Chronic Pain and How to Cope

Chronic pain, whether it comes and goes or is constant, makes it impossible to do your normal activities without discomfort. Chronic pain can be the result of an injury, illness or medical condition, or its cause may be unknown. Yet, most people with chronic pain can lessen it to tolerable levels, regardless of the cause, according to the American Chronic Pain Association.

These are common types of chronic pain:

• Headache

• Low back pain

• Cancer pain

• Arthritis pain

• Pain from nerve damage

• Pain from sickle cell disease

Pain and inflammation may actually change the nervous system. Because of this, pain may linger long after the physical injury that caused it has healed.

Living with chronic pain can lure you into feeling helpless about your condition. It can cause emotional problems or physical limitations that threaten your relationships, hamper your job performance and limit your activities. Anxiety, depression, anger, hopelessness or desperation about the pain can make it seem worse. This can, in turn, alter your personality and disrupt family and work relationships. Chronic pain can interfere with sleep, leaving you tired and less able to cope with the pain.

No single pain treatment works for everyone, and it's easy to feel like giving up if you've tried several treatments that haven't worked. You may have to wade through a lot of hype and controversy that leave you scratching your head and wondering: What's effective? What's safe? What's my best strategy?

Here are steps you can take to manage your pain and feel more in control:

• Learn all you can about your condition.

• Keep a pain diary that includes where the pain is, how bad it is, how often it occurs and what makes the pain better or worse.

• Find a health care provider who understands chronic pain, has experience treating pain similar to yours, is willing to talk and listen to you, and is willing to talk to your family. Not all doctors have been trained to treat pain. Sometimes, a team of health care professionals may need to be involved.

• With your health care provider, identify the pain and figure out a pain management plan. This plan may include medications, as well as non-medical treatments such as exercise and meditation.

• Take care of your mental health. If you think you may be depressed or are having difficulty with another mental or emotional problem, tell your health care provider. It's important to work closely with your provider to adjust your pain management plan as needed.

Many options for treatment

Most treatments will not get rid of all the pain, but they can reduce the amount of pain you have and how frequently you have it. Treatment can increase your ability to move and remain independent. Most treatment plans involve a combination of medication, therapy and lifestyle changes.

Medication

Many types of medication are used to treat chronic pain. Some drugs are long-acting to treat pain that is continuous; others are short-acting to treat pain that comes and goes. Some medications come in pill form, some as injections.

These are common pain-relieving medications, according to the American Society of Anesthesiologists (ASA), a group of doctors who specialize in relieving pain:

• Acetaminophen. This is a non-aspirin pain reliever most commonly sold as Tylenol. It can relieve minor pain, but does not reduce swelling. Acetaminophen is often used in combination with other prescribed and over-the-counter (OTC) drugs. Be sure to read the labels on all OTC drugs you take to make sure you are not getting too much acetaminophen.

• Aspirin. This drug, taken alone or as an ingredient with other drugs, can reduce swelling and inflammation and relieve pain.

• Non-steroidal anti-inflammatory drugs (NSAIDs). These medications, such as ibuprofen and naproxen, relieve pain and reduce inflammation and fever.

• Steroidal drugs. Cortisol and prednisone are two examples of these medications. These are for more serious inflammatory conditions, such as chronic arthritis.

• Opioid pain medication. This is used to treat acute cancer pain; occasionally these are prescribed for chronic pain not caused by cancer.

• Antidepressants. These drugs can relieve some kinds of pain and can help with sleep problems.

• Anti-seizure medications. These are prescribed for pain caused by damaged nerves.

• Local anesthetics. These drugs, with or without cortisone, are injected around nerve roots -- a group of nerves -- or into muscles or joints to decrease swelling, irritation, muscle spasms and abnormal nerve activity.

You and your health care provider need to choose medications carefully, based on the cause of your pain and how severe it is, as well as your risk for gastrointestinal or cardiovascular problems and addiction.

If you are taking prescribed pain medication, do NOT take OTC pain relievers, herbal medicines or dietary supplements unless you check with your health care provider first. Many of these can interact with prescribed medications and cause serious problems.

More options

Life would be simpler if taking a pill meant the end of chronic pain, but that's not true for many pain sufferers. Medications may not be the best option for mild pain. Medications don't help some people, and other people don't want to take them every day. Even when medications help, many people still face a lot of pain.

Fortunately, other options, alone or with medication, can help. Here are some to consider:

• Lifestyle changes . You may be able to ease your pain by losing weight, quitting smoking or exercising more. Exercise can help you stay flexible and mobile. Dietitians and physical and occupational therapists can help you reach your fitness goals.

• Electrical stimulation . Low-voltage electrical currents from small, battery-operated devices can stimulate nerves through the skin and interrupt the brain's normal pain signals. According to the ASA, transcutaneous electrical nerve stimulation is the most common form. It is not painful a treatment.

• Psychological support . Antidepressants prescribed to help relieve pain may also help depression related to the pain. Support and counseling from a psychiatrist or psychologist may be needed, as well as self-help therapies such as relaxation or biofeedback training.

• Surgery. Various surgical procedures target conditions that cause pain. New techniques, for example, can combat certain painful back disorders. The ASA says that surgery is considered only after all other methods have failed.

• Complementary therapies . Many people find that acupuncture, guided imagery, meditation and other alternative therapies can ease pain and improve a sense of well-being. Scientific evidence supporting these therapies varies.