from an old back injury, or are dealing with arthritis or an autoimmune disorder. Alternatively, maybe your chronic pain doesn't result from a particular injury or condition.

Either way, you're likely familiar with the effects—the aches, soreness, and frustration—of this all-too-common problem.

Luckily, there are many treatments that can relieve chronic pain (generally defined as pain that persists for more than three to six months). However, according to the United States Department of Veterans Affairs, about one quarter of chronic pain patients are seriously impaired: They have trouble functioning physically and/or emotionally, and their quality of life suffers. This is chronic pain syndrome (CPS).

Symptoms of Chronic Pain Syndrome

In people with CPS, physical pain may lead to:

  • Reduced activity and mobility
  • Fatigue
  • Insomnia
  • Emotional disturbances, such as feelings of isolation, depression, anxiety, irritability, and/or guilt
  • Abuse of pain medications or alcohol

Developing a Treatment Plan

All chronic pain patients may benefit from some form of treatment. Treatment methods vary, and depend on the patient's particular needs, says Penney Cowan, founder and executive director of the Rockland, CA-based American Chronic Pain Association: "Some people may need medication and physical therapy; others may need acupuncture," she points out. Speak to your doctor about the best approach for you. Common treatments include:

Medication. Over-the counter NSAIDs (nonsteroidal anti-inflammatory drugs), prescription analgesics, steroids, and antidepressants can all help relieve pain relief and enable better functioning.

Bed rest, braces, or splints. Rest and/or the temporary immobilization of the aching body part(s) can lessen pain and inflammation.

Surgery. Surgical intervention may adjust (or in some cases, remove) the body part causing pain.

Acupuncture. This traditional Chinese medical technique involves the insertion of fine needles at specific points on the body. Acupuncture helps adjust the body's energy, or qi, and encourages healing and health. "Techniques vary patient to patient," says Elizabeth Healy, licensed acupuncturist and director of West Village Acupuncture in New York City. Healy often uses acupuncture in conjunction with practices like tui na (therapeutic massage), gua sha (scraping) or cupping (suction), and notes she's had particular success treating a chronic migraine sufferer as well as a patient who'd had peripheral neuropathy (weakness, numbness, or pain) in the lower limbs, with a combination of acupuncture and internal herbal formulas.

Massage. "Patients suffering from CPS can benefit greatly from regular massage therapy treatments," says Anthony Zillmer, a licensed massage therapist at A2Z Massage Therapy in New York City. "While every patient is unique, I typically use firm and deep pressure in a circulation-based routine to stimulate blood flow and circulation of the hormone serotonin, the body's natural pain killer and mood elevator. I'm also very partial to adding heat, as it helps increase blood circulation."

Physical Therapy. Physical exercises such as cardiovascular, strength, and movement training can aid in building muscles, as well as increasing stamina, flexibility, and circulation. Speak to your healthcare provider about which exercise options are best for you.

Relaxation Techniques. Breathing and visualization exercises can help adjust your heart rate, lower your blood pressure, and decrease muscle tension, which contribute to reduced stress levels and less discomfort.

Living With Chronic Pain

For many people with chronic pain, "There's this expectation that all they need is a quick fix, like a pill," says Cowan. "Patients don't realize that chronic pain may never entirely go away. This doesn't mean they can't lead a full life, but patients need to be active participants in their health care." This requires becoming your own healthcare advocate, and effectively promoting your well-being. Here are a few ways you can do this:

1. Develop and maintain good communications with your healthcare provider. In this age of managed health care, doctors' visits tend to be short. Get the most out of your appointment by preparing in advance: "Write down questions, and be ready to discuss any improvements or deterioration in your condition," Cowan advises. Be as specific as possible about your symptoms, including the location and type(s) of pain you feel; this will help your doctor get a better idea of treatment options. The American Chronic Pain Association's website offers a number of graphic tools to help patients better communicate with their healthcare providers.

2. Listen to your body. "Often, patients push themselves too hard on their good days," Cowan observes. But self-care isn't just for days when the pain is overwhelming: "We have to take care of our bodies every day. Learn how to pace yourself."

3. Set realistic goals, and measure and celebrate your successes. Maybe you won't be running a marathon. But being healthy isn't just about completing an endurance test or living without pain. Setting and achieving realistic goals, like eating well and exercising daily, can lead to improvements in your energy levels, stamina, and sleeping patterns, all of which can add up to an enhanced quality of life. Cowan suggests patients track their healthy behaviors, and evaluate how these actions affect their day-to-day functioning.

4. Know your rights. "You have the right to ask for help," says Cowan. "You have the right to say no, and the right to do less than humanly possible." You also have the right to do all these things without feeling guilty.

5. Recognize your emotions. If you're angry, frustrated, or guilty, pretending otherwise may only exacerbate these bad feelings. "Don't bury your emotions," advises Cowan. "It only leads to stress and more pain. There are no wrong feelings, only inappropriate actions."


Liesa Harte, MD, reviewed this article.

 


 

Sources:

Penney Cowan, executive director, American Chronic Pain Association. Phone interview 6 December 2013.

American Chronic Pain Association. "Ten Steps From Patient to Person." Accessed 6 December 2013.  http://theacpa.org/Ten-Steps

Institute of Medicine of the National Academies. "Pain in America: A blueprint for transforming prevention, care, education, and research." 2011 June. Revised 2012 March. Accessed 6 December 2013. http://www.iom.edu/~/media/Files/Report%20Files/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research/Pain%20Research%202011%20Report%20Brief.pdf

National Institute of Neurological Disorders and Stroke. "NINDS Chronic Pain Information Page." Updated 30 August 2013. Accessed 4 December 2013. http://www.ninds.nih.gov/disorders/chronic_pain/chronic_pain.htm

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). "Questions and Answers about Fibromyalgia." Updated 2012 August. Accessed 5 December 2013. http://www.niams.nih.gov/health_info/fibromyalgia/

United States Department of Veterans Affairs. "Chronic Pain Primer." Reviewed 25 May 2010. Accessed 6 December 2013. http://www.va.gov/PAINMANAGEMENT/Chronic_Pain_Primer.asp