According to the American Pain Foundation, pain results in close to 40 million annual doctor visits. Chronic pain refers to pain that persists for more than six months or after an injury has healed. Neuropathic pain, or nerve pain, results from dysfunction of the nervous system. Neuropathic pain can stem from a spinal cord injury, in addition to a variety of diseases, such as alcoholism, diabetes, cancer or HIV. Chronic nerve pain can be treated with analgesic medications, and what are known as invasive therapies and complementary therapies.
Analgesic Medications
Analgesic medications are considered to be the first line of therapy for providing relief from chronic nerve pain. Acetaminophen, COX-2 inhibitors and nonsteroidal anti-inflammatory drugs are typically used to relieve relatively mild pain and inflammation. Opiods, such as codeine and morphine, are prescription medications that can be effective for relatively severe pain. However, in addition to the risk of physical dependence and addiction, opiods can have serious side effects that impair the ability to perform daily tasks. Reports showed that in certain patients, tricyclic anti-depressants can be more effective for treating chronic nerve pain than opiods. In addition, certain anti-seizure medications and topical anesthetics, such as the lidocaine patch, can provide effective chronic nerve pain relief. When trying to determine which pain medication or combination of medications is appropriate, it is important to keep in mind that a medication that may be very effective in one person may fail to relieve pain in another, according to the American Pain Foundation.
Invasive Therapies
When pharmacological therapy or surgery fails to provide pain relief, patients have the option of certain "invasive" treatments. Three common types of invasive therapies are spinal injections, spinal cord stimulators, or SCSs, and medication pumps. When a patient suffers from a chronic nerve pain condition such as spinal stenosis, an epidural injection may be administered to speed recovery from a flare-up of severe pain. Injection of steroid medication into the epidural space, a part of the spinal canal, can relieve pain by reducing inflammation. SCSs deliver electrical signals to the spinal cord and can reduce pain by interfering with the brain's reception of pain signals. The medication pump delivers drugs, most commonly opiods, directly to the pain receptors of the spinal cord. While SCSs and medication pumps can be very effective in reducing pain, neither is likely to eliminate all of the pain, says the American Chronic Pain Association.
Complementary Medicine
Many doctors recommend complementary and alternative medicine, or CAM, for chronic nerve pain management. CAM therapies can be placed into four categories: dietary supplements, "hands-on" practices, "energy therapies" and "mind-body therapies." A number of dietary supplements, such as St. John's Wort, have been implicated in relieving neuropathic pain. "Hands-on" therapies that many believe are beneficial for the treatment of chronic pain include aromatherapy, chiropractic and massage. "Energy therapies" include acupuncture, acupressure and Qigong. "Mind-body medicine," uses a wide range of approaches, including meditation, music therapy and yoga, that may help to relieve pain by positively affecting the mind. While there is strong scientific evidence supporting the benefits of certain CAM therapies, such as meditation, other CAM therapies lack the support of scientific studies, according to the American Pain Foundation.
References
- MedlinePlus: American Pain Foundation: Treatment Options: A guide To People Living With Chronic Pain
- PubMed: Recommendations For The Pharmacological Management Of Neuropathic Pain: An Overview And Literature Update
- American Chronic Pain Association: 2010 Consumer Guide to Pain Medication and Treatment
- PubMed: Intervention Management Of Chronic Pain
- National Institute Of Neurological Disorders And Stroke: Peripheral Neuropathy Fact Sheet
