Pain Treatments and Management

Following assessment and evaluation of your chronic pain condition, a treatment or management plan should be formed between you and your healthcare professional with your input, understanding and agreement.

Do pay attention to the importance of health literacy and knowledge of your condition, and treatments that you are undertaking.

It is important to work with your doctor to set realistic short and long term goals. While you may not totally alleviate your pain it may be possible to reduce it while working towards the reintroduction of hobbies and activities.

Plans may include medication, procedures, exercise, physiotherapy, psychological therapy etc. It should also focus on interventions and goals that help you to maintain or improve functional ability. We recommend you use self-management techniques and strategies and build what works for you into your own management plan.

As part of your management plan, it’s important to continue to monitor your pain. You can see how well your treatment is working, if changes are needed and help identify how far you have come, success, achievements and what needs to be addressed.

In 2021, The European Pain Federation (EFIC) published a position paper on the use of opioids for non-cancer pain and Pain Alliance Europe (PAE) published an information leaflet for patients.

Exercise is important. If you are not able to do a lot, then maybe start small and set a realistic goal. Find something that you enjoy doing.

Talk with your doctor about what is reasonable for you, what your tolerance levels are and how you can build them up slowly over time.

There are many treatments that can help you, including:

• • heat/cold therapy
  • peripheral nerve stimulation / transdermal electronic nerve stimulation (TENS)
  • occupational therapy
  • therapeutic exercises
  • hydrotherapy (can restore joint movement while strengthening and conditioning muscles)
  • exercise programmes
  • physiotherapy

You can learn more about movement and chronic pain, including information on the benefits of physiotherapy, alexander technique and if moving with freedom is safe for people with pain.

In addition to medication your pain consultant may discuss some interventional procedures that may be effective in treating your pain. These can include:

• • intramuscular or joint injections
  • peripheral nerve blocks
  • regional blocks or
  • sympathetic blocks

Advanced Interventions include

• • neuromodulation
  • intrathecal pump and
  • Vertebroplasty

Psychological therapies are shown to be effective in helping people with chronic pain improve their quality of life. Chronic pain is associated with higher levels of anxiety, depression and suicide. Common approaches that are shown to be effective include cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT). Psychotherapy focuses on validating your pain, managing stress, dealing with guilt, challenging negative or unhelpful beliefs and thoughts and identifying goals.