The most important aspect of treatment is ensuring that it is ‘evidence-based’. There are so many treatments being offered today that sound good but have no research to support them. You should be suspicious of anything that offers a cure for chronic pain. You can be 100% sure that if there was a cure we would know about it and would recommend it to you.
What does ‘evidence-based’ mean? It means that professional university based researchers have conducted trials to determine whether the treatment is helpful for people with chronic pain, and whether it is harmful. There are standards for how these trials are conducted that should be followed. Then the outcomes should be published in respected academic journals, where other academics and professionals can review the research and critique it. This is what makes a treatment ‘evidence-based’.
You do not need to worry about working out whether something is ‘evidence-based’, however. Your team at the pain centre keep up to date with the latest evidence and only use treatments that meet the appropriate standards.
There are many medications available today for the treatment of chronic pain. They type of medication recommended will depend on the type of pain, other medications being taken, other medical issues, and so on.
Diagnostic and Therapeutic Injections
Your pain specialist has advanced training in these procedures. They typically involve an injection to the area where you have pain. The injection can be used to diagnose your pain or to provide ongoing pain relief. The period of relief varies greatly. Importantly, however, injections can provide enough relief for you to work on a physical reconditioning programme that has the potential for long term benefits.
Radiofrequency lesion treatment involves using a small current to reduce the activity of a nerve that is causing pain. This is most effective when pain is localised.
Neurostimulation and Neuromodulation
This is a specialist procedure that your pain specialist will have advanced training in. It involves placing one or more micro wires in the spinal cord. A tiny device then stimulates the nerves through the wires leading to pain relief. In the right person this approach can provide long term reductions in pain.
Pain Management Programmes
Many people with chronic pain around the world have benefited from these programmes. Typically they involve attending weekly sessions for a short period of time. They include education about chronic pain, an activity and exercise programme, support, and developing effective coping strategies.
An effective physical programme is central to overcoming chronic pain and improving quality of life. Often the pain itself can make it hard to engage in such a programme and so a stepped approach is necessary. Graded exercise and activity programmes have excellent research evidence and form a central part of our treatment plans.
Clinical psychologists have traditionally worked in two areas with people with chronic pain. First, pain effects people and their life. They may develop depression, insomnia, anxiety, pain attacks, drug or alcohol problems, relationship conflict and so on. Clinical psychologists can help with these problems. Second, clinical psychologists have traditionally been involved in helping people learn effective coping skills, such as relaxation and meditation, pacing, dealing with flare-ups and so on.
Some people may develop dependence on medications prescribed to treat chronic pain. This can be a problem if the medications are not providing effective pain relief, where there are problematic side effects, or where the dose escalates without any positive impact on physical functioning. Where dependence and addiction have become a problem our drug health experts can be helpful.
At times it may be helpful to be admitted to hospital for treatment. For example, you may benefit from being in hospital to undergo a rehabilitation programme, or to reduce the amount of strong pain medications you are taking.
Work plays such a major role in a person’s life and without it many problems can emerge, in addition to the obvious financial stresses. Occupational rehabilitation specialists are experts in helping people get back to work.