No matter if you’re recently injured, post-surgical or in rehabilitation, it’s the one word that’s probably on your mind a lot.
And how could it not be?
When you’re hurt, pain is often all you can think about. It overrides the circuits, clouds your worldview and sits in judgment on every step in the healing process.
The Institute of Medicine, the medical branch of the National Academy of Sciences, estimates that chronic pain afflicts 116 million Americans. Ten percent to 50 percent of surgical patients who have pain after surgery go on to develop chronic pain, depending on the procedure, and for as many as 10 percent of those patients, the chronic postoperative pain is severe. (Source, New York Times)
Unless you are post-surgical, finding a drug to treat your pain can be a challenge (many doctor’s don’t like to prescribe them and they can make it hard for you to function in other parts of your life). So where else can you turn?
Below are 10 ideas to think about. Please note, the options below are NOT recommendations made by a medical professional, but rather resources you may want to investigate. Please consult with your doctor before you pursue any treatment options.
1. Physical Therapy: PT is usually the first option doctors recommend for pain management. Treatment may be performed by a physical therapist or physiotherapist, whose first course of action is usually to reduce pain and swelling and then to increase your flexibility, strength, and endurance using exercise. A physical therapist also may use manual therapy, education, and techniques such as heat, cold, water, ultrasound, and electrical stimulation (see next two items).
2. Iontophoresis (a.k.a. Electromotive Drug Administration): is a technique using a small electric charge to deliver a medicine or other chemical through the skin. It is basically an injection without the needle. This is often a tool used by physical therapists and can come in a “to go” model which your PT can charge up, stick on you and send you on your way.
3. TENS Unit: TENS stands for Transcutaneous electrical nerve stimulation, the use of electric current to stimulate the nerves for therapeutic purposes. TENS units can often be clipped onto your belt so you can use on the go too.
4. Acupuncture/Acupressure: Acupuncture is an alternative medicine that treats patients by insertion and manipulation of needles in the body -- different variations are practiced and taught throughout the world. Acupressure uses fingers to press key healing points instead of needles.
5. Prolotherapy: Prolotherapy uses a dextrose (sugar water) solution, which is injected into the ligament or tendon where it attaches to the bone. This causes a localized inflammation in hopes of stimulating the tissue to repair itself.
6. Cortisone injections: A cortisone injection is the injection of an anti-inflammatory, synthetically produced steroid which can be used to treat the inflammation of small areas of the body (local injections), or inflammation that is widespread throughout the body (systemic injections).
7. Chiropractic Treatment: Chiropractic Treatment is form of alternative medicine that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, and usually involves manual therapy, including manipulation of the spine, other joints, and soft tissues.
8. Massage Therapy: Massage is the manipulation of superficial and deeper layers of muscle and connective tissue to enhance function, aid in the healing process, and promote well-being. There are countless massage approaches including Myofascial release, Shiatsu, Trigger point and Watsu (which takes place in the water).
9. Self-Hypnosis/Biofeedback: Self-hypnosis is a form of hypnosis which is self-induced, and normally makes use of self-suggestion to put yourself in a calm state to reduce tension or stress that is connected to the pain. Similarly, biofeedback is the process of becoming aware of various physiological functions using instruments that provide information on the activity of those same systems, with a goal of being able to manipulate them at will.
10. Topical Pain Creams/Patches: Over the counter creams or ointments like Aspercreme, Bengay and Tiger Balm or painkillers like Zostrix, can help decreases inflammation and relieve pain by causing either coolness or heat at the pain site. A transdermal patch that contains lidocaine can also offer chronic pain relief. Lidoderm and Lidopain are two, available by prescription.
For an additional perspective on Pain, check out the excellent book, The Pain Chronicles: Cures, Myths, Mysteries, Prayers, Diaries, Brain Scans, Healing, and the Science of Suffering.
What other recommendations do you have on pain management to add to our list?
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Carl Balog MD
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