Treating chronic pain

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What distinguishes chronic pain from acute pain, is that chronic pain, such as that experienced by people with rheumatoid arthritis, does not diminish over time and lasts longer than six months.

Medical science is very efficient at treating most cases of both acute and chronic pain. Painkillers are a recent invention, and have only really been in common use for the last four generations or so.

There are many different ways of treating chronic pain. These include medical treatments, such as medicines and surgery to relieve pain, and non-medical treatments, which could include lifestyle changes and alternative treatments.

It must be remembered that painkillers do not make the pain go away, it interferes with the pain messages your body is sending to your brain, reducing the extent to which you feel the pain.

The medical treatments
include the use of three basic drug forms: non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol and opioids (both strong and weak).

These can be taken orally as liquids, capsules or tablets, they can be injected, or they can be inserted into the rectum as suppositories. Some painkillers are available as ointments or creams.

Here’s more about these three groups:

NSAIDs. These include well-known brand names such as Voltaren and Brufen. Aspirin is also an NSAID, but is often used these days for its blood-thinning effects. NSAIDs are effective against mild to moderate pain and also against inflammation and fever. These drugs are not steroids (cortisone). This type of painkiller is often used for menstrual pain, headaches, post-operative pain, trauma, bone pain and arthritis, to name but a few. Any medicines containing aspirin can lead to an increased risk of stomach ulcers, so doctors monitor patients who use this for chronic pain.

Paracetamol. These include brand names such as Panado and Dolorol. Paracetamol is a popular painkiller and can be bought over the counter. It has few side effects, but if taken in excess of dosage instructions, can lead to liver failure. Long-term use of paracetamol for chronic pain needs to be monitored carefully for this reason. Paracetamol is used to relieve mild to moderate pain and to reduce fever. Many cold and flu remedies contain paracetamol.

Opioids. One finds weak and strong opioids. Strong opioids are most often taken in a hospital setting, and are controlled very carefully, as they can be very addictive, and can lead to drowsiness and sedation. But they are extremely effective against severe pain, such that suffered by post-operative patients or patients who have been exposed to physical trauma. Codeine and morphine and pethidine are all opioids. Weaker opioids are often taken by people who experience chronic pain. Opioids should never be taken together with other nervous system depressants such as sleeping tablets or alcohol.

Many painkillers on the market are actually a combination of the above painkilling drugs, such as Myprodol, which contains paracetamol, ibuprofen (an NSAID) and codeine.

There are many non-medical treatment options to treat pain. These can include lifestyle changes, such as an exercise programme, a change in diet, weight loss, or rest. Alternative treatments can include hypnosis, acupuncture, massage, biofeedback, and chiropractic.

It must be remembered that everyone experiences pain differently, and that every person will respond in a different way to both medical and non-medical treatments.

Read more:

Treating acute pain

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