Chronic pain is a worldwide epidemic with more than 1.5 billion people living with this relentless condition. In the U.S., chronic pain affects more Americans than diabetes, heart disease and cancer combined. The American Academy of Pain Medicine reports that more than 100 million Americans suffer with chronic pain, compared to 25.8 million who have diabetes, 16.3 million who have coronary heart disease, 7 million who have had a stroke, and 11.9 million who have been diagnosed with cancer.
According to research data published in Americans in Pain study, nearly 25 percent of chronic pain sufferers surveyed have had to take a disability leave of absence from work; 20 percent had to change jobs; and 15 percent needed help with daily living activities and had to move into a different home that was easier to manage. Additionally, more than half say they have little or no control over their pain, and nearly two-thirds say their pain impacts their quality of life.
NAO pain medicine specialist, Michelle Boyer, P.A.-C., has nearly 17 years of experience caring for people who suffer with chronic pain. Boyer, who provides care in our Pain Wellness Clinic explains chronic pain and treatment options.
Q: What is the difference between pain and chronic pain?
A: Everyone experiences acute pain, which is a normal response triggered by the nervous system to alert the body of an injury or illness. Acute pain can be eliminated by treating the cause of the pain- fix the broken bone and the pain goes away.
Chronic pain, on the other hand, is pain that lasts more than a few months, continuously or off-and-on, and can be difficult to alleviate. Chronic pain is the result of pain signals in the nervous system that keep firing for weeks, months and even years. An initial injury or illness kicks off the pain mechanism, which then continues send out signals via the nerves into the body. Some chronic pain is actually caused by injuries to the nervous system itself.
Q: Can the pain be treated or alleviated?
For most people, the goal is to manage the pain. Fortunately, treatment options have increased and expanded over the years. Pain management specialists and centers are bringing relief to millions of pain sufferers. Those living with pain – from moderate to severe – have access to new and modified medications, advancements in technology, minimally invasive surgical procedures and alternative therapies, all focused on eliminating pain.
Q: What medications offer the best results?
A: There are several medications and medication delivery options available. Here are a few:
- Injections: Pain shots or injections deliver medicine directly where needed in your body. A specialist usually will use an X-ray to determine where the medication needs to be injected for optimal results. The benefits can last from four weeks to one year, depending on the type of pain, the source of the pain and how advanced the problem is. Some people require a series of shots for the results to last.
Steroids and local anesthetics (painkillers) are often used together in pain shots. Steroids ease inflammation, which in turn lowers pain; anesthetics numb the nerve or muscle. Nerve root blocks target the nerves along the spine that lead to pain in other areas, such as the arms or legs. Epidural steroid injections can help with spinal disc problems, like herniated discs. Trigger point injections work on tight spots in muscles. Sometimes, these spots are so tight they squeeze nerves and lead to pain in other places.
- Opioids: Often the first line of defense against pain is the use of medications that act on the nervous system to relieve pain, the most common being a powerful class of drugs called opioids. Some opioids have been around for centuries; others have been made in the past few decades. Medications in this class include hydrocodone, oxycodone, morphine, codeine and other related drugs, all of which require a physician’s prescription for use. These drugs are very effective in fighting both acute and chronic pain. They also can have an addictive component when not managed properly or overused.
Q: What are some less-known treatment options and pain management tools?
A: In addition to surgical procedures, there are a host of holistic, nonsurgical, hands-on and alternative therapies that can alleviate or help control the pain, including:
- Physical Therapy: One of the best means to help control and manage pain is to work with a physical therapist who is specially trained to treat chronic pain. In general, physical therapy targets the muscles in the area(s) of pain with the goal of increasing strength and mobility, which allows the joints and muscles to work better; therefore, reducing pain. Usually several and/or continuous sessions are needed.
- Radiofrequency Ablation: The tip of a special needle is heated, then placed very close to the nerve that is sending the pain signals. The heat zaps the nerve so that it can’t send the pain signal. The treatment helps with many types of pain, including arthritis; neuropathy; and lower back, hip, knee and neck pain. Radiofrequency ablation can relieve pain for eight months to a year. After which, a patient can receive the treatment again.
- Alternative therapies: Complementary and alternative therapies such as chiropractic, yoga, massage, meditation, sound, acupuncture and acupuncture aren’t new. However, there is plenty of recent research to support their effectiveness at controlling pain, decrease stress associated with chronic pain, positively increase sleep patterns, and help create a general sense of calm and wellbeing. Talk with your physician about alternative treatments, as some may have risks or side effects for certain people.
There are multiple websites of organizations devoted to helping people who suffer from pain. Click here for a good place to start.
Michelle Boyer, PA-C, is a certified physician assistant who specializes in pain control and management. She practices with John Ledington, MD, and Stephen Randazzo, FNP, in Northern Arizona Orthopaedics’ new Pain Wellness Clinic within the Spine and Pain Center. To schedule a visit with Michelle, call 928-774-7757.