Chronic Pain Management

The risk of opioid addiction is low for most people, but it may be higher for people with risk factors. Research shows that addiction risk often runs in families, so your family history is important. Studies also show various other factors can increase the risk — including tobacco use, certain mental health conditions, trauma or abuse earlier in your life, and heavy alcohol use.

You and your doctor will work on a plan to help maximize what medication can do FOR you and minimize what it can do to you.

Chronic pain can impact many areas of your life — your sleep, mood, relationships, work, daily routines, and even your sense of self. Pain management aims to reduce your level of pain and minimize its effect on your life, so you can do more of the things that make life meaningful and enjoyable.

Chronic pain can develop from an injury, surgery, infection, or dozens of medical conditions. Long after an injury or illness is healed, the nerves keep sending the alarm. Or, a chronic illness causes ongoing pain that can’t be resolved. This pain is real, complex, and common.

Types of chronic pain

There are dozens of specific chronic pain conditions, too many to list here. It may be more helpful to think about a few general categories:

• Bone or joint pain
• Nerve pain
• Visceral pain
• Muscle pain
• Headaches

With any type of pain, the intensity can vary from person to person and over time. The pain can come and go, it can be relatively constant, and there can also be times of more intense pain, sometimes called pain flare-ups.

Steps to managing pain

1. An assessment. Your doctor will gather information on your pain and other conditions that may affect it.
2. A management plan. You and your doctor will work together to create a plan based on your goals (see the next page). It will include medical treatments and other strategies that will be used to help manage your pain.
3. Follow-up. In follow-up appointments, your doctor will check how well these strategies are working and change the management plan as needed.
4. Self-help activities. There’s an important role for you to play, because effective pain management often involves things you do at home. It’s vital that you take an active approach to managing your pain. This booklet will get you started on ways to care for yourself and reduce your pain.
5. Time and persistence. Chronic pain management is like a journey that can take many turns as you try different approaches and find out what works best for you. It can mean learning new skills — and discovering strengths you didn’t know you had.

Pain management approaches

Research has shown that the best pain management combines multiple techniques, taking into account the effect of pain on body, mind, and spirit.

• Self-care strategies
• Medical treatments that focus on the body
• Treatments focusing on mind-body connection

Physical therapy

Pain can make muscles tighten or go into spasm, so your body is more tense. You move less, so you become less fit and flexible. This in turn can increase your pain. Physical therapy helps to break this vicious cycle. Physical therapy can relieve pain, promote healing, and help you move and function better. Many physical therapists are trained in pain management principles.

Injections and procedures

For some types of pain, procedures might be recommended to help diagnose what’s wrong, to treat pain, or both. Because they involve using a needle or scalpel, these treatments are sometimes called invasive therapies. They include injections, spinal cord stimulation, and implanted drug-delivery systems (“pain pumps”).

Pain medications

Medications can ease pain, help you sleep, or treat other symptoms. While medications are part of pain management for many people, they shouldn’t be the only part of your plan. Pain medications can have side effects and risks, which can increase when they’re taken for a long time.

• Opioid medication. Opioid medications (sometimes just called “opioids” or “pain pills”) are strong medications designed to reduce pain so you can function better. But opioids also pose unique risks because of the way they affect the brain.