What is the best treatment for chronic pain?
13 ways to manage chronic pain
Chronic pain may develop after an injury or due to a medical issue. Healthcare professionals define pain as chronic if it lasts longer than 3 months Trusted Source, or beyond the normal healing time for the underlying condition or injury.
Chronic pain can affect every part of a person’s life, from work and social life to sleep and mental health.
This article explores what pain management is, along with methods to ease pain and their effectiveness.
How common is chronic pain?
According to the Centers for Disease Control and Prevention (CDC), around 20% of adultsTrusted Source in the United States had chronic pain in 2016, while 8% had high-impact chronic pain.
The 2017 Global Burden of Disease StudyTrusted Source estimates that pain and diseases related to pain are the leading cause of disability worldwide, and the amount of people living with chronic pain is increasing.
Chronic pain has associations with numerous physical and mental health conditions, including:
- sleep problems
- social isolation
- overuse of medication
What is pain management?
Pain management refers to techniques to reduce and control the amount of pain a person experiences over the long term.
There are many ways to manage pain, and not all of them include taking medication.
Various physical methods can help relieve pain, including physical therapy, hot and cold therapy, massage, and acupuncture.
Hot and cold therapy
Hot and cold therapy is a common and safe technique to reduce pain.
Heat can help relax the muscles and dilate the blood vessels. It can also promote healing after an injury.
Cold therapy reduces blood flow and reduces inflammation that causes pain. It often involves applying an ice pack wrapped in a towel to the skin.
Massage is a type of soft-tissue manipulation. People may benefit from this technique when used with other pain management treatments, such as physical therapy and pain medication.
The benefits of massage include:
- increased flexibility
- reduced inflammation
- improved posture
- improved circulation
- reduced stiffness
A 2007 review Trusted Source on massage found that it may be effective for lower back pain. However, there is mixed evidence from examining its benefits for other chronic pain types.
Physical therapy involves physical techniques to strengthen and stretch the muscles and joints. It can relieve pain throughout the body, while the specific methods will vary by body part.
Therapeutic exercise can have long-term benefits for chronic pain, including helping people cope.
Techniques may involve massage, exercise plans, and red light therapy.
Acupuncture involves a practitioner applying thin needles to the skin at precise points in the body.
According to the National Center for Complementary and Integrative Health, evidence suggests this technique could help people manage certain pain conditions.
This includes short-term relief from pain in the lower back, neck, knee, and osteoarthritis. However, there is little evidence to suggest it is effective over the long term.
The proposed benefits of acupuncture are:
- pain relief
- reduced inflammation
- reduced muscle spasms
Acupuncture is generally safe when performed by trained practitioners using sterile needles.
Methods that combine psychology and the body can help many people manage chronic pain.
Cognitive behavior therapy
Psychological treatments for chronic pain include talking therapies, such as cognitive behavioral therapy (CBT).
Psychological treatments aim to reduce the negative impact that chronic pain can have on a person’s mental health.
A 2013 review on the effectiveness of psychological pain management techniques concludes that CBT is effective at reducing pain immediately after treatment compared with using no strategies.
The review also found that there was no evidence that CBT can reduce long-term pain. However, the technique was useful for reducing anxiety around pain and for improving quality of life.
Yoga aims to relax, strengthen, and keep the body flexible through stretching, with specific poses focusing on particular body areas.
A 2010 study Trusted Source into yoga’s effects on chronic pain found that it did not decrease participants’ pain, but it did help them cope, and they were more in control of how their pain affected their everyday life.
However, other studies Trusted Source have found yoga to be effective in reducing pain.
Yoga is a safe and accessible pain management technique that people can try at home, using online videos, or in a class with an instructor.
Tai chi is an exercise therapy involving slow, continuous, fluid body movements combined with breathing and relaxation techniques. The method is also gentle on the joints and muscles.
Tai chi can improve strength and joint stability, and the concentration it requires can improve a person’s mood.
Dealing with chronic pain can be stressful for many reasons, such as not feeling in control regarding a person’s discomfort.
Relaxation techniques can help ease muscle tension, muscle spasms, aches, and pains. They can also release endorphins, which are the body’s natural painkillers.
A person can help reduce stress through relaxation, which can ease some of the burden of chronic pain while promoting better sleep.
Relaxation methods for chronic pain include:
- Deep breathing techniques: Slow and relaxed breathing methods, such as box breathing, help relieve tension.
- Progressive muscle relaxation: Involves tensing and relaxing each muscle group in turn, for 10 seconds each, from the head to the toes. Focus on breathing and avoid muscles that feel painful.
- Thinking calmly: Spend 5 minutes imagining a calming scene, such as a sunny afternoon in nature, surrounded by green trees and birdsong.
- Calming activities: Set aside time for relaxing activities such as having a warm bath, reading a book, or crafting.
There is a wide range of medications to relieve pain. Each class and type of drug work differently, while some may be more suitable for certain people than others.
Nonsteroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of medications that reduce inflammation and pain. They are available in capsules, tablets, or as creams or gels for the skin.
However, NSAIDs may causeTrusted Source issues with the stomach and the cardiovascular system in some people. Talk with a doctor before beginning treatment with NSAIDs.
Opioids can treat moderate-to-severe pain and are generally only appropriate for short periods, as they can be addictive.
CDC guidelines Trusted Source recommend people should only use opioids when the benefits outweigh the risks.
There is a lack of evidence that this treatment works for chronic pain, as people typically use opioids for short periods.
Some antidepressants, such as amitriptyline, can help with pain relief.
Amitriptyline is an antidepressant that, at lower doses, people also use for chronic pain, such as diabetic neuropathy and fibromyalgia.
It can take 2–4 weeksTrusted Source for a person to feel the effects of the medication.
Side effects of amitriptyline can include:
- dry mouth
Beta-blockers slow down the heart and stop hormones, such as adrenaline, from working. Some people use them to treat migraines.
A studyTrusted Source shows that beta-blockers at low doses can temporarily improve chronic pain in females with fibromyalgia and temporomandibular syndrome.
However, beta-blockers may not be suitable for everyone. Consult with a doctor before using them for chronic pain.
Medicinal cannabis and cannabidiol (CBD) are increasingly common pain treatments.
A 2017 review Trusted Source states that cannabis may ease neuropathic pain, but not pain due to fibromyalgia, headaches, or rheumatoid arthritis.
In addition, cannabis for medicinal purposes may not be legal everywhere. High doses can trigger side effects, so it is best to check with a health professional before using cannabis CBD for pain relief.