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Managing Chronic Pain Syndrome

Living with chronic pain syndrome can be exhausting and completely dominate each and every day so managing it effectively is a priority.

The treatment prescribed for chronic pain will partly depend on the underlying cause, and the individual’s doctor’s own preferred regime.

The effect of living with chronic pain can be so incapacitating, it can leave individuals desperate to try anything to feel better but ironically in some cases, the treatment can cause a whole new set of problems too.

Painkillers may seem like the obvious solution but they are only effective in around 60% of cases and carry significant risks. Here’s a more comprehensive view of what treatments those with chronic pain disorder could try.

Pain relieving medication

Analgesia, or painkillers as they are often referred to, are often the first line of attack in treating chronic pain syndrome but they may only have a limited effect.

Different types of pain medication can be combined to get the maximum effect possible, as they work in different ways on the body.

NSAIDs – Non Steroid Anti Inflammatory Drugs – are a common type of painkiller, some of which can be purchased over the counter, such as Ibuprofen. These work in the body by blocking the effects of a particular group of enzymes which contribute to the production of both pain and inflammation. This is why NSAIDs can help not just with the management of pain, but also the reduction of inflammation too.

Paracetamol is a surprisingly powerful drug when taken on a regular basis and is believed to work by blocking another enzyme in the central nervous system. It can help to lower high temperatures but has no effect on inflammation.

Opioids are an extremely powerful type of medication and work by binding to receptors and decreasing a body’s reaction to pain and increasing tolerance levels. Codeine and Tramadol are two types of opioid painkiller often used.

The problems with painkillers

All of the above different groups of drugs can be combined in a cocktail to produce the strongest possible effect. Although there’s no risk of overdosing by combining different types of medication, taking the maximum dose of painkillers does carry a substantial risk of developing a new set of problems.

Strong painkillers often produce side effects which can be as debilitating as the chronic pain syndrome, causing nausea, dizziness and drowsiness. In some cases this means an individual will be unable to drive, or even stay awake, or their digestive system could suffer some very unpleasant effects.
Many side effects either wear off or lessen as the body becomes used to the drug, but then the risk of addiction develops. This is particularly a problem for drugs such as codeine.

Regularly taking drugs such as codeine can result in an unwitting addiction, and going without the medication will cause headaches and pain. The person will then take a painkiller to get rid of the pain, and the cycle starts again.

There’s unfortunately no easy answer for individuals that require high levels of painkiller medication regularly and it can be difficult to differentiate the cases where painkiller addiction is becoming a problem from those where chronic pain disorder is causing the symptoms.

Other drugs

Depending on the cause of pain, the doctor may opt to try a different type of drug, other than traditional analgesia to try and relieve the pain.
Anti-convulsants are frequently used, with drugs such as gabapentin and carbamazepine prescribed with a reasonable degree of success.
Unfortunately there can be significant side effects with this type of medication particularly at the higher dosages.

Triptans can be used, particularly for chronic pain disorder caused by cluster headaches or migraines, and work by changing the actions of serotonin in the brain which can prevent the release of other pain-causing chemicals in the body.

Another type of common treatment is antidepressants, particularly tricyclics such as Amitriptyline. These work on the neural transmitters and prevent pain messages being sent, by stopping the re-absorption of key chemicals in the nervous system.

Some people can be reluctant to take antidepressants because of the stigma that surrounds them, or may think that their doctor doesn’t believe their pain is a real condition. The dosage prescribed for pain is typically quite different to an antidepressant dosage and there’s no suggestion that the chronic pain is imaginary. Antidepressants can have a very powerful effect on the body as well as the mind, and can help to alleviate symptoms of pain in a different way.

Many of these alternative types of drugs take longer to work than simple analgesia and may take several weeks before an effect is felt.

Alternative therapies

Drugs are not the only answer to managing chronic pain; alternative therapies and self-help approaches can be surprisingly effective, especially when used in an overall pain management programme.

Acupunture can be used to manage Chronic Pain. Acupuncture is available on the NHS in some parts of the country and has shown to be helpful in combatting chronic pain.

Because pain signals travel through the mood centres in the brain, learning how to remain positive and manage negative emotions more easily can also help to reduce the symptoms. Yoga, breathing techniques and meditation can all be effective but it’s a good idea to attend a class to learn how to do this properly for maximum effect.

Low impact exercise can help with chronic pain, as the movement can trigger the release of feel-good endorphins such as dopamine, which can result in improved tolerance for pain. The exercise can also help to alleviate stiffness and pain caused by a lack of movement in the joints. Cycling, swimming and walking are all good ways to start.

Of course, not everyone is able to exercise and medical advice should always be sought before embarking on a programme.

This article is intended to provide a guide only and is not a substitute for medical advice. If you need help with chronic pain, you should contact a doctor or other suitably qualified medical professional.

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