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When Your Pain Medication Isn't Working

What your next steps might be in treating your chronic pain.
By Eric Metcalf, MPH
WebMD Feature
Reviewed by Laura J. Martin, MD

More than 100 million Americans have chronic pain. If you're one of them, controlling it will likely require searching for treatments beyond medication.

That's because pain medication, while helpful, often cannot provide complete relief of pain. It may reduce but not eliminate pain.

Recommended Related to Pain Management

Is Your Pain Acute or Chronic?

Pain is a normal part of life: a skinned knee, a tension headache, a bone fracture. But sometimes pain becomes chronic -- a problem to explore with your doctor.  WebMD asked Eduardo Fraifeld, MD, president of the American Academy of Pain Medicine, to help readers understand acute vs. chronic pain.

Read the Is Your Pain Acute or Chronic? article > >

Carla Ulbrich, 45, is willing to use medication to help control her chronic pain. But she sees it as just one piece of her overall plan. For the past 20 years, lupus and fibromyalgia have caused pain to smolder and flare around her body.

Pain medication offered varying degrees of relief, but also often led to side effects. She credits a mix of additional practices -- acupuncture, massage, heat, and changing her diet -- for much of her current success in controlling the pain.

"I'd say medication saved my life, but throwing medication at something never really gets to the root of it," says Ulbrich, who lives in Somerset, N.J.

No Quick Fixes for Chronic Pain

A broken leg, and the acute pain it causes, can often be treated relatively quickly, says Perry Fine, MD, a pain specialist at the University of Utah. But chronic pain is more akin to bigger problems like diabetes or advanced cancer, which can't be so quickly or easily "fixed."

The goal when treating chronic pain isn't necessarily to become pain-free. Instead, the target is often a good quality of life while managing pain at a tolerable level.

"What's important is for people in chronic pain to communicate ... with their doctor, and let them know what their pain level is that keeps them from doing certain things," Fine says. "For example, 'My pain is keeping me from sleeping, going to work, and getting around and walking.' Then talk to the practitioner about establishing specific, measurable goals such as being able to vacuum, go to work, have sex, and get to sleep."

To reach these goals, doctors may try:

  • Medication that address pain from different angles. For example, antidepressants can help "calm down" the nervous system and make it less sensitive to the pain, Fine says. The anti-seizure drugs gabapentin and pregabalin can also be effective for certain types of nerve pain.
  • Injecting anesthetic or steroids into injured areas.
  • Doing surgery to treat the source of pain. This includes joint replacements, repairing damaged discs in the spine, or taking pressure off a pinched nerve.

Your doctor may also suggest that you work with a physical or occupational therapist. You may also want to seek answers to the mental components of pain rather than just the physical side, Fine says.

Putting Your Mind to Work

"Most people with chronic pain are never 'cured' [of their pain], and that's a difficult thing to be told. Our society tells us if you're in pain, you shouldn't be," says Beverly Thorn, PhD, of the University of Alabama.

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