If you're living with chronic pain, here's important news. Today's pain specialists have sophisticated new treatments -- from effective drugs to implants and electrical stimulation -- to provide chronic pain relief. There's much that can be done to tame the beast.
These advances have emerged in the past several years, as researchers have gained a greater understanding of chronic pain and how it develops. The origins of chronic pain are all too familiar: sports injuries, back injuries, car accidents -- or health conditions like migraines, diabetes, arthritis, shingles, and cancer.
If osteoporosis has caused a spinal compression fracture, the treatment should address the pain, the fracture, and the underlying osteoporosis to prevent future fractures.
All components of treatment have improved greatly in the last decade, says Michael Schaufele, MD, a physiatrist and professor of orthopaedics at Emory University School of Medicine in Atlanta. "We have better interventional options to treat fractures and better treatments to prevent future fractures," he tells WebMD.
At times, however, there is no obvious cause of the chronic pain, no trauma or injury people can point to as a source of their chronic pain problem -- which has been frustrating for both patients and their doctors.
The Roots of Chronic Pain -- and Relief
In past generations, people often heard that chronic pain was "all in their heads," says Rollin M. Gallagher, MD, MPH, director of pain management at the Philadelphia VA Medical Center.
Today's pain specialists understand how the sensation of pain occurs -- how the nervous system, including the spinal cord, interacts with the brain to create that sensation, Gallagher says.
Insights into the neurotransmitter system -- the chemical messengers that pass nerve signals -- have opened the door for important new modes of chronic pain relief, he explains. In recent years, scientists have learned how to manipulate those chemical messengers to change the way they interact with the brain's signals.
That's led to use of antidepressants and other drugs that work with specific brain chemicals that affect emotions, and help with perception of pain. "We now have a whole new host of medications that are very effective" for chronic pain relief, Gallagher tells WebMD.
And with advances in MRI imaging, researchers can clearly demonstrate that the changes are very real in the brain, he says. "We can show exactly where the sensation of pain is occurring in the brain when it is activated by stimuli. We can see the effects of pain on emotion -- and emotion on pain."
There's new understanding, too, of a process called "central sensitization," says Kwai-Tung Chan, MD, a pain specialist and professor of physical medicine and rehabilitation at Baylor College of Medicine in Houston. "If initial pain from an injury is not adequately treated, those pain signals are sent repeatedly -- which leads to changes in the central nervous system, making it more and more sensitive. Over time, even the gentlest touch can become very painful."
Pain Specialists: Experts in Chronic Pain Relief
With these insights, pain specialists now prescribe treatments that attack moderate-to-severe chronic pain from different angles -- innovative drugs, targeted nerve-zapping procedures, and drug pumps that deliver strong painkillers to the nerve root. Doctors also endorse the use of psychotherapy, relaxation techniques and alternative therapies, supported by growing evidence of the mind-body connection in chronic pain relief.